Emergency Data Exchange Language (EDXL) Tracking of Emergency Patients (TEP). August 25, 2010. Presentation to the: OASIS Emergency Management Technical Committee Dial in: 1-888-325-3989 pass code: 561413 # Attendee URL: https://www323.livemeeting.com/cc/eiip/join?id=DHSOICSWG. - PowerPoint PPT Presentation
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Emergency Data Exchange Language (EDXL) Tracking of Emergency Patients (TEP)
August 25, 2010
Presentation to the:OASIS Emergency Management Technical Committee
PRESENTATION PURPOSE: OASIS Outreach and Education on the draft Standard – questions at the end
Practitioner Submission to EIC May 14, 2010 Practitioner Submission to OASIS June 8, 2010 TEP Voted within OASIS as a Work Product June 22, 2010 TEP Sub-committee Created Within EM-TC subcommittee
& Chairs Voted in (T. Grapes / D. McGarry) August 2010 Plan to Engage Sub-Committee Work Beginning of Oct. MOU in-progress between OASIS and HL7 for standard
The NASEMSO with many other agencies and organizations recognized the need for standards-based interoperability to realize the potential of the numerous patient tracking systems in existence or planned
Introduced TEP to the DHS S&T Office for Interoperability and Compatibility (OIC), sponsor of the EDXL development process – a mature, proven process for developing cross-profession, practitioner-driven messaging standards
Effort was Initiated by the PSG as the next EDXL Priority Helps close HITSP ER-EHR IS04 Gaps Supports HHS & DOD AHRQ Objectives
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TEP & TEC Messaging Standards
Requirements definition for Tracking of Emergency Patients and Tracking of Emergency Clients is occurring in two phases. TEP is in-process with the Practitioner Steering and Working Groups (PSG / SWG).
Phase I - Tracking of Emergency Patients (TEP): An XML standard for exchange of emergency patient and EMS tracking information; to increase the effectiveness of emergency medical management, patient tracking and care, and family notification.
Phase II - Tracking of Emergency Clients (TEC): Expands Phase I scope to support clients across the general population. TEC is aimed at more effective evacuation and services management, client tracking, Regulation, Re-unification, and use of assets for all Emergency clients.
Client: Generic term for any person displaced, evacuated, sheltering in place, expired, and/or requiring medical attention – i.e. Clients or customers of Emergency ServicesPatient: A type of client requiring medical attention, being medically evaluated; or a fatality .
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TEP Scope EDXL-TEP is an XML
messaging standard for exchange of emergency patient and tracking information across the EMS emergency medical care continuum.
TEP provides real-time information to responders, management and care facilities in the chain of emergency care and transport.
Emergency / Disaster EMS, ED / Hospitals / Care Facilities, Emergency Management, Ops, Dispatch, Command
Patient tracking information is exchanged from patient encounter (possibly re-using dispatch information) through admission or release.
TEP also supports hospital evacuations and day to day patient transfers.
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TEP Use Case
Events / Triggers
Key Events That Trigger Messages
Description
Responders dispatched PSAP / dispatch center dispatches responders to an incident. Possible starting point for sharing of incident and patient data
Patient Encountered The first or initial meeting or contact between a given care provider and a given patient.
Patient Evaluated or Triaged Medical observation, measurement, and assessment of a patient or possible patient
Patient Treated Medical performance or administering of procedures, medications, or other treatments.
Patient is physically moved from one location, site, or facility to another
Patient being transferred to new care provider Patient care responsibility is transferred from one care provider to another
Patient condition changes Patient health / medical condition changes in some way
Patient vitals and monitoring taken Care Provider takes vital signs or other measurements, typically using various monitoring equipment, some of which may be electronic
Patient Released Patient is released from care, and is no longer considered to be part of the EMS incident continuum of care, and is no longer tracked using TEP
Patient Admitted Patient is formally admitted into a fixed medical facility or a temporary deployable facility capable of providing definitive care, which typically involves transfer of Care Provider and physical location.
Patient ID information updated Further identifying information is collected / shared about the patient
Time-driven information i.e. transfer to AHRQ National Database
Patient Tracking information is automatically or manually shared with a National Database used for consolidated tracking of patients and clients
Change in conditions requiring patient reroute (change in patient condition, receiving facility full)
Change in circumstances requiring patient transport to re-route from current destination to a new destination
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EDXL-TEP Structure and Elements
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EDXL-TEP Structure and Elements
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EDXL-TEP Structure and Elements
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Emergency Data Exchange Language Tracking of Emergency Patients (EDXL-TEP)
Documentation may be found at the following website: http://www.evotecinc.com/TEP/
Incumbent Practitioner Steering Group (PSG) & Standards Working Group (SWG) EMS, Law Enforcement, Fire, Emergency Management, Health, Public Safety, States, Counties, Cities
Over 80 Newly Added Stakeholders plus Vendors – Examples: Health Information IT Standards Panel (HITSP) Gap-Filler National Association of State EMS Officials (NASEMSO) Joint National Emergency Medical Services Leadership Conference (JNEMSLC) DoD Health & Medical Defense Support of Civil Authorities – OASD(HD&ASA) HHS-Agency for Healthcare Research and Quality (AHRQ) HHS-Assistant Secretary for Preparedness and Response (ASPR)
National Disaster Medical System (NDMS) American Hospital Association (AHA) American Red Cross LA R-7 Hospital Disaster Preparedness/Emergency Nurses Association-ENA Association of Public Safety Communications Officials (APCO) National Emergency Numbering Association (NENA) Federal Emergency Management Agency (FEMA) State of Tennessee
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Standards Development Process
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LN FN Organization Represented
Mann Clay, Dr.NASEMSD, National EMS Information System (NEMSIS)
Mears Greg, Dr. UNC Chapel Hill EMS Medical Director
Donohue John Maryland Institute for EMS Systems (MIEMSS)
Sexton JeffTennessee DOH Office of Information Technology Services, HITSP
Moreland Joe Kansas Board of EMS
Whitney Jolene Bureau of EMS State of Utah
McGinnis KevinJNEMSLC, NASEMSO, Vice-Chair-OIC PSG, National Association of State EMS Officials-NASEMSO
TEP Steering Committee
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TEP Practitioner Submission
• Final Stakeholder review period completed March 1 – March 31, 2010; extended to April 14, 2010
• Additional comments received from:• National Institute of Health (NIH) / US National Library of
Medicine “Lost Person Finder (LPF)” effort. • Multiple DoD reviewers including the Health & Medical
Defense Support of Civil Authorities.
• Draft TEP Piloted and Improved: National Disaster Medical System (NDMS) live exercise at the Tennessee Air National Guard 164th Airlift Wing in Memphis
• Excellent TEP participation and inputTotal Issues submitted: 289
• Draft EDXL-TEP interoperability pilot inserted into the 2010 National Disaster Medical System (NDMS) Patient Movement Full-Scale Exercise, with follow-on analysis and presentation
• A live exercise using volunteer patients, driven by objectives of federal, state and local agencies and NDMS partner hospitals.
• DHS OIC pilot the draft EDXL-TEP specification in a field exercise before submitting to the standards approval process
• A hurricane makes landfall resulting in mass casualties requiring evacuation and medical treatment.
• Patients were tracked utilizing five independent Patient Tracking systems from Maryland's BWI airport, to a Memphis triage area where an actual C-130 landed and deplaned patients. Patients were then tracked through triage and ambulance boarding, through arrival at one of 5 Memphis area hospitals.
• First Electronic Patient Manifest for TN Air National Guard
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NDMS Patient Movement Exercise OrganizationsDHS Office for Interoperability and CompatibilityDHS Tech Support - Evolution TechnologiesHHS / ASPR / NDMSMaryland Institute for Emergency Medical Services Systems (MIEMSS)Memphis / Shelby County Health DepartmentMemphis / Shelby EMAMemphis FireMemphis Shelby Regional Hospital CoordinatorMethodist Hospital CorpVendor - Disaster Management Solutions (DMS)Vendor - EMSystemsVendor - Global Emergency Resources (GER)Vendor - HHS Joint Patient Assessment & Tracking System (JPATS) Vendor - UPP TechnologiesTN DOH Exercise Coordinator & State Response CoordinatorTN Air National GuardVeterans Administration
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EvacuationPatient Receiving Area (PRA) Maryland (MIEMSS)
1- Tag and Transport patient to NDMS DMAT at BWI Thurgood Marshall Airport
Begin tracking patients via DE-TEP(100 Patients for on-load to air transport.
To be moved by NDMS to another State for Hospitalization and/or Treatment)
DE-TEPDE-TEP
JPATSCOG 6978(Apprio)
JPATSCOG 6978(Apprio)
DM OPEN
DM OPEN
First TrackCOG 6975
(DM Solutions)
First TrackCOG 6975
(DM Solutions)
Patient TrackingCOG 6974
(UPP Technology)
Patient TrackingCOG 6974
(UPP Technology)
HAVECOG 6976
(EM Systems)
HAVECOG 6976
(EM Systems)
HC StandardCOG 6977(GER911)
HC StandardCOG 6977(GER911)
DE-TEPDE-TEP
2 – Load patients to aircraft and provide TEP
updates (JPATS update all)
Tennessee – Memphis Shelby:3 -Offload patients from aircraft (First Track update all)4 - Patient ambulance transport (First Track update all)