EMS Interoperability Solutions
0.1.1-current - ci-build International flag

EMS Interoperability Solutions, published by IHE Patient Care Coordination Technical Committee. This is not an authorized publication; it is the continuous build for version 0.1.1-current). This version is based on the current content of https://github.com/IHE/EMS-Overall/ and changes regularly. See the Directory of published versions

Use Case: Paramedicine Care Flow

When an ambulance transports a patient to a hospital for medical care, scene information, transfer information, patient assessments, and interventions are only verbally available to hospitals when the patient arrives. This results in inefficiencies and potential errors in the patient care process. This profile will map the flow of the patient information from the ambulance patient record, commonly known as the electronic Patient Care Report (ePCR), to the hospital Electronic Medical Record (EMR).

High-Level Paramedicine Care FlowAmbulanceAmbulanceHealth Information ExchangeHealth Information ExchangeHospitalHospitalStateState1(PD) Patient lookup by demographics2(QD/RD/C-CDA) Find/Retrieve best Medical Summary3Utilize Medical Summary to treat patient4(PUSH/PCS) transport summary5(Pub) Publish Discharge Summary6(QD/RD) Query/Retrieve - Discharge Summary7Deliver NEMSIS PCR including outcome data to the state


Figure: Use Case 1a High-Level Process Flow

The following diagram goes into transactional and content details.

Detailed - Paramedicine Care FlowAmbulanceAmbulanceHealth Information ExchangeHealth Information ExchangeHospitalHospitalStateState1(PD) Patient lookup by details that you have2Review results for best patient match3(QD) Look for Medical SummaryQuery for typeCode=LOINC34133-9LikelyOnDemand Document Entry.4Here is the list of possible Medical SummariesCCD / IHE-XPHR,C-CDAorIPS5pick the freshest or best entry from available document entries6(RD) Retrieve this document7Utilize Medical Summary to treat patient8(PUSH) transport summaryIHE-Paramedicine Care Summary (PCS)9Drop off patient at Emergency Department10Admit patient (ADT)11Admit details (undefined method)John/Jane Doe handling with temporary identityNeed Discharge Summary for reportingQuery for typeCode=LOINC18842-5Better - serviceStartTime=(time patient was dropped off)Best - referenceIdList=(admit detail)Document Content:XDS-MS Discharge Summary OptionorC-CDA Discharge Summary Optionalt 1: Subscribecould subscribe if HIE supports XDS Subscribe12Subscribe for Discharge Summary on this patientalt 2: Pollmust poll if subscribe is not available, or cross-community13(QD) Query, is the patient discharged yet?14Not yet15Discharge patient (ADT)16(Publish) Discharge Summary17(QD) Query for Discharge Summary18Here is the Discharge Summary details19(RD) Retrieve Discharge Summary20Here is the Discharge Summary21Extract some elements22Insert the received outcome data into the existing NEMSIS PCRNEMSIS PCR23Deliver NEMSIS PCR including outcome data to the state


Figure: Use Case 1 Process Flow