Developing a statewide emergency medical services database linked to Hospital outcomes

A feasibility study

Craig Newgard, Dana Zive, Susan Malveau, Robert Leopold, Will Worrall, Ritu Sahni

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background. Statewide emergency medical services (EMS) data linked to outcomes are critical for promoting high-quality emergency care; however, many states do not have such a resource. Objective. To demonstrate the feasibility of creating such a statewide database using a one-month pilot sample. Methods. This was a prospective cohort study of all EMS patient encounters throughout Oregon during May 2008. Eighty-three National EMS Information System (NEMSIS) variables were obtained from EMS agencies via electronic or paper charts. We reformatted raw data, mapped NEMSIS fields, entered hard-copy records, and uploaded data files to a statewide electronic medical records platform. Records from transport and nontransport (first-responder) agencies caring for the same patients were matched using probabilistic linkage, then linked to three statewide outcome databases (Oregon Hospital Discharge Database [OHDD], Oregon Trauma Registry [OTR], and Oregon Department of Transportation [ODOT] Crash File) using similar methodology. We estimated population-adjusted case ascertainment by county and used descriptive statistics to characterize the process. Results. During the one-month period, we collected 27,474 EMS records in 36 (100%) counties from 106 (77%) licensed transport agencies and 10 nontransport agencies, representing 20,673 persons. There were 3,302 admission record matches, 285 trauma registry matches, and 392 crash record matches. Overall, 3,979 hospital outcomes were matched to EMS records for 80 (75%) transport and six (60%) first-responder agencies. Median per-agency match rates were 16.3% for OHDD (interquartile range [IQR] 8.3-22.2%, range 0-56.5%), 0.9% for OTR (IQR 0-2.5%, range 0-60.0%), and 1.6% for ODOT (IQR 0-3.5%, range 0-23.1%). Conclusion. Developing a statewide EMS database linked to hospital outcomes is feasible. The processes used in this study and match rate estimates may provide a template for other states to follow, enhancing opportunities for outcomes-based EMS research and EMS quality assurance efforts.

Original languageEnglish (US)
Pages (from-to)303-319
Number of pages17
JournalPrehospital Emergency Care
Volume15
Issue number3
DOIs
StatePublished - Jul 1 2011

Fingerprint

Feasibility Studies
Emergency Medical Services
Databases
Registries
Information Systems
Medical Records
Wounds and Injuries
Electronic Health Records
Quality of Health Care
Information Storage and Retrieval
Biomedical Research
Cohort Studies
Prospective Studies

Keywords

  • database
  • emergency medical services
  • Emergencycare
  • health services
  • outcomes
  • regionalized care

ASJC Scopus subject areas

  • Emergency Medicine
  • Emergency

Cite this

Developing a statewide emergency medical services database linked to Hospital outcomes : A feasibility study. / Newgard, Craig; Zive, Dana; Malveau, Susan; Leopold, Robert; Worrall, Will; Sahni, Ritu.

In: Prehospital Emergency Care, Vol. 15, No. 3, 01.07.2011, p. 303-319.

Research output: Contribution to journalArticle

Newgard, Craig ; Zive, Dana ; Malveau, Susan ; Leopold, Robert ; Worrall, Will ; Sahni, Ritu. / Developing a statewide emergency medical services database linked to Hospital outcomes : A feasibility study. In: Prehospital Emergency Care. 2011 ; Vol. 15, No. 3. pp. 303-319.
@article{0968462c3764433ba4d4dfee4eea0ed3,
title = "Developing a statewide emergency medical services database linked to Hospital outcomes: A feasibility study",
abstract = "Background. Statewide emergency medical services (EMS) data linked to outcomes are critical for promoting high-quality emergency care; however, many states do not have such a resource. Objective. To demonstrate the feasibility of creating such a statewide database using a one-month pilot sample. Methods. This was a prospective cohort study of all EMS patient encounters throughout Oregon during May 2008. Eighty-three National EMS Information System (NEMSIS) variables were obtained from EMS agencies via electronic or paper charts. We reformatted raw data, mapped NEMSIS fields, entered hard-copy records, and uploaded data files to a statewide electronic medical records platform. Records from transport and nontransport (first-responder) agencies caring for the same patients were matched using probabilistic linkage, then linked to three statewide outcome databases (Oregon Hospital Discharge Database [OHDD], Oregon Trauma Registry [OTR], and Oregon Department of Transportation [ODOT] Crash File) using similar methodology. We estimated population-adjusted case ascertainment by county and used descriptive statistics to characterize the process. Results. During the one-month period, we collected 27,474 EMS records in 36 (100{\%}) counties from 106 (77{\%}) licensed transport agencies and 10 nontransport agencies, representing 20,673 persons. There were 3,302 admission record matches, 285 trauma registry matches, and 392 crash record matches. Overall, 3,979 hospital outcomes were matched to EMS records for 80 (75{\%}) transport and six (60{\%}) first-responder agencies. Median per-agency match rates were 16.3{\%} for OHDD (interquartile range [IQR] 8.3-22.2{\%}, range 0-56.5{\%}), 0.9{\%} for OTR (IQR 0-2.5{\%}, range 0-60.0{\%}), and 1.6{\%} for ODOT (IQR 0-3.5{\%}, range 0-23.1{\%}). Conclusion. Developing a statewide EMS database linked to hospital outcomes is feasible. The processes used in this study and match rate estimates may provide a template for other states to follow, enhancing opportunities for outcomes-based EMS research and EMS quality assurance efforts.",
keywords = "database, emergency medical services, Emergencycare, health services, outcomes, regionalized care",
author = "Craig Newgard and Dana Zive and Susan Malveau and Robert Leopold and Will Worrall and Ritu Sahni",
year = "2011",
month = "7",
day = "1",
doi = "10.3109/10903127.2011.561404",
language = "English (US)",
volume = "15",
pages = "303--319",
journal = "Prehospital Emergency Care",
issn = "1090-3127",
publisher = "Informa Healthcare",
number = "3",

}

TY - JOUR

T1 - Developing a statewide emergency medical services database linked to Hospital outcomes

T2 - A feasibility study

AU - Newgard, Craig

AU - Zive, Dana

AU - Malveau, Susan

AU - Leopold, Robert

AU - Worrall, Will

AU - Sahni, Ritu

PY - 2011/7/1

Y1 - 2011/7/1

N2 - Background. Statewide emergency medical services (EMS) data linked to outcomes are critical for promoting high-quality emergency care; however, many states do not have such a resource. Objective. To demonstrate the feasibility of creating such a statewide database using a one-month pilot sample. Methods. This was a prospective cohort study of all EMS patient encounters throughout Oregon during May 2008. Eighty-three National EMS Information System (NEMSIS) variables were obtained from EMS agencies via electronic or paper charts. We reformatted raw data, mapped NEMSIS fields, entered hard-copy records, and uploaded data files to a statewide electronic medical records platform. Records from transport and nontransport (first-responder) agencies caring for the same patients were matched using probabilistic linkage, then linked to three statewide outcome databases (Oregon Hospital Discharge Database [OHDD], Oregon Trauma Registry [OTR], and Oregon Department of Transportation [ODOT] Crash File) using similar methodology. We estimated population-adjusted case ascertainment by county and used descriptive statistics to characterize the process. Results. During the one-month period, we collected 27,474 EMS records in 36 (100%) counties from 106 (77%) licensed transport agencies and 10 nontransport agencies, representing 20,673 persons. There were 3,302 admission record matches, 285 trauma registry matches, and 392 crash record matches. Overall, 3,979 hospital outcomes were matched to EMS records for 80 (75%) transport and six (60%) first-responder agencies. Median per-agency match rates were 16.3% for OHDD (interquartile range [IQR] 8.3-22.2%, range 0-56.5%), 0.9% for OTR (IQR 0-2.5%, range 0-60.0%), and 1.6% for ODOT (IQR 0-3.5%, range 0-23.1%). Conclusion. Developing a statewide EMS database linked to hospital outcomes is feasible. The processes used in this study and match rate estimates may provide a template for other states to follow, enhancing opportunities for outcomes-based EMS research and EMS quality assurance efforts.

AB - Background. Statewide emergency medical services (EMS) data linked to outcomes are critical for promoting high-quality emergency care; however, many states do not have such a resource. Objective. To demonstrate the feasibility of creating such a statewide database using a one-month pilot sample. Methods. This was a prospective cohort study of all EMS patient encounters throughout Oregon during May 2008. Eighty-three National EMS Information System (NEMSIS) variables were obtained from EMS agencies via electronic or paper charts. We reformatted raw data, mapped NEMSIS fields, entered hard-copy records, and uploaded data files to a statewide electronic medical records platform. Records from transport and nontransport (first-responder) agencies caring for the same patients were matched using probabilistic linkage, then linked to three statewide outcome databases (Oregon Hospital Discharge Database [OHDD], Oregon Trauma Registry [OTR], and Oregon Department of Transportation [ODOT] Crash File) using similar methodology. We estimated population-adjusted case ascertainment by county and used descriptive statistics to characterize the process. Results. During the one-month period, we collected 27,474 EMS records in 36 (100%) counties from 106 (77%) licensed transport agencies and 10 nontransport agencies, representing 20,673 persons. There were 3,302 admission record matches, 285 trauma registry matches, and 392 crash record matches. Overall, 3,979 hospital outcomes were matched to EMS records for 80 (75%) transport and six (60%) first-responder agencies. Median per-agency match rates were 16.3% for OHDD (interquartile range [IQR] 8.3-22.2%, range 0-56.5%), 0.9% for OTR (IQR 0-2.5%, range 0-60.0%), and 1.6% for ODOT (IQR 0-3.5%, range 0-23.1%). Conclusion. Developing a statewide EMS database linked to hospital outcomes is feasible. The processes used in this study and match rate estimates may provide a template for other states to follow, enhancing opportunities for outcomes-based EMS research and EMS quality assurance efforts.

KW - database

KW - emergency medical services

KW - Emergencycare

KW - health services

KW - outcomes

KW - regionalized care

UR - http://www.scopus.com/inward/record.url?scp=79957635667&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79957635667&partnerID=8YFLogxK

U2 - 10.3109/10903127.2011.561404

DO - 10.3109/10903127.2011.561404

M3 - Article

VL - 15

SP - 303

EP - 319

JO - Prehospital Emergency Care

JF - Prehospital Emergency Care

SN - 1090-3127

IS - 3

ER -