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Utilizing a Patient Tracking System for Public Health Emergencies

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Largest municipal provider of EMS in New England ... a text only summary (which can be pasted into an email and read on a blackberry) ... – PowerPoint PPT presentation

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Title: Utilizing a Patient Tracking System for Public Health Emergencies


1
Utilizing a Patient Tracking System for Public
Health Emergencies
Laura Williams, MPH Boston EMS Justin Pendarvis,
MPH Boston Public Health, CDC
2
Boston EMS
Your Emergency 9-1-1 Responders
  • Largest municipal provider of EMS in New England
  • Employs 350 uniformed field and administrative
    staff
  • Responds to approximately 100,000 calls per year
  • 69,000 patient transports per year

3
More than An Ambulance Service
  • Additional Areas of Responsibility
  • Boston MMRS
  • Special Events and Special Operations
  • Surge Planning
  • Disaster Planning
  • DelValle Institute for Emergency Preparedness

4
Boston Public Health Commission
  • Communicable Disease Control Division
  • Manage disease outbreaks for the city
  • Syndromic Surveillance
  • Advise response agencies and the public on
    measures to control the spread of the disease and
    reduce morbidity and mortality.
  • Work with Office of Public Health
    Preparedness, Healthcare, and first
    response agencies

5
Communicable Disease Control Division
  • Since 2004 BPHC CDC has effectively managed
    several mass prophylaxis clinics in response to
    infectious disease outbreaks. However patient
    information data was largely collected on paper
    based forms, limiting the availability of
    real-time clinic data to incident command.

6
The History
  • 2003 Identified gap in emergency response
    capabilities for tracking patients who are unable
    to identify themselves.
  • 2004 Focus groups identified required patient
    data elements for system Childrens Hospital
    helped tailor the system for lost children.
  • 2004 Access database prototype developed for
    the 2004 DNC.
  • 2005 Awarded Boston UASI funds, for building
    out a regional patient tracking system.
  • 2005 to 2006 Core group from EMS CDC office
    clarified system requirements, issued an RFP, and
    selected a vendor.
  • 2006 to 2007 Work with vendor and stakeholders
    to build out the system to meet Boston
    requirements.

7
The System
  • Key components
  • The ability to identify lost individuals
    reunite family members
  • Data views and reports that allow for incident
    management (showing locations, numbers triage)
  • Flexibility to handle short term/high impact
    incidents, which would require rapid data entry,
    and long term events, such as a pandemic flu that
    would require collection of more extensive data.

8
The Team Throughout every stage of this project
Coordination with Stakeholders has been Constant
  • 13 EMS Providers (municipal, fire based,
    private)
  • Boston Public Health (PHP CDC)
  • Massachusetts Public Health Department
  • 17 Hospitals
  • The Mayors Office of Emergency Preparedness
  • Boston Emergency Management
  • Community Health Centers
  • Chief Medical Examiners

9
Patient Tracking Users
  • EMS
  • Enter information in the field during patient
    loading.
  • Hospitals
  • Notified when patients are transferred to their
    facility
  • System will be integrated with their registration
    system
  • Emergency Managers
  • Log on to web interface for immediate view of
    scale and scope of the incident
  • Public Health
  • View records on web interface or via local
    application to determine appropriate response.
  • Volunteers
  • Family Reunification patients will be
    searchable via name or identifiable
    characteristics.

10
Defining the Data Elements
  • Weekly meetings took place for six months to
    discuss the data requirements for the system.
  • A representative from the Boston Public Health
    Commission CDC department was present at each of
    these meetings to ensure that PHIN standards
    were met and that the system could be utilized
    during a pandemic flu.

Countermeasure/response administration
functional requirements, version 1.0 4/26/05
11
Data Standards
  • Health Insurance Portability and Accountability
    Act (HIPAA) compliance
  • Standardized vocabulary protocols as defined by
    the National Incident Management System (NIMS)
    and the CDC Public Health Information Network
    (PHIN)
  • Each individual and agency have a predetermined
    level of access to the data.

12
Data Elements - Demographics
  • Patient Tracking ID
  • First Name
  • Middle Name/Initial
  • Last Name
  • Street Address
  • City
  • State
  • Zip Code
  • Phone
  • Phone Type
  • Email Address
  • Housing Type
  • Temporary Address
  • Permanent Home Destroyed
  • Age
  • Date of Birth

Height Feet/Inches Weight Gender Eye Color Hair
Length Hair Color Facial Hair Skin
Color Shirt Pant/Skirt Shoes Uniform Found with
Objects Identifying Marks Alternate ID Driver's
License Driver's License State
DL/ID Raw Data (from Scan/swipe) Ethnic
Background Language(s) Spoken Translation
Required Insurance Image Image Description
13
Complaint/History Vital Signs
  • Triage Category
  • Complaint Category
  • Complaint Description
  • Incident Involvement
  • Allergies
  • Medications
  • Medical History
  • Glasses
  • Dentures
  • Hearing Aid
  • Contaminated
  • Contamination Description
  • Decontaminated
  • Decon Date Time

Blood Pressure Pulse Respiration Temperature
14
Complaint/History
Triage status values are based on START triage
definitions, although we added WHITE (uninjured)
and GREY (almost dead)
15
Medications Procedures
  • Med Time
  • Medication Name
  • Dose
  • Amount
  • Lot
  • Manufacturer
  • Route
  • Site
  • Administered By
  • Ordered by
  • Reaction
  • State Administered
  • Comment

Procedure Time Procedure Name Procedure
Results Administered by Ordered by Reaction State
Administered Treatment Level Treatment Comment
16
Relatives Property
  • Relative Type
  • Relative Note
  • Relative Link to Exist Patient
  • Relative First Name
  • Relative Middle Initial
  • Relative Last Name
  • Relative Street Address
  • Relative City
  • Relative State
  • Relative Zip
  • Relative Phone
  • Relative Email

Prop. ID Prop. Description Prop Current
Location Prop. Current Loc Comment Prop.
Destination Prop. Destination Comment Prop.
Destination Contact Prop. Returned to Owner
17
Provider
  • Provider Name
  • Provider Unit ID (if applicable)
  • Actual Start Time
  • End Time (either estimated or actual)
  • Latitude
  • Longitude
  • Disposition
  • Actual Patient Arrival Time
  • Actual Patient Arrival Update User
  • Actual Patient Discharge by
  • Actual Patient Discharge Time

FOR GIS MAPPING
18
Labels
19
Incident Management
  • The system is set to provide real time summary
    information on the location and triage status of
    all individuals involved in an incident.
  • This data is extractable in various formats
    including user defined fields to Excel, a graph
    summary, and a text only summary (which can be
    pasted into an email and read on a blackberry).
  • WebEOC board providing a summary of the
    incident(s)

20
WebEOC Interface/Summary View
21
Hospital Integrations
  • We have successfully developed an
    interface between our tracking system and the
    Massachusetts General Hospital registration
    system. This will allow selected information
    (name, age, gender, ID, location, etc) to be
    pulled from the records of disaster patients
    during registration, directly into our patient
    tracking system.
  • Over the coming year we will work with other
    Metro-Boston hospitals to develop the same type
    of interface.

22
Types of Interfaces
HRS
WebEOC
23
Using Industry Standards
24
Security
  • Data Provider includes Authentication
  • All transactions are 128 bit HTTPS
  • SSL encryption
  • a third party certificate authority

25
Sample Data
26
Symbol MC-9094
  • Field Data Collection Device
  • Photograph Capability

27
Patient Tracking System Hardware Communication
  • Command Kits field kits with Panasonic
    Toughbooks with 802.11 receiver, and both
    cellular and satellite communication devices
    serves as a local data collection

point, mechanism for transferring data to
regional server, and local command station.
28
Thank You! Williams_la_at_bostonems.org 617-343-1109
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