EMS Annual Report 2017 Home > Learning and Improving

Learning and Improving

The Knowledge Management Division is comprised of two sections: The Business Analysis & Research (BAR) Team, and the Clinical Performance Management Team. The goal of both sections is to improve performance through the use of data, analysis and process improvement. This is accomplished by using reporting tools, Business Intelligence (BI) via different presentation tools, such as the web, or in the case of clinical improvement opportunities, providing individual feedback and education in a one on one environment.
Medical Officers reviewing patient's EKG
The division has other responsibilities, including:
  • Geospatial Information Services (GIS). The BAR Team provides GIS services for the department. The section has a presence on the City GIS Operating Board and the City GIS Emergency Response Team.
  • Providing software and hardware support for Electronic Patient Care Record (ePCR), Billing and Records Management System (RMS) systems used by EMS.
  • Support of medical devices and equipment used in EMS.
  • Development and support of web and social media for EMS.
  • Development and support of Business Intelligence solutions for EMS.
  • Participation in governance initiatives for GIS, BI, and Information Technology (IT).
  • IT Governance participation:  Public Safety IT Operation Board (Chair), and The CIO Council.
Business Analysis & Research (BAR)
Business Intelligence and Data Infrastructure
We continued to focus on improving our data infrastructure in 2016, with particular emphasis on refining our data warehouse and operational data stores. In addition, the team remains committed to automating data processing where possible. The overarching goal is to ensure data quality, availability, while reducing manual processing of data
NEMESIS version 3
The team upgraded our Electronic Patient Care Record (ePCR) system so that we are compliant with the latest National Emergency Medical Services Information System (NEMSIS) dataset. NEMSIS seeks to provide a data standard for EMS systems in the United States. This standard offers a consistent dataset (agreed upon by EMS agency consensus), and offers the ability to communicate with hospital record systems. This capability allows us to measure and benchmark with other EMS agencies, and allows us to understand the relationship between prehospital care and the hospital outcome.
Understanding the healthcare continuum
The team worked with a vendor and the HCA hospital network to create a solution that allows EMS to view hospital outcome data and vice versa.  The solution utilizes scanners located in Emergency Departments – Our Medics scan a patient ID into our record.  The EMS and hospital records are later linked and are viewable by hospital and EMS staff.  This gives us insight into our impact on patient care and allows us to follow the course of patients that we transport.
Clinical Performance Management
This team is responsible for clinical performance in EMS. To accomplish this, the team fields calls from providers who call with questions or to report an event that has a clinical component. The team performs fact finding, which includes interviewing providers, as well as review of other pertinent information, including the dispatch record and the patient care record. The outcome of the investigation can result in education to the provider, or a personal “Thank You” for a job well done. This type of information is aggregated and reported. Opportunities for improvement are given to education staff for dissemination to the system.
Designated Medical Officers (DMO's) - Field Deployment
Three DMO’s are assigned to a shift to better align with the schedule our medics are on. The DMO’s are included in the 911 response matrix and are dispatched to assist with various calls. The DMO is on scene to provide clinical expertise and provide assistance as needed. In addition, the DMO’s visit with medics and provide education on system issues we have identified, and provide feedback on clinical performance. One of goals with this deployment was to focus on creating a positive relationship with our medics. To date, the feedback has been positive!
Average Days to Close Clinical Reviews by Month (Fiscal Year 2017)

Total Clinical Reviews
Average Days to Close Clinical Reviews
  • Deployed the Designated Medical Officers (DMO) in the field and assigned them to a shift.  This created better alignment with the schedules that our Medics work.  The DMO’s are assigned to the dispatch matrix and are automatically assigned to high priority calls, such as cardiac arrests.
  • Added an additional DMO, for a total of 4.  This will allows us to cover each shift with a DMO.  This will create a better a division of labor among the team (4 shifts were covered by 3 DMO’s prior).  This also creates better alignment and consistency between shifts.
  • Deployed 5 additional Wi-Fi hotspots at EMS stations (10 total).  This is part of a larger project that aims to improve internet connectivity for line staff.
  • Began a test deployment of Surface Pro devices for EMS captains.  The goal is to create a mobile office solution where Captains can complete work while deployed on an ambulance.
  • Completed a draft dashboard in the Open Performance environment.  This dashboard will replace our current external facing website for performance metrics and will go live in early 2018.  The new dashboard utilizes visual cues to call out current performance status and uses a more pleasing visualization scheme.
  • Deployed the Optima predictive analytics solution.  The solution analyzes past data to help predict where incidents occur in the future.
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