Another Delay in Getting Electronic Health Records to First Responders

Andrew Kitchenman | April 18, 2013 | Health Care
Bankruptcy of software supplier just the latest roadblock in five-year plan to equip EMS units with potentially life-saving medical data

While emergency medical services would seem to be an area where instant access to health records would be critically important, implementing such a scheme has proven difficult. An attempt to institute a statewide system five years ago has met with numerous obstacles and now seems to be back to square one.

When the state contracted in 2008 with emsCharts, a Pittsburgh-based software supplier, to offer all EMS providers access to electronic health records, officials had high hopes that the data would soon be available to paramedics and other EMS workers across the state.

With six months left on the contract, however, emsCharts has declared bankruptcy. Some 37 percent of EMS organizations have adopted the software program, and state officials are reviewing where to go from here.

Sen. Linda R. Greenstein (D-Mercer and Middlesex) raised the issue with state Health Commissioner Mary E. O’Dowd at a Senate budget hearing yesterday, questioning what the state plans to do when the emsCharts contract expires on October 31. She noted that state budget documents left it unclear whether the program would continue to be funded.

Greenstein said that she would like to see all EMS providers have access to the records.

“In an ideal world it would seem to be a very good system for all EMS organizations to be participating in,” she said after the hearing.

While the emsCharts system was touted as being free to EMS units in 2008, O’Dowd said local providers wound up having to make an “investment” to implement it. In addition, “five years is a long time in terms of technology,” she said.

“We have to evaluate what is our best next step moving forward,” O’Dowd said.

Every EMS provider varies in both how advanced their computers are and how compatible they are with the electronic records kept by local hospitals.

“It may or may not be something that the department can solve, and we are certainly trying to have a very thoughtful conversation internally,” the commissioner said.

When Greenstein asked O’Dowd how effective the system has proven to be, the commissioner said its effectiveness has differed depending on the EMS provider.

“If it’s something that’s working well for them in their community, I think it’s something that has great potential,” she said, adding that she didn’t have a statewide evaluation of the program.

O’Dowd said after the hearing that state officials would work to avoid having EMS departments that currently access records through emsCharts experience a disruption in service when the contract ends. She noted that other providers are using systems that they prefer to emsCharts.

“I’m in the very early stages of understanding the dynamics of this situation, so I’m trying to get a better perspective,” she said. “I have more questions than answers at this point.”

The issue of making these records available may grow in importance as healthcare providers in the state implement a new form that complements advance directives.

Known as the practitioner orders for life-sustaining treatment, or POLST, it informs medical providers as to what measures a patent wants taken to keep him or her alive.

Since paramedics and emergency medical technicians are frequently in a position to make life-or-death decisions, experts have said it would be good for them to be able to access the POLST electronically.

O’Dowd acknowledged yesterday that it would be advantageous to make POLST orders available to EMS “in theory.”

Healthcare experts have touted electronic health records as a way to increase the effectiveness and efficiency of care

But O’Dowd noted that adoption has been inconsistent: While 100 percent of hospitals, 97 percent of pharmacies, and 90 percent of federal-qualified health centers have taken steps to adopt these records, only 28 percent of doctors have done so. She added that the state is trying to help providers adopt electronic records. One way to accomplish that is by establishing regional health information organizations — networks that include hospitals, doctors, labs, nursing homes, and insurers.

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