Trending Topics

EMS World Expo Quick Take: How big data is used to improve EMS clinical care

Big data is readily available to EMS leaders to capture, review and apply to making change to improve patient outcomes in every community

crop-OTNQSDGY-Presenter-VerdugoS.jpg

Silvia Verdugo, MD, MPH, was one of three presenters at EMS World Expo who described the prevalence of big data and its application to common patient encounters, such as opioid overdose and STEMI, to make improvements in community health.

20190823_emsworld_820x180_v2.png

NEW ORLEANS — EMS patient encounters generate a tremendous amount of data that is available for query, report and action. Three presenters at EMS World Expo described the prevalence of big data and its application to common patient encounters, such as opioid overdose and STEMI, to make improvements in community health.

Memorable quotes on using data to improve EMS clinical care

Here are memorable quotes from the three presenters.

“Focus on how we take all of the data that is gathered to improve the health and safety of a community.”

“Gathering all this data and not doing anything with it will frustrate every field provider.”

“Put data in front of providers on a local level frequently.”

— Brent Myers, MD, MPH

“EMS data is an important contributor to the data and understanding of non-fatal opioid overdoses.”

“Include every possible data element in every data source to understand what is happening with the patient.”

— Silvia Verdugo, MD, MPH

“It’s all about action. The data doesn’t need to be perfect. Take action and share the data.”

— Scott Bourn, PhD, RN, FACHE

Top takeaways on application of big data to EMS clinical problems

Here are the top takeaways from the presentation.

1. Focus on making change

A project utilizing big data needs to be driven by a desire to make change in clinical care and patient outcomes.

“Just because you can measure something doesn’t mean you should,” Bourne said. The things you measure in EMS data should be relevant to taking action and making change.

2. Start with a good benchmark

Improvement requires setting a benchmark that is based on a standard of care, for an event that is not rare and is measurable. Over time, based on the findings or trends of the data, the benchmark can change. For example, Myers described the difference between “was an ETCO2 value recorded”, which could be any numerical value versus “was an ETCO2 value appropriate to the patient’s chief complaint.”

3. The measurable numbers need to be in a field that can be queried

The EMS Index, a data set of more than 7.5 million EMS ePCR records, for aspirin administration for adults with chest pain revealed an alarmingly low frequency of administration. Myers described three reasons why the administration rate is so low:

  • Narrative only-inclusion – the ePCR doesn’t have a specific field for aspirin administration so it might have been given but the data of administration is not easily queried.

  • Miscategorized – the patient was mis-categorized as a chest pain patient because of blunt trauma or persistent cough.

  • No record – the ePCR had no mention of aspirin administered, contraindicated, anywhere in the record.

Verdugo further explored how data elements are present in the CAD and ePCR fields. For example, in the dispatch information and patient care report there are many codes and keywords to confirm the patient has experienced an opioid overdose. A single patient encounter had more than a dozen clues that the patient experienced a non-fatal opioid overdose.

4. Conduct specific and sensible data queries

There are lots of data elements in the CAD report and ePCR to query. Verdugo encouraged attendees, through two examples of opioid overdose, to use multiple queries, both specific and sensible, to review the data for all cases of opioid overdose.

5. Set the data free

Verdugo finished the presentation with a call to attendees to gather data, use the data to act and share the data within the EMS agency, with response partners, hospital clinicians, and public health departments. Data collected that is not used for improvement is likely to frustrate frontline providers.

Learn more about big data for EMS improvement

To learn more about the use of data in EMS for improving patient care and community health read these EMS1 articles:

Greg Friese, MS, NRP, is the Lexipol Editorial Director, leading the efforts of the editorial team on Police1, FireRescue1, Corrections1 and EMS1. Greg served as the EMS1 editor-in-chief for five years. He has a bachelor’s degree from the University of Wisconsin-Madison and a master’s degree from the University of Idaho. He is an educator, author, national registry paramedic since 2005, and a long-distance runner. Greg was a 2010 recipient of the EMS 10 Award for innovation. He is also a three-time Jesse H. Neal award winner, the most prestigious award in specialized journalism, and the 2018 and 2020 Eddie Award winner for best Column/Blog. Connect with Greg on LinkedIn.
RECOMMENDED FOR YOU