IMPROVING TRAUMA CASE DATA WITH MOBILE TELEMEDICINE
Challenge and Executive Summary
Healthcare officials have been focusing on Trauma for many years now, and it may feel like it’s already under control. According to CHI Health, someone in our nation dies from trauma every 4 seconds. How can we improve these outcomes? Welcome to trauma with mobile telemedicine. With mobile telemedicine, we now have the chance to reinvent the way we handle trauma cases. Trauma centers are tasked with the responsibility of reporting all collected data to National Trauma Registries, but many fail to do so because of the complexity of gathering accurate data and lack of time or staff for the hospitals to update the registry.
Through the use of a specialized digital mobile telemedicine app, EMS and trauma teams are uniquely positioned to improve the saving of lives through timely intervention with engaging hospital and trauma team staff via app features to initiate broader acute care workflow improvements. Multi-faceted alerts including data collection and vitals shared real-time with ETA tracking to providers, speeds treatment and engagement to improve outcomes while adding short and long-term educational value. A vital part of trauma cases is making sure to keep track of the collected data and patient data while sharing it with trauma teams and registries. Keeping track of this data requires consistency that can be hard to achieve without set protocols or automation tools. To achieve this consistency Emergency Medical Services (EMS), Hospital staff and Trauma teams must work together to live in a cohesive and comprehensive system.
The Trauma Case workflow process below utilizes GD e-Bridge WorkFLOW Mobile Telemedicine app. The solution provides an easy to use, state or region-wide mechanism to alert, notify and track all trauma cases in real time from prehospital first medical contact through hospital emergency department, handoff to trauma teams and trauma registries. This will help the trauma team be better prepared for inbound patients while lessening the handoff time and increasing data accuracy
Note that all GD e-Bridge WorkFLOW templates are highly configurable, allowing flexibility to operate protocols your way, ensuring maximum effectiveness and compliance to your teams and trauma accreditations.
SAMPLE TRAUMA WORKFLOW
1. 911 communications center receives a call for a possible trauma and dispatches EMS
2. EMS receives the CAD location information and responds. Dispatch and arrival times documented in CAD.
3. Upon arrival, EMS’ patient assessment identifies possible trauma case
4. Once the patient is found eligible for trauma, EMS clicks the “Trauma” button of the GD e-Bridge app on their mobile device and treats the patient. The location is tagged and the running clock begins*.
5. The highly configurable workflow template prompts for initial patient demographic*, driver’s license, ID scan/ picture, and medical incident and treatment information.
6. Notifications for events are time stamped, logged and shared in real- time with preselected team members via GD e-Bridge app (ED computer, mobile devices, etc).
7. Existing or newly assigned specialists can be notified and added to the team- either pre-configured or at any point by ED staff after arrival.
8. Patient/Case/Event can be added to the Trauma Registry either at this point or by ED staff after arrival.
9. Live (synchronous) or asynchronous video consult with physician, recovery coach, etc is available. Secure multi-media such as pictures, video, audio, text, team chat and vital sign and ECG sharing is available.
10. If transporting, live ETA is sent to receiving hospital, registry and specialists once en route.
11. If AMA refusal, video consult with physician or specialist may avert refusal, otherwise video documentation of refusal is recorded to mitigate risk
12. Hospital ED physician/ nurse adds hospital patient registration to the case, allowing them to pre-register the patient before arrival.
13. Non-trauma designation hospital can forward data to the registry
14. ED team member assigns bed and EMS is notified pre-arrival, via the app.
15. Hospital ED can see tracking map with priority and live ETA. Once ambulance is within “geofence” of hospital an “arrival” alert is announced and displayed and team members are alerted on the GD e-Bridge app.
16. EMS arrives and moves the patient to the pre-assigned bed and hands off the patient to ED staff that is already prepared and ready with a pre-registered ID wristband
17. ED staff take over patient care and the pre-hospital phase has ended
18. EMS clears up from the call and goes back in service but is available for questions, team chat, notifications and outcome results, via the GD e-Bridge app.
19. Downstream outcome feedback/ status is entered, EMS is notified via GD e-Bridge.
- Consistent registry entries
- Process Improvement for trauma patient intervention and flow
- Feedback and benchmarking
- Communication with EMS on outcome data
- Continued education and training for trauma teams and EMS officials based on trend report and time studies
- EMS transfer and follow up performed easier
- Consistency in working protocols
Trauma events to monitor & Capture
- Airway intervention
- GCS, Assessments
- Extremity and environment events
- Mechanism of injury
- Photo/ video documentation of scene, MOI
- Vitals and ECG sharing
- Transfer notes/ approvals
- Level I, II or III activations
- Physiological Criteria
- Anatomical Criteria
- Surgeon or physician request
- Other considerations / requests