what-when-how
In Depth Tutorials and Information
hree phases were defined to scrutinize the information-sharing procedures of
EMS units. he irst phase included visiting diferent facilities and interviewing
their personnel. Ambulance drivers, firemen, and even dispatch personnel were
questioned on their end-to-end operations from the time they received word of
the emergency until they completed their particular assignments. he researchers
traveled on real-world missions as well as simulations and witnessed what data are
transferred between EMS entities.
he second phase also included interviews with EMS personnel and manage-
ment; however, the questions were related to why each agency had, or did not have,
access to the information being exchanged. Once it was determined what informa-
tion was essential to each EMS organization, the deficiencies in the system could
be found and corrected. he third and inal stage evaluated the previous two stages
in order to create a system that would eliminate foreseeable problems for a large
emergency medical service system.
he San Mateo County EMS Agency uses a computer-aided dispatch (CAD)
system to record patient information, such as caller information, location data,
and initial health problem data. his CAD system is controlled by the dispatch's
County Communication Center. he time stamp data from ambulances and ire
stations are also recorded in the CAD system. he county also employs an elec-
tronic patient care record (PCR), which is controlled by the EMS Agency. he
EMS crews enter information into the PCRs through wireless laptops. Patient
health and treatment are recorded in the PCRs. he hospitals also have their
own computer-based system; however, it has limited access to both the CAD
and PCRs.
he many systems that rarely transfer information between each other hinder
the ability of medical personnel to gather all the information necessary to treat a
patient properly. Ideally, the county would like to employ only a PCR that would
include all information for every agency. hrough interviews, it was found that
hospitals are a main deterrent to having a fully integrated system because, along
with other concerns, they must respect patients' privacy and they do not want to
pay the high cost of integration. San Mateo has begun pursuing legislation to force
more data exchange between hospitals and other agencies.
After reviewing the San Mateo case, it was determined that the county might
benefit from adopting the National Intelligent Transportation System (ITS)
architecture. his ITS “provides a common structure for the design of intelligent
transportation systems and prescribes a general framework that supports the devel-
opment of many different designs.” Table 14.5 shows how the San Mateo system
would be mapped in the national architecture.
In Schooley et al. [5], a case study was explained as an examination of the par-
ticular EMS Agency in San Mateo through the TCIS framework. he issues con-
cerning shared information between various medical organizations were discussed,
as well as the end-to-end evaluation of the system [5].
