Wireless medical records system comes to Indianapolis

Health specialists in Indianapolis have established the nation’s first ambulance-based information system that allows paramedics and emergency medical personnel immediate access to the statewide electronic health records (EHRs) of patients.

The Regenstrief Institute and Wishard Health Services set up the system earlier this year with grants from the Health and Human Services and Homeland Security departments. The goal is to help the medics provide more effective emergency care to patients by having real-time access to a digital record of the patients’ pre-existing medical conditions, previous treatments, allergies, current medications and other information.

“We are the first in the country to push out statewide information,” Dr. John Finnell, a Regenstrief investigator and associate professor of emergency medicine at the Indiana University School of Medicine, said today.

Currently, some ambulances have computer applications on board that can identity whether a patient has been transported before, and the reasons for the transport, and some medical facts about the patient. The Regenstrief system is automatically making available a much broader amount of the patients’ medical information in real time to ambulance systems in Indianapolis and its suburbs.

About eight of the 20 ambulance systems in the city and its suburbs have signed up thus far, and the largest system has been using the data in the field since June, Finnell said. Eventually, as more systems join in, the system could be providing data to 1,500 authorized personnel, he said.

The ambulance-based system is similar to what is already being done in Indiana’s hospital emergency rooms, which can access statewide EHRs. The system is slightly more limited in scope; for example, it has information such as whether the patient has a chronic disease, such as high blood pressure or congestive heart disease, but does not include radiology results.

The system seeks to provide the patient health data on the way to the accident or incident scene so that care at the scene can begin immediately, Finnell said. Typically, when a call is reported to 911, the dispatch center automatically picks up a name and location. Based on that information, EHRs are accessed automatically and transmitted to ambulances.

If there is a discrepancy and the name and address do not match on both sets of records, no records are sent to minimize errors, Finnell said. If more information is provided, such as a Social Security number, the system will send the records.

The system is fast, accurate and automatic to deal with situations where patients may be unconscious and unable to provide basic information or may not recall important medical details about their health.

“Patients don’t remember the details of their medical history,” Finnell said. “They don’t know their medications, and they don’t realize that [medical computer systems] don’t routinely talk to each other.”

Starting in January, Finnell said he will be researching how the medics use the system and how it affects their workflow. That study will take about a year.

“There are a lot of workflow considerations, and you can definitely introduce other types of error,” Finnell said. “We want to describe what problems we see, either with connectivity, or with using information to alter care. The medics are used to working in a vacuum; now that they have additional information, how does that change what they do?"

In Washington, the Obama administration and Congress have approved more than $19 billion in economic stimulus law money to speed the adoption of EHRs nationwide.