How Children’s Hospital of Omaha achieved interoperability between EMS and hospital patient data

When clinical program manager Megan Sorensen was hired to lead the pediatric and neonatal critical care transport program at Children’s Hospital & Medical Center in Omaha, she recognized a significant challenge with integrating the patient care records systems. While the records system worked for documentation in a hospital setting, it was impeding her EMS crew in providing care while transporting patients via ambulance, airplane or helicopter; creating interoperability between prehospital and hospital data was a priority.

With ImageTrend, the pediatric and neonatal critical care transport team at Children’s Hospital & Medical Center in Omaha can pull the data they need to make life easier for providers in the field, as well as achieve interoperability between prehospital and hospital data.

In 2014, the program transported more than 1,800 patients, each with their own documentation of care. Because of the limitations of the existing records system, half of the documentation was recorded electronically and the other half by paper, creating additional work and time for each transport.

Recognizing that the program was growing at a rate of 20 to 30 percent annually, Sorensen knew this problem needed to be addressed. Without clear and consistent documentation, it would be nearly impossible to perform a chart review or implement care improvement. Compounding the issue was the importance of accurate records for billing reimbursement and compliance. Change was needed, and fast.

CHOOSING A NEW PATIENT CARE RECORD SYSTEM

Sorensen and her team explored their options for a new patient care record system with the specific needs of their program in mind. The new solution needed to work both with and without an internet connection – a scenario her crew regularly faced when transporting patients. They also needed a system that would be able to exchange data with their hospital records system (Epic), partner organizations and the state’s reporting system.

Sorensen explored several options and eventually chose a solution from ImageTrend. She and her team were able to preview the software and determined that it met their needs. Even better, they already knew it would be compatible with partner organizations and the state because the state of Nebraska was using ImageTrend for its EMS services.

In December 2015, the Omaha Children’s pediatric and neonatal critical care transport program implemented ImageTrend Elite and Health Information Hub (HIH). ImageTrend’s implementation program helped guide Sorensen’s team through the transition, and she assigned a small group of her staff to train and become experts and resources for other staff. Between the in-house expertise her staff gained and the tools that ImageTrend offers, such as an online university, the program was up to speed in short order.

MAKING PATIENT RECORDS PORTABLE AND MOBILE

Once implemented, ImageTrend’s system offered solutions to team’s challenges. ImageTrend Elite provides the ability to customize fields and create a single record in which to record all patient data, as well as the ability to fill that record in whether they were currently connected to the internet or not.

In cases where they are not connected, such as during an air transport, ImageTrend Elite can record the information to a secure database on the device, then sync the records when an internet connection is re-established.

Using HIH, the documentation from the critical care transport is transmitted from the NEMSIS-based system to the hospital’s HL7-based system. The hospital’s electronic medical records system then contains a PDF copy of the critical care transport documentation as part of the patient’s medical record without having to be transcribed or scanned from a printed copy.

Because ImageTrend works on a variety of tablets and computers, including iPads, providers can bring a single device to take photos, record data and perform other tasks, reducing the overall amount of gear they need to carry.

FASTER AND MORE ACCURATE REPORTING

Within months of deploying ImageTrend Elite and HIH, the results spoke for themselves, says Sorensen. Her organization saw gains in efficiency, as providers could spend less time charting after treating a patient once they gained the ability to quickly and accurately chart them during treatment.

On the management side, the ease of reporting was another major benefit. The increased ability to pull reports and drill down into data made process improvements possible. It also meant they could offer better training to providers.

“The most significant effect ImageTrend has on our program is our ability to do true process improvement,” said Sorensen. “You can’t go wrong. They give you the tools you need.”

With better reporting came opportunities to better use that data. Because all the records are now electronic, data is more readily available for easier and more comprehensive reporting.

 “We have a nurse that’s doing a research study on adverse events and crew configuration. When we went from nurse/nurse crews to nurse/paramedic crews, we wanted to go back and see if we had any change in adverse effects due to the shift,” Sorensen said. “Now, we can go in and easily create a report that will tell us anything we need to know. I can pull any data at a moment’s notice from this wide array of information, and it has made our research more robust and our evidence-based practice more robust.”

Using ImageTrend enables Sorensen and her team to pull the data they need to make life easier for providers in the field, as well as improve their organization’s practices and research capabilities and achieve interoperability between prehospital and hospital data.