Examining How Health Information Exchange Can Help in a Colorado Emergency

CORHIO recently completed an analysis for the North Central Region Healthcare Coalition, evaluating hospital evacuations, deploying ambulances to safely transport patients, and how HIE could help.

The North Central Region Healthcare Coalition (NCR HCC) was created in 2017 to consolidate efforts within the 10 Denver Metro counties and align the footprint of Colorado's healthcare coalitions with existing emergency management regions. HCCs are described as bringing together "groups of individual healthcare and response organizations - such as hospitals, EMS providers, emergency management organizations [and] public health agencies … to prepare for and respond to disasters and emergencies," according to the Office of the Assistant Secretary for Preparedness and Response of the U.S. Department of Health and Human Services (the "ASPR"). Increasingly, HCCs also help their members meet Centers for Medicare and Medicaid Services Emergency Preparedness Rule requirements. Not surprisingly, many CORHIO members are also NCR HCC members.

It's probably less known that CORHIO maintains its own active membership in the NCR HCC. Director of Emergency Medical Services Ezekiel Peters co-chairs the EMS Subcommittee that collaboratively serves the NCR HCC and several other regional bodies. The EMS Subcommittee has long been concerned about the number of ambulances available in the region and their efficient assignment during medical surge events; routing of surge patients to appropriate facilities with available beds; and tracking of patients and reunification of families moving through the health system. Now CORHIO is working with the NCR HCC to help find solutions to these big problems.

Hospital Evacuation Test Exercises

Every year, the ASPR requires that each HCC conduct a Coalition Surge Test in response to a scenario requiring multiple simultaneous hospital evacuations. In prior years, EMS agencies have had little direct role in the exercise. This April, the EMS Subcommittee, including Peters, worked with the HCC to stand up an EMS Multiagency Coordination Center (MACC) to directly receive and respond to evacuating hospitals' requests for ambulances. During the exercise, Peters identified that CORHIO might be able to further advance the EMS MACC concept by creating a virtual version of the MACC that includes the display of HIE data, especially regarding patients' locations, acuities, and movements.

"Conceiving these novel ways the HIE might be applied to hospital evacuation and decompression only came about because of CORHIO's ongoing engagement and conversations with the emergency services community while trying to solve real-world scenarios," said Peters.

Exploring a Virtual Coordination Center

With Peters' guidance, CORHIO sought NCR HCC grant funding to conduct a thorough analysis of creating a virtual EMS Multiagency Coordination Center for responses to hospital evacuations and decompressions. The HCC awarded CORHIO funds for a first phase in May, with CORHIO delivering its first report in June. This month, the HCC funded the second phase of the project, which will focus on HL7 Admit, Discharge, and Transfer messages in the MACC.

"I'm honored that CORHIO was trusted by Coalition members to use their money to explore new solutions to these persistent problems,” said Peters. “Like the Healthcare Coalition, the EMS Subcommittee, and other regional organizations, CORHIO's true strength is as a collaborative structure among trusted partners."

Because the CORHIO HIE contains records for over 6 million unique patients and receives real-time updates of all participating hospital admissions, transfers and discharges, it’s in a unique position to support patient movements and tracking during hospital evacuation and decompression.

Using existing HL7 Admit, Discharge, and Transfer messages between individual facilities' electronic health records, CORHIO's Health Information Exchange could serve to:

• Streamline communications between emergency response agencies and hospitals
• Improve efficiency in assigning and transferring patients to receiving facilities
• Maintain end-to-end patient tracking across different healthcare and electronic health record systems during hospital evacuation and decompression

For more details, read the white paper:

Using an EMS Multiagency Coordination Center and Health Information Exchange Admit, Discharge, and Transfer Messages to Manage NCR Patient Movements Under Medical Surge