[Slide 1]{.underline}

Logos for American College of Emergency Physicians (registered
trademark), Infinity Healthcare, Medical College of Wisconsin, EMSystem
(registered trademark) and National Institute for Medical Informatics
are included on this slide.

First Responder EHR

American Health Information Community Electronic Health Record Workgroup

May 2, 2006

Edward Barthell MD MS

American College of Emergency Physicians

[Slide 2]{.underline}

Heading: First Responders

Listed are: Fire Departments, Police Departments, Emergency Medical
Services (EMS), and Hospital Emergency Departments.

A photo of emergency room is repeated at the bottom of the slide.

[Slide 3]{.underline}

Heading: Different Scenarios - Different First Responders - Different
Data Needs

Listed are: Routine daily care (Geriatric situations, impaired pts),
Kinetic energy trauma (Plane crash, explosion), Toxic or radiologic
exposure (Tokyo subway sarin), Emerging infectious disease -- pandemic
(Crypto, Monkey pox, SARS, influenza)

To the right, it says: Flexible Systems Required and 3 photos a
microscopic organism, an explosion and a person in scrubs examining a
chicken.

[Slide 4]{.underline}

Heading: Discrete Data Needs --Communication

The following is presented in a table format with two column headings:
Routine and Disaster.

Row 1: Prehospital EMS

Under the heading called Routine are listed: Demographics, Meds --
Allergies, Problem List, Advanced Directives, Destination?

Under the heading called Disaster are listed: Patient ID#, Red -- Yellow
-- Green, Destination?

Row 2: Hospital EDs

Under the heading called Routine are listed: Demographics -- PMD, Meds
-- Allergies, Problem List, Advanced Directives, Previous EKG, What's
coming?, Available inpatient space?

Under the heading called Disaster are listed: Demographics - ID#, Meds
-- Allergies, What's coming?, Available destinations?

[Slide 5]{.underline}

Heading: Mechanisms to make data available

Under the subheading called: Prehospital EMS, the following are listed:
Radio notification from dispatch, Pagers -- Cell phones commonly
available, Paper based charting predominates, Patient tracking systems
evolving, est \<15%, Electronic charting systems evolving, est \<15%,
Wireless network access evolving

Under the subheading called: Hospital EDs, the following are listed:
Registration / ADT systems, est \>95%, Internet access now available,
est \>95%, Web based capacity / diversion systems common, est \>50%,
Electronic tracking systems becoming common, est \>30%, Electronic
physician charting still evolving, est \<15%

[Slide 6]{.underline}

Under the heading: References, the following are listed:

Barthell, E, Kulick S, Felton CW, Silva JS, Schwartz RJ, Reece GA:
Session 107: The National Information Infrastructure Health Information
Network NII-HIN. Proceedings of the 1996 Annual HIMSS Conference,
Atlanta, GA, March 3-7, 1996; 4:157-167.

Cordell WH, Overhage JM, Waeckerle JF for the Information Management
Work Group: Strategies for improving information management in emergency
medicine to meet clinical, research, and administrative needs. Annals of
Emergency Medicine 1998; 31:172-178.

Barthell EN, Cordell WH, Moorhead JC, Handler J, Feied C, Smith MS,
Cochrane DG, Felton CW, Collins MA: The Frontlines of Medicine Project:
A Proposal for the Standardized Communication of Emergency Department
Data for Public Health Uses Including Syndromic Surveillance for
Biological and Chemical Terrorism. Annal of Emergency Medicine 2002;
39:422-429.

Barthell EN, Pemble KR: The National Emergency Medical Extranet Project.
The Journal of Emergency Medicine 2003; 24:95-100.

Barthell EN, Foldy SL, Pemble KR, Felton CW, Greischar PJ, Pirrallo RG,
Bazan WJ: Assuring Community Emergency Care Capacity with Collaborative
Internet Tools: The Milwaukee Experience. J Public Health Management
Practice 2003; 9:35-42.

Under the heading called: Standards activities, the following are
listed: HL7 -- Technical workgroup developing EDIS functional model and
V2.0 of Data Elements for Emergency Department Systems (DEEDS), NHTSA
Uniform Prehospital Dataset V2.0 for EMS, see also NEMSIS.org, OASIS
EDXL -- CAP and HAVE specifications for alerting and hospital capacity
reporting