EMS1’s special coverage series, Driving Change by Embracing the Data Revolution in EMS, sponsored by ESO, explores strategies for improving data collection, analysis and application to strategically effect improvements in EMS operations and patient care.
There’s a great quote about data from the CEO of a company called Mixpanel that reads: “Most of the world will make decisions by either guessing or using their gut. They will be either lucky or wrong.” In our line of business, lucky or wrong can have dire consequences. It really is a matter of life or death.
The good news is we are getting smarter and more refined about data in our approach to diagnosis and treatment in a way that is actually producing material results. EMS agencies and hospitals around the country are continuing to recognize the value of bi-directional data sharing between healthcare organizations. Access to critical information in real time yields better patient care and improved performance for both entities.
From a clinical perspective, more of the right type of data and proper analysis of that data is a good thing. We have many examples across the healthcare spectrum of providers and practitioners being able to make smarter choices regarding transport and treatment options for patients.
In many ways, patients themselves are leveraging data to make smarter decisions about their own healthcare needs. Think of the recent commercial for the Apple Watch where the folks featured had health issues highlighted because of the anomalies in breathing, heart rhythms, etc. Important, relevant data saved or improved their lives.
But the beneficial potential of data is far more holistic than just the obvious clinical ones. At the end of the day, we are all human beings. Unnecessary stress, strain and fatigue play a role in our jobs if we don’t have access to useful tools and information that can help us be more efficient and effective.
The ability to communicate our value to the communities in which we live and serve is powerful. All of these pieces fit together like a puzzle and ultimately help drive a much more positive outcome for patients – as well as the people who help those patients.
Data in the clinical setting
Data can help EMS providers and hospital staff make much smarter decisions and choices about a patient’s treatment options – whether it’s a motor vehicle crash, an acute stroke, a STEMI, an overdose or a patient utilizing 911 to access the healthcare system for a less time-critical condition – with the fullest picture possible.
For example, stroke assessment and care have changed since the beginning of 2018, dramatically. This can’t be emphasized enough as the entire industry is still processing this information. Two recent studies – the DAWN Trial and the DEFUSE-3 Study – highlight findings that provide new guidelines for stroke patient assessment and transport. Specifically, these studies indicate the benefit of extending the treatment window to 16 or even 24 hours after the onset of symptoms for a subset of patients with large vessel occlusion acute ischemic stroke (LVO-AIS).
While the nearest hospital may have been an appropriate destination in the past, the new research indicates transport to the nearest thrombectomy-capable or comprehensive stroke center may be preferred for those with evidence of LVO-AIS, even when it is not the nearest facility.
Engaging with the community
Data also provides the foundation to tell a story and share successes in the community regarding positive patient outcomes.
The team at West County EMS and Fire Protection District, covering an area of 21 square miles just west of St. Louis, implemented a data-driven platform to explore key metrics, from basic metrics (e.g., arrival time), to more complex metrics (e.g., showing that they utilize end-tidal CO2 monitoring on 100 percent of advanced airways).
Additionally, the bi-directional data sharing with their hospital partners gives them insight into the majority of their calls. Comparing dispatch complaints to primary impression, to ED diagnosis, and ultimately to discharge diagnosis, creates a leaner process and improves care.
What this translates into is improved relationships with hospitals, a story that can be delivered to the community based on facts and numbers, and – of course – better results for the patients that are being transported.
Where do we go from here?
Smart data and predictive data are here to stay. This evolution will continue to shape the way EMS agencies and providers:
- Assess patients.
- Respond to encounters.
- Interact with hospitals and other organizations across the healthcare spectrum.
- Tell their stories to the community.
Tighter integration and information sharing across multiple systems, and a more evidence-based approach to patient care will continue to mature and evolve. Progressive agencies will be early adopters of this approach while other agencies may be laggards. But there’s no denying that the landscape has been forever altered and those organizations that embrace a data-driven culture will continue to see the most improvements in patient outcomes – as well as happier staff and a better narrative for the community.
