CrashHelp: An Innovation to Improve Traffic Crash Emergency Medical

Response!

Thomas Horan, Ph.D.!Benjamin Schooley, Ph.D. !

May 25, 2011!

Research Aims

! Our research goal is to develop and test models and tools to improve technology enabled EMS systems.

! Our focus: ! How can we more effectively collect, share, and visualize

information? ! What existing and emerging technologies could be

applied? ! What are the best practices and how can we improve

upon them?

Research Activities

!  Conceptual Model – 2004-2006 ! Development of Time-Critical Information Services

Model for EMS that emphasizes end-to-end performance

!  Case Study Research – 2005-2009 ! Two case studies to validate the model and explore

best practices: San Mateo County, Mayo Clinic Trauma System

!  Prototype Development and Testing – 2009-present ! Review of Comparative Cases ! Design and Testing of prototype: CrashHelp

Background: ITS and EMS

! The four “E’s” of transportation safety (USDOT, 2006) ! Education, Engineering, Enforcement, Emergency medical

services (EMS)

“EMS is the Safety-Net of Transportation, it needs to be there when the other three E’s fail” - Idaho EMS Director

! ITS is needed to: ! Support the end-to-end emergency response process ! Provide information that can be used at the point of care, as well

as to guide traffic safety analysis and improvements.

Background: MVC’s and EMS

! Almost 35,000 traffic related fatalities per year ! Approximately 60% are on rural roads, 70% in

Minnesota ! Medical and emergency service costs are roughly 15

percent of the cost of MVC’s (NHTSA, 2008) ! According to FHWA, in 2005 dollars, the average cost of

a fatality was $3,246,192 and the average cost of an injury was $68,170

! Timely and effective emergency medical response to MVC’s can significantly reduce the likelihood of death, disability, and economic consequences.

Background: EMS

! An essential medical care safety net in the U.S. ! Over 240 million 9-1-1 calls every year (2009,

FCC) ! Over 6,000 9-1-1 call centers ! Over 16 million medical transports to hospitals

(IOM, 2006) ! Over 4,800 emergency departments (GAO,

2006) ! 80% of fire service calls are now EMS related

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!  Many existing and emerging technologies

- NextGeneration 911 - IP telephony - AACN - Mobile phones

- Computer Aided Dispatch (CAD) - GPS/AVL/GIS - Navigation - Pagers, cell phones - Interoperable 2-way radios

- e-Patient care records (PCR) - Hospital availability/ diversion systems - Patient tracking systems

Research Findings !

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!  Major Gaps Information exchange from pre-hospital to hospital

Research Findings !

CrashHelp High Level Design Principles

! Solution must facilitate information hand-off at or before patient hand-off to ED

! Solution must facilitate coordination across EMS organizations

! Solution must interfere in least possible way with medical care processes and practices

! Solution must provide value added context to decision makers at ED/Trauma Center

! Users must be protected from themselves (security & privacy)

! Users must want to use it, be able to use it, like to use it ! Leverage growth of mobile computing (smartphones) ! Leverage expansion of cell phone network ! Leverage the web

CrashHelp System Prototype

CrashHelp System Architecture

Mobile Phone Application

! Secure login ! Add new Incident ! Review existing incidents

! Take Pictures and Video

Mobile Phone Application

! Review, delete, encrypt, pictures, video

Mobile Phone Application

! Record audio messages, Paramedic/EMT verbal snapshot: ! Vitals ! Origin of incident ! Mechanism of Injury ! Treatments given ! Other: e.g., patient

history

Mobile Phone Application

! Review and add basic patient

data

(gender, age, And name)

Mobile Phone Application

! Choose destination ! Get location ! Send phone number ! Send EMS personnel info ! Send data ! Data encrypted and stored

securely on device and is “purged” after sending

! Data sends only when phone has a connection ! Text message sent to

ED staff member

Mobile Phone Application

Web Application

Web Application

Web Application

Web Application

Web Application

Web Application

Pilot Test & Evaluation ! Improved information collection by on-scene

EMS personnel

! Improved communication between pre-hospital transport and hospital organizations (ED / Trauma)

! Improved care decision making by hospital personnel (for some incidents)

! Improved resource utilization by hospital personnel

Questions?

Acknowledgements

! Sponsors: ! ITS Institute, Center for Transportation

Studies, Center for Excellence in Rural Safety

! CrashHelp Team: ! Drs. Benjamin Schooley, Brian Hilton ! Yousef Abed, Joe Roberts, Abdullah Murad

Publications Phase III Schooley, B., Horan, T., Hilton, B., McClintock, R., Lee, Y. (2010). CrashHelp: Iterative Design, Development, and Evaluation of a

GIS Tool for Managing Emergency Medical Responses to Motor Vehicle Crashes. ISCRAM2010: 7th International Conference on Information Systems for Crisis Response and Management. May 2-5, Seattle, WA. BEST PAPER AWARD

Schooley, B., Horan, T., Marich, M. (2009). User Perspectives on the Minnesota Inter-organizational Mayday Information System, in Van De Valle and Turoff (eds.) AMIS Monograph Series: Volume on Information Systems for Emergency Management. IDEA Press..

Schooley, B., Horan, T., Marich, M., Hilton, B. (2009). Integrated Patient Health Information Systems to Improve Traffic Crash Emergency Response and Treatment. Presented at the 42nd Annual IEEE Hawaii International Conference on Systems Sciences (HICSS), Waikoloa Village, Hawaii, January 6-9, 2009.S

Phase II Schooley, B., Marich, M., and Horan, T. (2008). Understanding IT Governance in the San Mateo County EMS System. Presented to

the 5th International Conference on Information Systems for Crisis Response and Management (ISCRAM), May 4-7, 2008, Washington, D.C.

Schooley, B., and Horan, T. End-to-end Government Performance Management Through Inter-organizational Information Integration: Case Study of Emergency Medical Services, Government Information Quarterly, 24(4), 755-784, 2007.

Horan, T., and Schooley, B. Time-Critical Information Services, Communications of the ACM, Vol. 50, No. 3, 2007, 73-78. Horan, T., Kaplancali, U., Burkhard, R., and Schooley, B.. Inductive Design and Testing of a Performance Ontology for Mobile

Emergency Medical Services, in Ramish, R., (ED.) Ontologies for Information Systems, IDEA Press, 2006. Marich, M., Horan, T., and Schooley, B. (2006). Implications of Time-Critical Information Services on Emergency Response ITS

Architecture. Submitted to 12 th Annual Americas Conference on Information Systems (AMCIS), Acapulco , Mexico, August 4-6, 2006.

Phase I Horan, T., Marich, M., and Schooley, B., Time-critical Information Services: Analysis and Workshop Findings on Technology,

Organizational, and Policy Dimensions to Emergency Response and Related E-governmental Services, Proceedings of the 2006 International Conference on Digital Government Research, ACM International Conference Proceeding Series, Vol. 151, June, 2006.

Horan, T., McCabe, D., Burkhard, R., Schooley, B., Performance Information Systems for Emergency Response: Field Examination and Simulation of End-To-End Rural Response Systems, Journal of Homeland Security and Emergency Management, 2: 1, Article 4, 2005.

Horan, T., and Schooley, B. (2005). Interorganizational Emergency Medical Services: Case Study of Rural Wireless Deployment and Management. Information Systems Frontiers, 7(2), pp. 155-173.

Horan, T., and Schooley, B. (2005). End-to-End Assessment of E-Governmental Services: Lessons from a Multi-method Approach to Time-Critical Information Services. In Proceedings of The 6th National Conference on Digital Government Research, Atlanta , GA , May 15-18.

Horan, T., Schooley, B., and Dadabayeva, N. (2003). Case Study of Wireless EMS in Small Town and Rural Environments. Presented at the 82nd TRB Annual Meeting, Washington , D.C. , January 12-16.