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Automated Ambulance Dispatch Interoperability. Tony Yates Department of Health +44 7791278599 tony@nhs.net July 2012. Contents. Interoperability Landscape Initial Pilots What is Interoperability Dispatch Process Dispatch Message Contingency National Contingency.
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Automated Ambulance DispatchInteroperability Tony Yates Department of Health +44 7791278599 tony@nhs.net July 2012
Contents Interoperability Landscape Initial Pilots What is Interoperability Dispatch Process Dispatch Message Contingency National Contingency
What is Interoperability Semantic Interoperability Beyond the ability of two or more computer systems to exchange information, semantic interoperability is the ability to automatically interpret the information exchanged meaningfully and accurately in order to produce useful results as defined by the end users of both systems. To achieve semantic interoperability, both sides must refer to a common information exchange reference model. The content of the information exchange requests are unambiguously defined: what is sent is the same as what is understood. Spec 2.1 brings this Source: http://en.wikipedia.org/wiki/Interoperability
What can the message carry? Address – Structured Northing’s and Easting's Contact Details Chief Complaint (Primary Reason for call) Scene Safety Police Required Other information e.g access codes Response Requirement Secondary dispatch code Encounter Event
Address Structured – What is that? Unstructured Structured House Name House Number Street Name Town County Postcode Northings and Eastings • Address Line 1 • Address Line 2 • Address Line 3 • Address Line 4 • Address Line 5 • Postcode We are using this We are not using this
What if they don’t have all that? • The system will not be able to validate against the specification schema • This means they cannot send the message without the minimum required fields populated
Northings and Eastings? Some vendors have mapping technology that will allow them to populate at a higher level of granularity. This will allow them to populate N/E in the dispatch message.
I need Northings and Eastings Dispatch CAD’s need N/E to be able to dispatch to a location. Unless their systems can match the structured address to their gazetteer it will reject the message for a manual handover.
What are the contact details? The phone number to get in touch with the patient/caller should they need to be contacted
What about Chief Complaint This is known as primary reason for call in 111. It is collected before the call handler enters into a triage process (Pathways or similar) e.g I have a pain in my chest I am struggling to breath I slipped on a banana and hurt my back
Scene Safety? When the triage system asks the question “Is the scene safe for our crew to attend” a flag will be set in the message and an update sent to the CAD in real time. This happens for positive and negative responses These are known as trigger point updates
Police Notified Flag? When the triage system asks the question “Is the scene safe for our crew to attend” a flag will be set to notify that the police have been informed by the 111 provider in real time. This happens for positive and negative responses These are known as trigger point updates
Access Codes? There is a separate section for any other pertinent information such as access codes or information that may be useful for the crew. An update is sent in real time. This happens for positive and negative responses These are known as trigger point updates
Call Closed When the call is closed, a final message will be sent to the ambulance service to let them know the final state and notify that no other updates will be coming through.
Dispatch Codes There are two codes that can be sent. The 1st is mandatory and signifies the ambulance requirement, this is agreed by ECPAG. Code Description R1 Red 1 R2 Red 2 G2 Green 2 G3 Green 3 G4 Green 4
Dispatch Codes There are two codes that can be sent. The 2nd is optional as it may vary as other clinical content systems come online. DX010 DX011 Etc. These could also be AMPDS codes should the content not be Pathways based at the front end of 111. This second code will always be there in practice but if it isn’t the 1st one should be acted upon
Encounter Event? This is the triage questions and answers that are an output of pathways There are two flavors of this, the clinical summary which is a short version of the triage. There is also a full Q/A report. NHS Pathways decide what should be in this message.
What if all this fails? MOU’s will be in place for doing manual dispatch requests. These will go straight to the Ambulance service and will not be re-triaged. A minimum data set which is similar to the message content will need to be verbally handed over DDI’s will need to be created to circumvent the BT 999 operators and the caller being re-triaged.
How does it all work? Call Triage Auto Manual Dispatch Required Call Connect Call Connect 5 seconds on Avg. CAD Switch Trigger Point Updates Dispatch MDS 1 Min Avg CAD Dispatch
What if it none of this works? 999 Processes will be in place to dial 999. It is accepted in this very rare circumstance the caller will be re-triaged.
