Information sharing will drive EMS growth, improvement
NHTSA "Beyond EMS Data Collection" report identifies steps for EMS improvement and quality to become information driven
For the typical EMS provider, data may be one of the least sexy topics to discuss around the station dinner table or while sitting at a post. The mention of the word makes most of us imagine spreadsheets, calculators and back office staff entering data into computers — not very relevant to what we do with patients in the field.
In reality, nothing could be further from the truth. Data and information analytics permeates everything that we do as field providers, including better patient care, more targeted services toward the community and increased reimbursement for what do provide. In fact, the National Highway Traffic Safety Administration's Office of EMS has just issued a report on the need to create a culture of information-driven EMS systems to drive future growth and development of the industry. While it's not very likely that you'll be reading this document to your partner in between calls, you should take notice that such reports will impact how you may provide field care.
Data shapes the EMS elephant
There have been concerted efforts to collect data at local, regional and national levels since the mid 1990s. However we still define EMS by what we do locally, on the unit every day. As a result, each of us has a specific opinion as to what we feel is "true" regarding the EMS industry.
It's very much like the old story about blind individuals trying to describe what an elephant is. One man touches the trunk and says one thing, while another woman touches the tail and describes the elephant in a totally different way. Given how systems have developed over the past fifty years, the variability in describing the EMS elephant is huge.
Data can remove the mask of blindness and allow us to see EMS for what it is. The more we know about what we do, how we do it, and most critically, the outcomes associated with our care, the better we are able to adapt our operational tactics and plan for better success.
Better outcomes mean better EMS
You would think that it is self-evident, but consider how much we do in EMS that is not grounded in evidence: transporting patients to the hospital with lights and sirens activated; ALS first responders; myriad of medications we administer in the field. Indeed many interventions and tactics in EMS have been driven by best guesses and so-called expert opinion, with little or no understanding of the outcomes of such interventions.
One area that has seen improvement is in cardiac resuscitation. Many EMS systems are reporting better ROSC and discharge from hospital rates due to better chest compressions, increased bystander CPR and public access AEDs. While we may debate about the specifics and nuances of different interventions, the needle is moving in the right direction.
Significant barriers to data collection, sharing
The EMS industry has a problem sharing information. Some of the reluctance to share is warranted — proprietary data influences the bottom line and the potential for litigation exposure. Pretty much everything else can be blinded or otherwise made anonymous, so that the aggregated dataset becomes large enough to establish true benchmarks for quality.
Because EMS systems have developed independently of each other since the beginning, it's no surprise that data collection has also been kept in siloes. It'll take willingness to participate, effort — and money — to create data collection systems that are universal and therefore, applicable to the entire industry.
Moving forward from here
NHTSA has already started the process for the next iteration of field care services in the United States. I suspect that there will be a greater emphasis on evidence-based processes that will underlie the EMS safety net. For those of us coming into the profession, these are the developments to pay attention to, as unsexy as it is; your future is wrapped up within their outcomes.