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Flexible, Secure Health Telemetry from Ambulances to the Emergency Department

Executive Summary. Issue:Current ambulance-to-Emergency-Room workflow is simplistic and inefficient with respect to telemetrySecurity of patient data (HIPAA) is a concern for any changes to the workflowOpportunities for improving and advancing current operations:Digitizing the received ECG dataAdding audio, video, and still images of the patient to the transmissionProject:Collaboration between UVA Systems Engineering, UVA Hospital's Emergency Department, and Lockheed Martin to build a secure system capable of taking advantage of these opportunities.

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Flexible, Secure Health Telemetry from Ambulances to the Emergency Department

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    1. Flexible, Secure Health Telemetry from Ambulances to the Emergency Department A Systems Engineering Project with the University of Virginia Medical Center 1

    2. Executive Summary Issue: Current ambulance-to-Emergency-Room workflow is simplistic and inefficient with respect to telemetry Security of patient data (HIPAA) is a concern for any changes to the workflow Opportunities for improving and advancing current operations: Digitizing the received ECG data Adding audio, video, and still images of the patient to the transmission Project: Collaboration between UVA Systems Engineering, UVA Hospital’s Emergency Department, and Lockheed Martin to build a secure system capable of taking advantage of these opportunities 2

    3. General Health System Objectives 3

    4. Current ECG-Ambulance Workflow 4

    5. ECG as a fax Hard to share information with specialists when it is a sheet of paper May want more than just the standard few seconds of an ECG report The fax needs to be scanned again to be added to the EMR Anecdotally, this system is finicky Additional information could give more clinically relevant data E.D. may want to have the flexibility to collect and transmit other information from EMS while en route, and being locked into a proprietary system could be limiting in the future 5

    6. Cloud-Based Flexible Framework 6

    7. General Concept for New Structures 7

    8. Technology Involved 8

    9. Project Description We want to prototype and evaluate a first generation, cloud-based system Digitizing the ECG received by the physician Upgrading the current fax workflow Supplementing that telemetry with additional information without complicating the EMS workflow New opportunities for EMS to create audio and video clips and still images that are medically relevant to Emergency Department health care providers We will explore the corresponding needs for and issues related to additional security 9

    10. Focus #1: Digital ECG 10

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    12. Scientific Hypothesis Hypothesis: A rich stream of multimedia data including digital rather than faxed ECG will help Emergency Room physicians provide better, faster decision making as it relates to the care of patients who arrive at the hospital via ambulance. Methodology: Pilot study for 6 months in 12 ambulances Monitor system effectiveness Pre- and post- study data collection for comparison How much and how often the technology is used Time until patient disposition and or definitive care (quality indicator) Patient satisfaction scores with the care they received (quality indicator) Identify operational problems with the technology 12

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    14. Questions? 14

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