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HomeMy WebLinkAboutAgenda PacketCITY OF NEWPORT BEACH CIVIL SERVICE BOARD AGENDA Council Chambers - 100 Civic Center Drive, Newport Beach 92660 Monday, June 5, 2017 - 5:00 PM Civil Service Board Members: Maiqual Talbot, Chair Roberta Fesler, Vice Chair Robyn Grant, Board Member Douglas Wood, Board Member Sharon Wood, Board Member Staff Members: Barbara J. Salvini, Human Resources Director/Secretary to the Board Andrew Maiorano, Deputy City Attorney Traci Mackinen, Administrative Assistant to the HR Director The Civil Service Board meeting is subject to the Ralph M. Brown Act. Among other things, the Brown Act requires that the Civil Service Board agenda be posted at least seventy-two (72) hours in advance of each regular meeting and that the public be allowed to comment on agenda items before the Board and items not on the agenda but are within the subject matter jurisdiction of the Civil Service Board. The Chair may limit public comments to a reasonable amount of time, generally three (3) minutes per person. The City of Newport Beach’s goal is to comply with the Americans with Disabilities Act (ADA) in all respects. If, as an attendee or a participant at this meeting, you will need special assistance beyond what is normally provided, we will attempt to accommodate you in every reasonable manner. Please contact Barbara Salvini, Human Resources Director, at least forty-eight (48) hours prior to the meeting to inform us of your particular needs and to determine if accommodation is feasible at (949) 644-3256 or bsalvini@newportbeachca.gov. NOTICE REGARDING PRESENTATIONS REQUIRING USE OF CITY EQUIPMENT Any presentation requiring the use of the City of Newport Beach’s equipment must be submitted to the Human Resources Department 24 hours prior to the scheduled meeting. I.CALL MEETING TO ORDER II.ROLL CALL III.FLAG SALUTE IV.PUBLIC COMMENTS Public comments are invited on agenda and non-agenda items generally considered to be within the subject matter jurisdiction of the Civil Service Board. Speakers must limit comments to three (3) minutes. Before speaking, we invite, but do not require, you to state your name for the record. The Civil Service Board has the discretion to extend or shorten the speakers’ time limit on agenda or non-agenda items, provided the time limit adjustment is applied equally to all speakers. As a courtesy, please turn cell phones off or set them in the silent mode. V.CONSENT CALENDAR APPROVAL OF CIVIL SERVICE BOARD MEETING MINUTESA. 1.APPROVE MINUTES FOR THE MAY 1, 2017, REGULAR MEETING. Waive reading of the subject Minutes, approve as written and order filed. File: Draft Minutes of May 1, 2017 VI.CURRENT BUSINESS ORAL REPORTSA. June 5, 2017 Page 2 Civil Service Board Meeting 1.CITY-WIDE AND HUMAN RESOURCES MATTERS - Barbara J. Salvini, Human Resources Director 2.FIRE DEPARTMENT MATTERS - Jeff Boyles, Acting Assistant Fire Chief 3.POLICE DEPARTMENT MATTERS - Jonathan Stafford, Deputy Director of Police Services File: Fire - JEMS Magazine VII.CIVIL SERVICE BOARD ANNOUNCEMENTS OR MATTERS WHICH MEMBERS WOULD LIKE PLACED ON A FUTURE AGENDA FOR DISCUSSION, ACTION OR REPORT (NON-DISCUSSION ITEM) VIII.ADJOURNMENT DraftCITY OF NEWPORT BEACH CIVIL SERVICE BOARD MINUTES Council Chambers 100 Civic Center Drive Monday, May 1, 2017 Regular Meeting 5:00 p.m. I.CALL MEETING TO ORDER Chair Talbot called the meeting to order at 5:00 p.m. II.ROLL CALL Civil Service Board Members: Maiqual Talbot, Chair Roberta Fesler, Vice Chair (absent) Robyn Grant, Board Member Douglas Wood, Board Member Sharon Wood, Board Member Staff Members: Barbara Salvini, Human Resources Director Andrew Maiorano, Deputy City Attorney Traci Mackinen, Administrative Assistant to the HR Director III.FLAG SALUTE – Led by Board Member Grant IV.PUBLIC COMMENTS None. V.CONSENT CALENDAR A.APPROVAL OF CIVIL SERVICE BOARD MEETING MINUTES 1.APPROVE MINUTES FOR THE APRIL 3, 2017, REGULAR MEETING. Chair Talbot corrected "Policy Academy" in the last bullet on page 4 to "Police Academy". Motion made by Board Member Sharon Wood, seconded by Board Member Doug Wood, to approve the Minutes for the April 3, 2017, regular meeting as amended. Motion carried 4-0. AYES: Grant, Talbot, D. Wood, S. Wood. NOES: None ABSTAIN: None ABSENT: Fesler DraftMay 1, 2017, NB Civil Service Board Minutes Page 2 of 7 VI. CURRENT BUSINESS A. ORAL REPORTS 1. CITY-WIDE AND HUMAN RESOURCES MATTERS – Barbara Salvini, Human Resources Director HR Director Barbara Salvini reported: • Congratulations to Acting Fire Chief Chip Duncan as he has been selected as the new Fire Chief. • The City's negotiating team is meeting with the Association of Newport Beach Ocean Lifeguards and Police Officers Association, whose employment agreements expire in June. • The annual Employee Service Awards is scheduled for June 15, 2017. The top five candidates for the Dorothy Palen – Employee of the Year award are Roger Bartholow, Facilities Maintenance Worker II in Recreation and Senior Services; Anne Donnelly, Police Dispatcher in the Police Department; Joe Harrison, Fire Paramedic in the Fire Department; Faz Kiatkwankul, Senior IT Applications Analyst in the City Manager/IT Department; and Gregg Ramirez, Senior Planner in the Community Development Department. • The HR Department has hired Tosha Sanchez as its full-time Department Assistant. She had been working part-time for the City. • An employee training on Effective Business Writing was just completed and focused on the writing of everyday items such as letters, emails, and memos; the mechanics of good writing; and correcting common grammatical errors. • The City of Newport Beach Scholarship program closed on Friday with 21 submissions. Six $700 scholarships will be awarded this year. In response to Board Member Grant's question, Ms. Salvini advised that the Employee Service Awards event begins at 11:30 a.m. in the Community Room. 2. FIRE DEPARTMENT MATTERS – Jeff Boyles, Acting Assistant Fire Chief Acting Assistant Fire Chief Boyles reported: • Acting Fire Chief Chip Duncan was named Fire Chief and the department was very happy about this permanent placement. DraftMay 1, 2017, NB Civil Service Board Minutes Page 3 of 7 • Terrorism Liaison Officer (TLO) training for all firefighters in the county was held in Newport Beach. Board Member Grant attended and completed the training. • The Fire Department accepted delivery of a new ambulance for the Corona del Mar Fire Station. A resident donated $250,000 towards this purchase. • Wildland fire season has begun and to date there have been fires in San Bernardino and Riverside. Newport Beach firefighters are ready to assist with fires in the County. • Fire Captain recruitment is underway with 21 candidates. • On April 14, an MCI (Mass Casualty Incident) crash/rescue drill was held at John Wayne Airport. • A fire occurred off Vista Ridge on April 28. A County helicopter and fire engines from around the County provided assistance. Heavy vegetation growth and the recent rains are a concern for the coming dry season. • On April 29, Fire Engineer John Mollica, Fire Captain Dan Chapman, and Fire Paramedic Bryan Carter participated in the Donate Life 5K walk at Cal State Fullerton. • The Orange County Marathon is scheduled for Sunday, May 7. • On May 18, Board Member Grant is hosting Government Day at City Hall. • May 20 is Public Safety Day with events being held at the Police Department and behind Fire Station 3. • CERT spring training programs are completed with 42 participants completing the 24-hour programs and Drill the Skills. • The fourth annual Neighborhood Drill was held on April 29 with 12 neighborhoods participating. The CERT volunteers distributed 8,500 door hangers. • In April, the Fire Department responded to 981 total dispatches, 746 of which were medical calls. Of the 746 medical calls, 572 involved transportation via ambulance to the hospital. DraftMay 1, 2017, NB Civil Service Board Minutes Page 4 of 7 • The Newport Beach Fire Department is number one in Orange County for incidents of regaining a heartbeat in patients in full arrest. EMS personnel regained a pulse in 30.9% of arresting patients upon arrival at the hospital. • Marine Operations statistics for April: Public Assists/Preventative Actions 9,921 Boat Calls 184 Medical Aids 249 Rescues 154 Estimated Beach Population 970,000 • On April 12, Human Resources conducted interviews and background checks for 25 candidates to begin the Basic Lifeguard Academy. • On April 20, Lifeguards learned of a 55-foot whale carcass off the Newport Pier. The following day, Lifeguards towed the carcass 7 miles out to sea, but then the carcass drifted back in near Laguna Beach. Lifeguards then towed the carcass 14 miles out to sea. Municipal agencies have a federal EPA permit allowing the transport of marine carcasses for disposal at sea. • Junior Lifeguards have ordered a Viking all-terrain vehicle to transport kids, instructors, and equipment. In response to Board Member Grant's questions, Acting Assistant Fire Chief Boyles advised that the donors for the ambulance are open to some public recognition of their donation and to having their donation noted on the ambulance but declined to announce their identity at that time. He will coordinate with the donors with respect to publication of their information. Battalion Chief Brian McDonough reported a high-angle rescue exercise was held at Bonita Canyon on Sunday. In reply to Board Member Sharon Wood's inquiry, EMS Division Chief Kristin Thompson stated staff is now studying administration of CPR by individuals. During January, February, and March, about 3% of the population received CPR prior to EMS arrival. Staff is now tracking the numbers for administration of CPR and use of AEDs prior to EMS arrival. To date, the Fire Department has trained 340 civilians in CPR and will continue training during the year. 3. POLICE DEPARTMENT MATTERS – Damon Psaros, Police Lieutenant Lieutenant Psaros reported: DraftMay 1, 2017, NB Civil Service Board Minutes Page 5 of 7 • He acknowledged Board Member Grant for hosting Government Day, congratulated Fire Chief Duncan on his promotion, and thanked the Fire Department for its response to a recent officer-involved shooting (OIS). • On April 15, 2017, the Dispatch Center received a 911 call regarding a domestic violence incident. On arriving at the scene, the police officer determined the suspect had a knife. In compliance with instructions, the suspect dropped the knife but picked it up again. Fearing for his safety, the officer fired at the suspect. The suspect was pronounced deceased on arrival at the hospital. • The California Public Radio Association named Anne Donnelly as runner up for Dispatcher of the Year on April 13, 2017. • During Volunteer Appreciation Week, the Police Department celebrated 30 volunteers with notes, gifts, and an awards dinner. OneOC, an Orange County nonprofit resource center, distributed Presidential Service awards to volunteers for their work in 2016. • Two of the 30 Police Department volunteers will be retiring from the program. Four applicants are undergoing background checks, and four additional applicants are on a wait list. • Officers have been using focused patrols to fight burglaries and other property crimes. The Police Department is moving to a DDACTS (data-driven approach to crime and traffic safety) model for policing. • Two recruits are in the Police Academy and doing well. Two additional recruits received conditional job offers and began the Costa Mesa pre-academy. Unfortunately, one recruit in the pre-academy resigned his position. • A probationary officer has resigned his position. • In April, the Police Department received 6,668 calls for service, an increase over the 6,106 calls in April 2016. • As of April 26, 2017, Part I crime has decreased 1.1% due to 5 fewer auto burglaries, 11 fewer bike thefts, and 10 fewer petty thefts. DraftMay 1, 2017, NB Civil Service Board Minutes Page 6 of 7 • Police officers are now using their mobile data computers (MDC) inside the station rather than using desktop computers. As a result, the Police Department will provide docking stations for MDCs in the station. • A contract for the Mobile Video System (MVS) project and a dispatch console project will be presented to the City Council on May 9. The dispatch console project will replace all six positions in dispatch and create more interoperability with agencies in different counties. • Public Safety Day is scheduled for May 20, 2017. Chair Talbot requested statistics from the Police Department's focus on distracted drivers. In reply to Board Member Grant's question, Lieutenant Psaros advised that only a few mounts for MDC docking stations will be needed. The cost will be minimal and allocated from the current IT budget for the Police Department. The Police Department is requesting funds for the dispatch console project in order to take advantage of a substantial price discount currently being offered now. In response to Board Member Doug Wood's inquiry, Lieutenant Psaros indicated Public Safety Day will be held in the Police Department parking lot. VII. CIVIL SERVICE BOARD ANNOUNCEMENTS OR MATTERS WHICH MEMBERS WOULD LIKE PLACED ON A FUTURE AGENDA FOR DISCUSSION, ACTION OR REPORT (NON-DISCUSSION ITEM) Board Member Sharon Wood announced she would not be present for the June Civil Service Board meeting. Chair Talbot, on behalf of the Board, congratulated Chief Duncan on his promotion. Fire Chief Duncan thanked Chair Talbot and the Civil Service Board for their support. VIII. ADJOURNMENT - There being no further business to come before the Civil Service Board, the meeting was adjourned at 5:38 p.m. The agenda for the Regular Meeting was posted on Thursday, March 30, 2017, before 5:00 p.m., on the City’s website, public counter in the Human Resources Department (Bay A2) and in the Meeting Agenda Binder located in the entrance of the City Council Chambers at 100 Civic Center Drive. DraftMay 1, 2017, NB Civil Service Board Minutes Page 7 of 7 Prepared by: Traci Mackinen, Administrative Assistant to the HR Director City of Newport Beach Approved by: Maiqual Talbot, Chairperson Civil Service Board 2016/2017 FEBRUARY 21–23, 2018, CHARLOTTE, NCwww.emstoday.com The future is now, p. 8 Orange County, Calif., medics access patient histories, p. 24 Using data to prove value of MIH-CP programs, p. 30 CRUCIAL DATA MAY 2017 EVENT Medicine p. 36 CLEAN Ambulances p. 44 PULSE Oximetry p. 48 EXERTIONAL Heat Stroke p. 54 1705JEMS_C1 1 4/21/17 9:20 AM CSB Meeting - June 5, 2017 Fire Dept. Handout 24 JEMS | MAY 2017 www.jeMs.coM 1705JEMS_24 24 4/21/17 9:18 AM CSB Meeting - June 5, 2017 Fire Dept. Handout www.jems.com mAY 2017 | JEMS 25 Orange County, Calif., begins field implementation of EMS access to patient history via bidirectional information exchange By Daniel R. Smiley & Samuel J. Stratton, MD, MPH, FACEP, FAAEM You and your partner respond to a 9-1-1 call for a woman with altered mental status. After ensuring there are no immediate life threats and completing your initial assessment, you attempt to get informa- tion about the patient’s medical history, current medications and allergies. She isn’t able to offer clear information on her current medications, and when you turn to the family, the patient’s family member hands you a bag with at least 15 different medications. This is an all-too-familiar scenario for many EMS responders. EMTs and para- medics typically rely only on those on scene to volunteer critical medical infor- mation prior to treatment: the patient, family members, friends or others. A patient’s past medical history is other- wise unknown, leaving EMS providers to start from scratch as they input the patient’s data into their electronic patient care report (ePCR) system and, eventu- ally, transmit relevant data to the receiv- ing hospital via radio or cell phone. This traditional model is prone to errors and inaccurate data and is simply inefficient. In Orange County, Calif., however, it’s a completely different picture following the field implementation of +EMS and the Search, Alert, File and Reconcile (SAFR) model for health information exchange (HIE), which provides a patient’s medical information at providers’ fingertips within seconds. To accomplish this, an estab- lished HIE is augmented by the alerting and bidirectional data flow capabilities in ImageTrend’s Health Information Hub (HIH) and Hospital Hub to facilitate the technical interactions among EMS, the HIE and hospitals. Here’s how it works: As the medic is evaluating and treating a patient in the field, they use their ePCR software, ImageTrend Elite, to search for the patient by first and last name, gender and date of birth. The field EMS data tab- let connects to a cloud-based HIE through HIH, where the patient’s cumulative hospital, medical provider and EMS electronic medical record is identified, allowing the medic to immediately populate the ePCR with the patient’s medications, allergies, recent hospitalizations and past medical history. An alert within Hospital Hub noti- fies the receiving hospital of the incom- ing patient and receives pre-arrival field and medical record information trans- mitted from EMS to the ED, including: primary impression, age, gender, arrival times, vitals and procedures—including 12-lead ECGs—performed by the EMS Health information exchange programs facilitate the secure sharing of a patient’s health information throughout the continuum of patient care. Photo courtesy Newport Beach Fire Department 1705JEMS_25 25 4/21/17 9:18 AM CSB Meeting - June 5, 2017 Fire Dept. Handout 26 JEMS | MAY 2017 www.jeMs.coM ARMED WITH HISTORY crew. A predetermined set of rules triggers the completed ePCR information to be sent automatically in a National EMS Informa- tion System (NEMSIS) CCD (Continuity of Care Document) file to the HIE, which is then available in near real-time to the appro- priate patient healthcare provider. The HIH retrieves hospital discharge, insurance and clinical information from the HIE, which then populates ImageTrend Elite for agencies to view and use for continuous quality improvement and to achieve better patient outcomes. Having immediate access to a patient’s healthcare information in the field provides EMTs and paramedics with reliable infor- mation, such as recent hospitalizations, past medical history, medications, allergies, pre- ferred healthcare facilities and end-of-life decisions, that can affect initial care decisions and long-term outcomes. Giving EMS pro- viders secure access to this additional patient data helps to paint a more complete picture of the patient in order to facilitate more appro- priate prehospital care in addition to optimiz- ing the transition of care in the hospital ED. GOING ELECTRONIC California EMS providers are mandated by state regulations and local policy to complete a PCR when they make contact with a patient to document incident demographics, assess- ments and treatments. Historically, the PCR was completed on a paper form and a carbon copy was hand delivered to the receiving hospi- tal ED. Despite including a significant amount of information relevant to emergency care, it was often illegible and nearly impossible to extract data for prospective or retrospective analysis of the quality of patient care. This wasn’t a problem unique to California, and in an effort to begin to solve these problems, the National Highway Traffic Safety Admin- istration (NHTSA) sponsored the creation of the NEMSIS standard in 2001. In a few years, NEMSIS defined the technical infrastructure and dataset necessary to create ePCR solutions. The statewide California EMS Informa- tion System (CEMSIS) uses the NEMSIS 3.4 standard and includes additional data nec- essary to meet the needs of the state. Califor- nia’s Emergency Medical Services Authority (EMSA) requests each of the 33 local EMS agencies (LEMSA) to submit EMS data from their respective jurisdictions to the CEMSIS data repository. At least 20 agencies currently participates and EMSA anticipates that the repository will potentially receive up to four million records annually. Orange County EMS (OCEMS) cre- ated a system called Orange County Medi- cal Emergency Data System (OC-MEDS) to assist with EMS provider agencies, ambulance companies, and fire departments to transition from their outdated paper based documenta- tion methods to OC-MEDS and report their ePCRs in real-time. OC-MEDS was the first comprehensive system of its kind in Califor- nia that included the collection of emergency patient information at the time of service and made it available for instantaneous reporting to receiving hospitals, base hospitals and the local EMS agency. STANDARDIZATION & INTEGRATION In 2013, EMSA began exploring how to Medics can locate patient care data on the HIE directly from ePCR software. Once the correct patient is identi- fied, the ePCR is populated with the available information. Photo courtesy Newport Beach Fire Department 1705JEMS_26 26 4/21/17 9:18 AM CSB Meeting - June 5, 2017 Fire Dept. Handout Outgoing data from hospital Incoming data to hospital 1. Search: EMS looks up patient from HIE and incident is posted 2. Alert: Hospital HubTM alerts the receiving ED 3. File: Demographic information is sent to the HIE via Admit Discharge Transfer (ADT) message 4. File: Once incident is finished, a Continuity of Care Document (CCD) is posted to the HIE 5. Reconcile: Following additional care, Observation and Results (ORU)/CCD clinical outcomes are received by EMS Health Information HubTM ORU/CCD clinical outcome data received NEMSIS CCD sent with clinical data ADT message sent with demographics Patient history received Patient query sent Alerting to Hospital HubTM at receiving ED ePCR Hospital HubTM Health Information Exchange (HIE) www.jems.com mAY 2017 | JEMS 27 improve technology for EMS providers, envi- sioning a future where EMS is integrated into the broader healthcare system. More specif- ically, that EMS patient records would be shared with hospital electronic health records (EHRs), with the goal of eliminating the paper PCR that paramedics drop off at the hospital during the transfer of care. In 2014, the +EMS Project was devel- oped in collaboration with the U.S. Health and Human Services Office of the National Coordinator (ONC) for Health Informa- tion Technology staff to support nationwide HIE and care coordination efforts. Funda- mental to the project, EMSA developed the SAFR model to describe the minimum func- tional aspects of EMS HIE data exchange. The SAFR model created a framework and defined concrete data elements and functions that explained HIE concepts in terms appli- cable to the EMS community. EMSA also developed a work group called Consumable Data and Transport to create the list of spec- ifications for the SAFR functionality and the specific elements. In 2015, health information technology (HIT) standards were changing rapidly and EMS systems would soon be mandated to adopt these new standards. On Jan. 1, 2016, new state law (CA Health and Safety Code 1797.227) mandated that EMS providers tran- sition to modern data systems and submit NEMSIS 3.4-compliant data in realtime to their local EMS agencies. California had the foresight to create a statewide data collection system that mod- ernizes all EMS data systems and would com- ply with federal HIT standards. This allows EMS providers to exchange patient care infor- mation with other health care providers (such as receiving hospitals) who use the same stan- dards. The exchange of patient care infor- mation is a cornerstone of the Institute of Healthcare Improvement Triple Aim Initia- tive and is supported and sponsored by the federal ONC. In late 2015, EMSA was awarded a $2.75 million federal grant funded by the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009, to support the creation of bidirectional HIE between EMS providers and hospitals. Although many other healthcare providers have already implemented their exchanges, EMS systems have largely been excluded from any funding to support their implementation. EMSA used grant funds to support local/ regional health systems to realize the goal Orange County’s ePCR solution, ImageTrend Elite, takes advantage of a bidirectional health information exchange to allow medics to populate the ePCR with the patient’s medications, allergies, recent hospitalizations and past medical history. Screenshots courtesy ImageTrend Figure 1: Illustrated SAFR model for health information exchange 1705JEMS_27 27 4/21/17 9:18 AM CSB Meeting - June 5, 2017 Fire Dept. Handout 28 JEMS | MAY 2017 www.jeMs.coM ARMED WITH HISTORY of HIE+EMS interoperability in California. EMSA Director Howard Backer, MD, MPH, FACEP, emphasizes, “Providing patients’ current medical information to all medical providers is essential to provide accu- rate and high quality care. EMS must often make rapid treatment decisions on the streets or in homes and need access to critical medical history to provide the best care.” On July 26, 2016, EMSA awarded San Diego Health Connect $592,000, in partnership with One California Partnership Regional Health Infor- mation Exchange (OCPRHIO), to carry out the SAFR functionality for San Diego, Orange, and Impe- rial Counties. The funding for this local assistance grant funding oppor- tunity supports a collaborative solu- tion to integrate EMS as a critical component of the health care system into the HIE landscape. Currently, the grant is being piloted in three counties: San Diego, Orange and Imperial. Pursuant to project objectives, each respec- tive regional health information organization must establish partnerships with their county LEMSA and must identify one EMS provider and one hospital with which information will be exchanged. Health information organizations can work together with first responders to improve the data shared during day-to-day patient care, emergencies and disaster. DATA SHARING There are many components for seamless HIE with EMS. EMSA established the SAFR model with the intention of optimizing bidi- rectional data exchange (from the HIE to the on-scene EMS provider, and from the EMS provider back to the receiving facility and the HIE) as well as to support quality improve- ment and research. The SAFR model serves as an HIE framework for EMS by defining the minimum functionality necessary to achieve HIE in easy-to-understand terms. The SAFR model successfully meets all EMS data sharing goals through four func- tions. (See Table 1 and Figure 1.) 1. Search: Search individuals’ health infor- mation for past medical history, medications, allergies, and end-of-life decisions (i.e., phy- sician orders for life sustaining treatment or do-not-resuscitate orders) to enhance clinical decision making in the field. 2. Alert: Alert the receiving hospital about an individual’s status directly onto an electronic computer dashboard in the ED to provide decision support and prepare for an individ- ual’s arrival especially for conditions requir- ing time-sensitive treatment or therapy such as trauma, heart attack or stroke. 3.File: File the EMS patient care report structured data directly into the receiving facil- ity’s EHR system for ease of access and better continuity of care. 4. Reconcile: Reconcile the EHR informa- tion including diagnoses, disposition, bill- ing, and payment back into the EMS patient care report for use in quality improvement of the EMS system, performance measures, and population health, making EMS a full participant in the exchange of elec- tronic health information. For EMS care teams, the verification of billing and payment information will serve as a critical return on investment. On Feb. 23, 2017, OCEMS, New- port Beach Fire Department and Hoag Memorial Hospital Presbyte- rian were first in California to begin the implementation of +EMS and the SAFR model for HIE. Paramedic Geoffrey Cathey, from New- port Beach Fire Department, reported, “I had more accurate information about the patient and saved time because I was able to rapidly search her ePCR on my device to access the patient’s history, medications and allergies.” While still on scene, Cathey electronically transmitted the patient’s medical information through OCPRHIO to the Hoag Hospital Newport Beach ED’s dashboard demonstrat- ing the first day-to-day emergency HIE in the state of California and nationally. Carla E. Schneider, MSN, CEN, MICN, the ED director of Hoag Memorial Hospital Presbyterian states, “Overcrowded EDs are often faced with challenges that are associ- ated with surges in patient arrivals. Specif- ically, related to allocating resources, based on patient acuity, in a timely manner. The information available through HIE, includ- ing patient history and current state, allows the healthcare team to collaborate and prior- itize care. Overall, the availability of real-time health information supports our shared objec- tive of providing safe, timely and high quality care to the communities we serve.” HIE programs help the sharing of secure access of a patient’s health information, from dispatch of EMS to on-scene care, transport- ing of patients to the ED, admitting them to the hospital, discharging the patient, and reporting of patient’s outcome back to the EMS provider for data review for improving Table 1: Summary of SAFR model for health information exchange Search Improve prehospital clinical decision-making and patient care. Alert Improve receiving hospital preparedness, transitions of care and overall patient care. File Build a better longitudinal patient record. Reconcile Improve overall care and population health. The future of EMS patient care … is dependent on successful & secure health information exchange. 1705JEMS_28 28 4/21/17 9:18 AM CSB Meeting - June 5, 2017 Fire Dept. Handout the quality of emergency services provided. It’s been recognized that the future of EMS patient care (and of all healthcare providers) is now dependent on successful and secure HIE. To facilitate these exchanges, non-profit regional health information organizations and private HIE networks have been developed throughout the state and nation to connect healthcare providers with one another. Once connected, relevant patient care infor- mation is shared amongst providers, which greatly aids in the continuum of patient care, lowers healthcare costs and further supports the sustainment of healthy communities. These connections further support “meaningful use” initiatives, which incentivize the use of mod- ern health technology. Executive Director Paul Budilo of the non- profit One California Partnership Regional Health Information Exchange states, “This effort is a tremendous win for EMS and it demonstrates a profound change in the par- adigm of patient care. Our organization has established beneficial partnerships and increased functionality between multiple healthcare providers and hospitals in Orange County including the Hoag Memorial Hos- pital Presbyterian, Memorial Care Health System, St. Joseph Health System, KPC Healthcare and others.” As first responders, EMS providers often have to make quick, lifesaving decisions with- out any patient health information during emergencies. HIE in EMS gives an edge previ- ously not afforded to emergency medical tech- nicians and paramedics. Every entity within the healthcare continuum, from ambulance providers to hospitals, and local EMS agencies, should benefit from immediate, secured, elec- tronic access to a patient’s health information. Access to information leads to better care through efficient transitions of care, improved outcomes and experiences. EMS ePCR sys- tems of the near future should support full functionality for HIE. Connecting EMS to the broader health care system through HIE is necessary, and it’s inevitable. JEMS Daniel R. Smiley has served as the chief deputy director for the Calfornia Emergency Medical Services Authority (EMSA) since 1989. Samuel J. Stratton, MD, MPH, FACEP, FAAEM, is a deputy health officer and the EMS medical director in Orange County, Calif. He’s also a professor in the UCLA Fielding School of Pub- lic Health and David Geffen School of Medicine. Acknowledgment: Search, Alert, File, Reconcile (SAFR) Functionality for EMS was developed by the California Emer- gency Medical Services Authority (Daniel R. Smiley, June Iljana, Ryan Stanfield) under ONC Cooperative Agreement Grant #90IX0006/01-00 (2015). The authors would like to thank the following agencies for their assistance with this article: RESOURCES • The Office of the National Coordinator for Health Information Technology. (Jan. 2017.) Emergency Medical Services (EMS) data integration to optimize patient care: The Search, Alert, File, Reconcile (SAFR) model of health information exchange. HealthIT.gov. Retrieved April 4, 2017, from www.healthit.gov/ sites/default/files/emr_safer_knowledge_product_final.pdf. •The Office of the National Coordinator for Health Information Technology. (June 21, 2016.) Health information exchange & emergency medical services. HealthIT.gov. Retrieved April 4, 2017, from www.healthit.gov/sites/default/files/HIE_Value_ Prop_EMS_Memo_6_21_16_FINAL_generic.pdf. For more information, visit JEMS.com/rs and enter 10. 1705JEMS_29 29 4/21/17 9:18 AM CSB Meeting - June 5, 2017 Fire Dept. Handout