poul anders hansen's presentation from hospital + innovation 2015
TRANSCRIPT
Prehospital treatments – starting in the ambulancePoul Anders HansenMD, Head of the Prehospital Care Organisation,North Denmark Region.
Different ambulance service
• Ambulance only for transport – non or minimal treatment by ambulancpersonnel
• Treatment in ambulances at different levels (EMT and/or Paramedics) and transportation
• Ambulance is an hospitalbed on wheel
Why is treatment in ambulances necessary ?
Aalborg Univ. hospital
Sygehus VendsysselHjørring
Sygehus HimmerlandHobro
Sygehus HimmerlandFane
Sygehus Thy-MorsThisted
Nordjylland
Midtdjylland
Syddanmark
Sjælland
Hovedstaden
University Hospital
Hospital with emergency departments
Hospital without emergency department
Sygehus VendsysselFrederikshavn
Distance
Timedependent disease
You must have medical support to guide the ambulancepersonnel in treating patients?
You can use– Phone
– ECG, communication
– Electronic prehospital patient record– ECG, vitals, medication, triage, photo ect.
– Video contact with emergency departments and physician– Livestream video of the patient in ambulance
North Denmark Region• Have EMT and Paramedic in ambulances• We use
– Phone– Electronic prehospital patient record– Video conference
The developement plan was designed in a dialog between JUDEX, The Prehospital Organisation and Falck A/S.
There were two defined problems:1) A clinical need to optimize the prehospital care of the patient.
2) A need to optimize the communication between the prehospital staff and the hospital staff, and to improve the documentation in the patients medical record.
Electronic prehospital patient record amPHI
National solution in DenmarkOrganisation:• 5 Regions in Denmark (5.6 millioner inhabitant)
Projekt:• CSC won a national tender for a elektronic prehospital
patient record solution • amPHI in a new version from North Denmark Region
is now implemented in Denmark and it include about 500 ambulancer, Docters cars and 3 helicopters.
• One solution means that any ambulance i Denmark can hand over a patient to any ED in Denmark, giving the same information to the ED personel.
Nordjylland
Midtdjylland
Syddanmark
Sjælland
Hovedstaden
8
amPHI™ evolution
The digital North Jutland
Quality control (Falck)
Feedback from hospitals
Beta test
46 ambulances i The North Denmark Region
Emegency response vehicles (doctor)8 ambulances in marginal areas
Acute Medical Coordination
10 Emergency response vehicles (paramedics)
Tele-ECG
2002
2003
20082007200620052004
2009
2010
Communication with ambulances
Emergency helicopterPrehospital ECG in EPJ
Integration to C-View og EPJ
Wireless transmission from ambulances of sound clinical data, ECG as well as an ongoing video transmission
Prehospital telemedicine ( Doctor at distance )ECG
VIDEO
Internet hot spot
Hot spot
PHONE
RECORD
Dispatch centre
PAS/EPR
Interactive boards
Prehospital record
Central services
1) Tra
nsport
3) Treatment info
2) Patient history
2) Patient history
4) Prehospital record
1) 2) 3) 4)
Emergency solution overview1) Transport information:• Accident and possible patient information
2) Patient history: admission• Person id and demographics• Previous hospital admissions and diagnosis• Critical medical data (i.e. conditions and allergies, medicine)
3) Prehospital treatment information:• Status / diagnosis, treatments, medications• Various scores related to patient condition (i.e. trauma, triage)• Vital signs (i.e. hart rate, blood pressure, pulse) and other
measurements from patient monitor
4) Prehospital record information:• Complete prehospital record• Various scores (i.e. trauma, triage)• Vital signs (i.e. hart rate, blood pressure, pulse)• ECG’s
Dispatch centre
PAS/EPR
Interactive boards
Data flow:• Complete prehospital record to the EPR• Various scores to the ERP• Vital signs to the EPR• ECG’s to the EPR
Prehospital record
Central services
4) Prehospital record
Export to acute EPR
Correct treatment and visitation are the key-words
• ECG is sent directly from the ambulance to the doctor in the cardiology department
• the result can be seen in the electronic journal
128 km between patient and doctor
Mobilt hotspot
Docters terminal
Video konference from location and during transport to hospital
Video based communication between ambulance and relevant medical speciality at hospital
Ambulance
“Doctor at distance”
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