scholarly journals Approach to Onboarding Emergency Medical Services (EMS) Data Into a Syndromic Surveillance System

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Samurl P. Prahlow ◽  
David Atrubin ◽  
Allison Culpepper ◽  
Janet J. Hamilton ◽  
Joshua Sturms ◽  
...  
Keyword(s):  
Public Health ◽  
Emergency Medical Services ◽  
Surveillance System ◽  
Syndromic Surveillance ◽  
Health Surveillance ◽  
Use Cases ◽  
Data Sources ◽  
Medical Services ◽  
Emergency Medical ◽  
Data Elements

ObjectiveTo describe the strategy and process used by the Florida Department of Health (FDOH) Bureau of Epidemiology to onboard emergency medical services (EMS) data into FDOH’s syndromic surveillance system, the Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE-FL).IntroductionSyndromic surveillance has become an integral component of public health surveillance efforts within the state of Florida. The near real-time nature of these data are critical during events such as the Zika virus outbreak in Florida in 2016 and in the aftermath of Hurricane Irma in 2017. Additionally, syndromic surveillance data are utilized to support daily reportable disease detection and other surveillance efforts. Although syndromic systems typically utilize emergency department (ED) visit data, ESSENCE-FL also includes data from non-traditional sources: urgent care center visit data, mortality data, reportable disease data, and Florida Poison Information Center Network (FPICN) data. Inclusion of these data sources within the same system enables the broad accessibility of the data to more than 400 users statewide, and allows for rapid visualization of multiple data sources in order to address public health needs. Currently, the ESSENCE-FL team is actively working to incorporate EMS data into ESSENCE-FL to further increase public health surveillance capacity and data visualization.MethodsThe ESSENCE-FL team worked collaboratively with various public health program stakeholders to bring EMS data, aggregated by the FDOH Bureau of Emergency Medical Oversight Emergency Medical Services Tracking and Reporting System (EMSTARS) team, into ESSENCE-FL. The ESSENCE-FL team met with the EMSTARS team to discuss use cases, demonstrate both systems, and to obtain project buy-in and support. Initial project meetings included review of ESSENCE-FL system support, user types (roles and access), as well as data security and compliance. An overall project timeline was established, and deliverables were added into system support contracts. Multiple stakeholders, across disciplines representing each key use case, reviewed the Florida version of the National Emergency Medical Services Information System (NEMSIS) version 3.4 data dictionary to identify program-specific data element needs. An element scoring spreadsheet was returned to the ESSENCE-FL team. These scores were aggregated and discordant scores were reviewed by the ESSENCE-FL team. A one-month extract of EMS data was reviewed to assess variable completeness and relevance. Monthly team meetings facilitated the final decisions on the data elements by leveraging lessons learned through onboarding other data sources, findings from the analysis of the one-month extract, stakeholder comments, and advice from other states known to be leveraging EMS data for public health surveillance.ResultsThrough a collaborative and broad approach with partners, the ESSENCE-FL team attained stakeholder buy-in and identified 81 data elements to be included in the EMS feed to ESSENCE-FL. The final list of data elements was determined to best support health surveillance of this population prior to presenting to the ED. The inclusion of the EMS data in ESSENCE-FL will increase the epidemiologic characterization and analysis of the opioid epidemic in Florida. Additional key use cases identified during this project included enhanced injury surveillance, enhanced occupational health surveillance, and characterization of potential differences between EMS and ED visits.ConclusionsThis comprehensive approach can be used by other jurisdictions considering adding EMS data to their syndromic surveillance systems. When considering onboarding a new data source into a surveillance system, it is important to work closely with stakeholders from disciplines representing each of the key use cases to broaden buy-in and support for the project. Through employing this comprehensive approach, syndromic surveillance systems can be better developed to include data that are widely utilizable to many different stakeholders in the public health community.

Emergency Medical Services and Syndromic Surveillance: A Comparison With Traditional Surveillance and Effects on Timeliness

2021 ◽  
Vol 136 (1_suppl) ◽  
pp. 72S-79S
Author(s):  
Peter J. Rock ◽  
Dana Quesinberry ◽  
Michael D. Singleton ◽  
Svetla Slavova
Keyword(s):  
Public Health ◽  
Time Series ◽  
Emergency Medical Services ◽  
Syndromic Surveillance ◽  
Surveillance Data ◽  
Medical Services ◽  
Opioid Overdose ◽  
Billing Data ◽  
Public Health Response ◽  
Emergency Medical

Objective Traditional public health surveillance of nonfatal opioid overdose relies on emergency department (ED) billing data, which can be delayed substantially. We compared the timeliness of 2 new data sources for rapid drug overdose surveillance—emergency medical services (EMS) and syndromic surveillance—with ED billing data. Methods We used data on nonfatal opioid overdoses in Kentucky captured in EMS, syndromic surveillance, and ED billing systems during 2018-2019. We evaluated the time-series relationships between EMS and ED billing data and syndromic surveillance and ED billing data by calculating cross-correlation functions, controlling for influences of autocorrelations. A case example demonstrates the usefulness of EMS and syndromic surveillance data to monitor rapid changes in opioid overdose encounters in Kentucky during the COVID-19 epidemic. Results EMS and syndromic surveillance data showed moderate-to-strong correlation with ED billing data on a lag of 0 ( r = 0.694; 95% CI, 0.579-0.782; t = 9.73; df = 101; P < .001; and r = 0.656; 95% CI, 0.530-0.754; t = 8.73; df = 101; P < .001; respectively) at the week-aggregated level. After the COVID-19 emergency declaration, EMS and syndromic surveillance time series had steep increases in April and May 2020, followed by declines from June through September 2020. The ED billing data were available for analysis 3 months after the end of a calendar quarter but closely followed the trends identified by the EMS and syndromic surveillance data. Conclusion Data from EMS and syndromic surveillance systems can be reliably used to monitor nonfatal opioid overdose trends in Kentucky in near–real time to inform timely public health response.

The 2017 Solar Eclipse: Implementing Enhanced Syndromic Surveillance on the Path of Totality in Kentucky

2020 ◽  
pp. 1-4
Author(s):  
Kristen Heitzinger ◽  
Douglas A. Thoroughman ◽  
Blake D. Johnson ◽  
Andrew Chandler ◽  
John W. Prather ◽  
...  
Keyword(s):  
Public Health ◽  
Emergency Medical Services ◽  
Solar Eclipse ◽  
Syndromic Surveillance ◽  
First Aid ◽  
Medical Services ◽  
Care Providers ◽  
Syndromic Surveillance System ◽  
Mass Gatherings ◽  
Emergency Medical

ABSTRACT Objective: The 2017 solar eclipse was associated with mass gatherings in many of the 14 states along the path of totality. The Kentucky Department for Public Health implemented an enhanced syndromic surveillance system to detect increases in emergency department (ED) visits and other health care needs near Hopkinsville, Kentucky, where the point of greatest eclipse occurred. Methods: EDs flagged visits of patients who participated in eclipse events from August 17–22. Data from 14 area emergency medical services and 26 first-aid stations were also monitored to detect health-related events occurring during the eclipse period. Results: Forty-four potential eclipse event-related visits were identified, primarily injuries, gastrointestinal illness, and heat-related illness. First-aid stations and emergency medical services commonly attended to patients with pain and heat-related illness. Conclusions: Kentucky’s experience during the eclipse demonstrated the value of patient visit flagging to describe the disease burden during a mass gathering and to investigate epidemiological links between cases. A close collaboration between public health authorities within and across jurisdictions, health information exchanges, hospitals, and other first-response care providers will optimize health surveillance activities before, during, and after mass gatherings.

Public Health Surveillance of Behavioral Health Emergencies Through Emergency Medical Services Data

2021 ◽  
pp. 1-12
Author(s):  
Madison K. Rivard ◽  
Rebecca E. Cash ◽  
Kirsten Chrzan ◽  
Jonathan Powell ◽  
Gail Kaye ◽  
...  
Keyword(s):  
Public Health ◽  
Emergency Medical Services ◽  
Behavioral Health ◽  
Public Health Surveillance ◽  
Health Surveillance ◽  
Medical Services ◽  
Emergency Medical

scholarly journals (A231) Deficiencies in the Preparedness of Emergency Medical Services Providers for Terrorist Incidents Involving Children

2011 ◽  
Vol 26 (S1) ◽  
pp. s63-s63
Author(s):  
M. Reilly
Keyword(s):  
Public Health ◽  
United States ◽  
Emergency Medical Services ◽  
A Priori ◽  
The United States ◽  
Medical Services ◽  
Special Populations ◽  
Provider Education ◽  
Emergency Medical ◽  
Nationally Representative

IntroductionRecent studies have discussed major deficiencies in the preparedness of emergency medical services (EMS) providers to effectively respond to disasters, terrorism and other public health emergencies. Lack of funding, lack of national uniformity of systems and oversight, and lack of necessary education and training have all been cited as reasons for the inadequate emergency medical preparedness in the United States.MethodsA nationally representative sample of over 285,000 emergency medical technicians (EMTs) and Paramedics in the United States was surveyed to assess whether they had received training in pediatric considerations for blast and radiological incidents, as part of their initial provider education or in continuing medical education (CME) within the previous 24 months. Providers were also surveyed on their level of comfort in responding to and potentially treating pediatric victims of these events. Independent variables were entered into a multivariate model and those identified as statistically significant predictors of comfort were further analyzed.ResultsVery few variables in our model caused a statistically significant increase in comfort with events involving children in this sample. Pediatric considerations for blast or radiological events represented the lowest levels of comfort in all respondents. Greater than 70% of respondents reported no training as part of their initial provider education in considerations for pediatrics following blast events. Over 80% of respondents reported no training in considerations for pediatrics following events associated with radiation or radioactivity. 88% of respondents stated they were not comfortable with responding to or treating pediatric victims of a radiological incident.ConclusionsOut study validates our a priori hypothesis and several previous studies that suggest deficiencies in preparedness as they relate to special populations - specifically pediatrics. Increased education for EMS providers on the considerations of special populations during disasters and acts of terrorism, especially pediatrics, is essential in order to reduce pediatric-related morbidity and mortality following a disaster, act of terrorism or public health emergency.

The 1994 Northridge Earthquake Disaster Response: The Local Emergency Medical Services Agency Experience

1996 ◽  
Vol 11 (3) ◽  
pp. 172-179 ◽  
Author(s):  
Samuel J. Stratton ◽  
Virginia Price Hastings ◽  
Darlene Isbell ◽  
John Celentano ◽  
Miguel Ascarrunz ◽  
...  
Keyword(s):  
Public Health ◽  
Emergency Medical Services ◽  
Disaster Response ◽  
Communication Systems ◽  
Medical Services ◽  
Northridge Earthquake ◽  
Power Sources ◽  
Incident Command ◽  
Emergency Medical ◽  
1994 Northridge Earthquake

AbstractIntroduction:This paper describes the 1994 Northridge earthquake experience of the local emergency medical services (EMS) agency. Discussed are means that should improve future local agency disaster responses.Methods:Data reported are descriptive and were collected from multiple independent sources, and can be reviewed publicly and confirmed. Validated data collected during the disaster by the Local EMS Agency also are reported.Results:The experience of the Los Angeles County EMS Agency was similar to that of earthquake disasters previously reported. Communication systems, water, food, shelter, sanitation means, power sources, and medical supplies were resources needed early in the disaster. Urban Search and Rescue Teams and Disaster Medical Assistance Teams were important elements in the response to the Northridge earthquake. The acute phase of the disaster ended within 48 to 72 hours and public health then became the predominant health-care issue. Locating community food and water supplies near shelters, providing transportation to medical care, and public-health visits to shelter locations helped prevent the development of long-term park encampments. An incident command system for the field, hospitals, and government responders was necessary for an organized response to the disaster.Conclusion:Disaster preparedness, multiple forms of reliable communication, rapid mobilization of resources, and knowledge of available state and federal resources are necessary for a disaster response by a local EMS agency.

Trauma System Development and Future Directions

1993 ◽  
Vol 8 (2) ◽  
pp. 111-114 ◽  
Author(s):  
Judith B. Braslow ◽  
Joan A. Snyder
Keyword(s):  
Public Health ◽  
Emergency Medical Services ◽  
Trauma Care ◽  
System Development ◽  
Trauma System ◽  
The United States ◽  
Advisory Council ◽  
Medical Services ◽  
Emergency Medical ◽  
Care Systems

AbstractTraumatic injury, both unintentional and intentional, is a serious public health problem. Trauma care systems play a significant role in reducing mortality, morbidity, and disability due to injuries. However, barriers to the provision of prompt and appropriate emergency medical services still exist in many areas of the United States. Title XII of the Public Health Service Act provides for programs in support of trauma care planning and system development by states and localities. This legislation includes provisions for: 1) grants to state agencies to modify the trauma care component of the state Emergency Medical Services (EMS) plan; 2) grants to improve the quality and availability of trauma care in rural areas; 3) development of a Model Trauma Care System Plan for states to use as a guide in trauma system development; and 4) the establishment of a National Advisory Council on Trauma Care Systems.

scholarly journals Harmonization of three public health insurance schemes on emergency medical services

2014 ◽  
Vol 14 (S1) ◽  
Author(s):  
Wannapha Bamrungkhet ◽  
Sutherada Chimnoi ◽  
Samrit Srithamrongsawat ◽  
Supasit Pannarunothai
Keyword(s):  
Public Health ◽  
Health Insurance ◽  
Emergency Medical Services ◽  
Public Health Insurance ◽  
Medical Services ◽  
Emergency Medical

A Public Health Enforcement Initiative to Combat Underage Drinking Using Emergency Medical Services Call Data

2012 ◽  
Vol 27 (2) ◽  
pp. 167-171
Author(s):  
Daniel L. Lemkin ◽  
Michael C. Bond ◽  
Donald W. Alves ◽  
Richard A. Bissell
Keyword(s):  
Public Health ◽  
Emergency Medical Services ◽  
Alcohol Intoxication ◽  
Underage Drinking ◽  
Medical Services ◽  
Government Officials ◽  
Societal Costs ◽  
Response Data ◽  
Emergency Medical ◽  
Disproportionate Number

AbstractObjectiveThe objective of this study was to determine whether Emergency Medical Services (EMS) records can identify bars that serve a disproportionate number of minors, and if government officials will use this data to direct underage drinker enforcement efforts.MethodsEmergency Medical Services call logs to all bars in the study area were cross-referenced with a local hospital's records. The records of patients with alcohol-related complaints were analyzed. Outlier bars were identified, and presented to government officials who completed a survey to assess if this information would prompt new enforcement efforts.ResultsEmergency Medical Services responded to 149 establishments during the study period. Eighty-four responses were distributed across six bars, and 78 were matched with the hospital's records. Fifty-one patients, 18 (35%) of whom were underage, were treated for alcohol intoxication, with 46% of the cases originating from four bars. Government officials found the information useful, and planned to initiate new operations based on the information.ConclusionsAlcohol consumption by minors can lead to life-long abuse, with high personal, financial, and societal costs. Emergency Medical Services response data and hospital records can be used to identify bars that allow underage drinking, which is useful in directing law enforcement efforts.Lemkin DL, Bond MC, Alves DW, Bissell RA. A public health enforcement initiative to combat underage drinking using emergency medical services call data. Prehosp Disaster Med. 2012;27(2):1-5.

Uniform Prehospital Data Elements and Definitions: A Report From the Uniform Prehospital Emergency Medical Services Data Conference

1995 ◽  
Vol 25 (4) ◽  
pp. 525-534 ◽  
Author(s):  
Daniel Spaite ◽  
Ronald Benoit ◽  
Douglas Brown ◽  
Richard Cales ◽  
Drew Dawson∥ ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Medical Services ◽  
Emergency Medical ◽  
Prehospital Emergency ◽  
Data Elements

scholarly journals Occupational Exposures and Programmatic Response to COVID-19 Pandemic: An Emergency Medical Services Experience

2020 ◽  
Author(s):  
David L. Murphy ◽  
Leslie M. Barnard ◽  
Christopher J. Drucker ◽  
Betty Y. Yang ◽  
Jamie M. Emert ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Retrospective Cohort ◽  
Public Health Surveillance ◽  
Occupational Exposures ◽  
Health Surveillance ◽  
Medical Services ◽  
Protective Equipment ◽  
King County ◽  
Emergency Medical ◽  
Risk Patients

AbstractBackgroundRigorous assessment of occupational COVID-19 risk and personal protective equipment (PPE) use are not well-described. We evaluated 9-1-1 emergency medical services (EMS) encounters for patients with COVID-19 to assess occupational exposure, programmatic strategies to reduce exposure, and PPE use.MethodsWe conducted a retrospective cohort investigation of lab-confirmed COVID-19 patients in King County, WA who received 9-1-1 EMS responses from February 14, 2020 to March 26, 2020. We reviewed dispatch, EMS, and public health surveillance records to evaluate the temporal relationship between exposure and programmatic changes to EMS operations designed to identify high-risk patients, protect the workforce, and conserve PPE.ResultsThere were 274 EMS encounters for 220 unique COVID-19 patients involving 700 unique EMS providers with 988 EMS person-encounters. Use of “full” PPE including mask, eye protection, gown and gloves (MEGG) was 67%. There were 151 person-exposures among 129 individuals, who required 981 quarantine days. Of the 700 EMS providers, 3 (0.4%) tested positive within 14 days of encounter. Programmatic changes were associated with a temporal reduction in exposures. When stratified at the study encounters midpoint, 94% (142/151) of exposures occurred during the first 137 EMS encounters compared to 6% (9/151) during the second 137 EMS encounters (p<0.01). By the investigation’s final week, EMS deployed MEGG PPE in 34% (3579/10,468) of all EMS person-encounters.ConclusionLess than 0.5% of EMS providers experienced COVID-19 illness within 14 days of occupational encounter. Programmatic strategies were associated with a reduction in exposures, while achieving a measured use of PPE.

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