Office of Preparedness and Emergency Operations

1
Office of Preparedness and Emergency Operations

• Electronic Medical Records and Patient Tracking

February 11, 2009
2
Agenda

• Overview
• Background
• Disaster Medical Deployment Suite (DMIS)
• Establishment of the DMISSC (Steering Committee)
• Documentation of Medical Care EMR
• Brief overview of Electronic Medical Records
  (EMR)
• Health Information Repository
• Brief overview of Health Information Repository
• Patient Tracking - JPATS
• Overview of Joint Patient Assessment and Tracking
  (JPATS)
• JPATS Demo
• Questions

3
ASPR Mission Vision

• Mission
• Lead the nation in preventing, responding to and
  reducing the adverse health effects of public
  health emergencies and disasters
• Vision
• A nation prepared to prevent, respond to and
  reduce the adverse health effects of public
  health emergencies and disasters

4
NDMS Mission Vision

• Mission
• Temporarily supplement Federal, Tribal, State and
  Local capabilities by funding, organizing,
  training, equipping, deploying and sustaining a
  specialized and focused range of public health
  and medical capabilities
• Vision
• Serve the Federal response by providing disaster
  medical care and patient movement

5
Overview - Background

• Triggers for ESF-8 Support
• In the event medical systems within a domestic
  disaster area are overwhelmed, there may be a
  need for a system to move patients out of the
  disaster area, prior to and/or after an event.
• Local authorities may operate Casualty Collection
  Points (CCPs) that feed into State-operated
  Regional Evacuation Points (REPs).

6
Overview - Background

• Triggers for ESF8 Support (continued)
• If State or local authorities become overwhelmed,
  Federal assistance may be requested to deploy
  appropriate assets to assist at CCPs or REPs
  (e.g., DMATs, or DoD, VA or HHS Public Health
  Service medical assets).
• If State or local authorities determine that
  resources are inadequate to transport or care for
  all patients, a request for Federal medical
  evacuation assistance can be initiated.

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Overview - Background

• Medical Care and Tracking of Disaster Patients
• ESF-8 is responsible for treating and tracking
  disaster victims seeking care throughout the
  continuum of medical care
• Onsite care ? NDMS teams, RDF, MRC, FMS Staff
  (variety of venues for medical care)
• During Transport ? DoD (air), ambulance contract
  , other modes as necessary
• Definitive Care ? NDMS Hospitals (FCC referred)

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Deployment System Footprint

• Disaster Medical Information Suite
• Electronic Medical Record System (EMR)
• Health Information Repository
• Joint Patient Assessment and Tracking System
  (JPATS)

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Deployment System Footprint
Health Information Repository
Future interface from JPATS to Repository
Electronic Medical Record (EMR)
Joint Patient Assessment and Tracking (JPATS)
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Overview - EMR

• Background and Benefits of Electronic Medical
  Records
• NDMS implemented an electronic medical encounter
  documentation system for the 2006 hurricane
  season
• Drive Standardization across ASPR medical
  response teams
• Implement consistent, automated encounter
  tracking during disaster deployments
• Provide basic data elements for health
  surveillance during disasters
• Provides legible medical records

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Overview EMR

• Deployment Systems Environment

12
Overview EMR

• Deployment System Environment

13
Overview EMR
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Overview EMR

• Footprint
• (8) Panasonic CF-18 Toughbooks (NDMS EMR
  client)
• (4) Panasonic CF-29 Toughbooks (Server
  Pharmacy Station/Backup Server)
• (3) Wireless Access Point
• (2) Ethernet Switch

15
Demonstration

• Electronic Medical Record

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Overview Health Information Repository

• Provides Situational Awareness Command
  Control
• Repository provides patient summary information
  to the Secretary's Operation Center (SOC) and
  Incident Response Command Teams (IRCT).
• Medical response teams transmit EMR records twice
  a day.
• Sit reps are due at 0700 and 1900.

17
Overview Health Information Repository
Data Being Pushed to the Repository
18
Overview Health Information Repository

• Health Surveillance Repository ? Patient Count
  by Age

19
Overview Health Information Repository

• Health Surveillance Repository? Overview of
  Response Stats

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Overview Health Information Repository

• Health Surveillance Repository Patients by State
• ?

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Overview - JPATS

• Joint Patient Assessment and Tracking System
  (JPATS)
• Used by patient tracking teams located at every
  major patient care and reception point
• System users are tied to a physical location
• Major response points include DMAT, FMS,
  Regional Evacuation Points (REP), FCC Patient
  Reception Area (PRA)
• Modified version of the DoD JPTA System
• Web based system providing capability for real
  time accountability of patients seen by ESF8
  personnel
• Requires connectivity to access JPATS web system
• Tracts patients not evacuees (ETAS or FEMA
  system)

22
Overview JPATS
23
Demonstration

• Joint Patient Assessment and Tracking System
  (JPATS)

24
Overview JPATS
25
JPATS Functions- Login Page
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JPATS Functions- Register/Search Patient
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JPATS Functions - Register Patient Search

• Registering a Patient Searching for existing
  Patients
• For this first iteration of JPATS, patients will
  be registered upon their first interaction with
  ESF8 personnel, whether in a DMAT BOO or within
  the DMA Strike Team
• All patients will be registered, regardless of
  the length of their encounter
• Registration requires searching for an existing
  patient using a Name, Date of Birth, Sex and an
  ID
• Five Possible ID Type Values
• Social Security Number
• Drivers License / Other
• Patient is Unconscious
• Patient Will Not Release
• Electronic Medical Record
• If a patient is found, the Search Results page is
  displayed. If not, the Register Patient page is
  displayed

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JPATS Functions- Register Patient
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JPATS Functions- Register Patient Search

• Since the Patient was not found, enter Medical
  Data on this patient
• Enter a Patient Type
• Options are ESF8, NDMS, Evacuee, Other, Unknown
• Enter an Injury Nature in the descriptive field
  
• Enter a Health Status
• Options are Critical, Priority, Routine,
  Deceased, N/A
• Enter a Category
• Options are Medical/Surgical, Psychiatric,
  Burns, Pediatric, Critical Care, Unknown
• Enter Location Data on this patient
• Enter an Originating Location If this is the
  first visit, enter First Visit
• Current Location will be defaulted from your User
  ID profile
• Enter Transport Type and Number If self, enter
  POV
• Enter Disposition and Date If no Disposition
  leave blank

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JPATS Functions- Incoming Patients
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JPATS Functions- Incoming Patients
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JPATS Functions- Incoming Patients

• Incoming Patients are those that have a
  Pending Transfer to your facility
• Incoming Patient Registration
• Simplified registration based upon accepting the
  patient
• Patient Status can be updated once registered in
  your facility
• Patient status needs to be updated until patient
  is repatriated
• This can be done either by the FCC or some agreed
  upon ESF-8 personnel

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JPATS Functions- Reports