Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise F. Rogers, Chief, San Mateo County Health
Travis Kusman, Director, Emergency Medical Services
Subject: Agreement to Accept Funding from the State of California Emergency Medical Services Authority for Development of a Locally Based Health Information Exchange
RECOMMENDATION:
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Adopt a resolution authorizing an agreement with the State of California Emergency Medical Services Authority to receive funding for development of a locally based electronic Health Information Exchange, for the term of November 1, 2019 through September 30, 2021, in an amount not to exceed $1,500,000.
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BACKGROUND:
The State of California Emergency Medical Services Authority (EMSA) has made grant funding available for the local development and implementation of secure data sharing between emergency medical services (EMS) field providers and designated 9-1-1 receiving hospitals via Health Information Exchange (HIE) systems. Funds will be used to develop and implement secure and Health Insurance Portability and Accountability Act (HIPAA) compliant health information technology and infrastructure to enable EMS first response and ambulance caregivers to access critical patient medical information at the scene of an emergency, readily share their assessment findings and the treatment that they render with hospital personnel, and enhance overall clinical quality improvement within the County’s EMS system.
DISCUSSION:
In August 2019, the EMSA awarded San Mateo County Emergency Medical Services (EMS Agency) grant funding to develop and implement a locally based HIE for the San Mateo County EMS system known as +EMS SAFR. Funds were awarded through a competitive application process with awards based on approval of technical work plan and grant milestones.
Paramedics and Emergency Medical Technicians (EMTs) must often make rapid patient treatment decisions in the day to day practice of emergency medical care in the field. Having access to a patient’s current medical information during a medical emergency is essential for provision of appropriate care. Through +EMS SAFR, the EMS Agency aims to enhance clinical decision-making and outcomes for 9-1-1 medical patients by enabling enhanced sharing of prehospital and hospital electronic medical records. This new connected approach will provide the following benefits for healthcare providers and patients:
• Paramedics and EMTs on ambulances, as well as non-transport first responders, will be able to access individual patient information relevant to an emergency case to enhance their clinical decision making.
• Patient outcome data will be returned to the EMS Agency and EMS providers for quality and system improvement.
• Hospital emergency departments receiving real-time patient information from EMS providers will lead to improved clinical decision support and will create an environment where time-sensitive treatments can be expedited through advance notification, such as in the provision of definitive care to trauma, chest pain, cardiac arrest or stroke patients.
• The integration of electronic pre-hospital care records into hospital electronic health record (EHR) systems will allow clinical care providers in both urban and rural communities to support a more comprehensive, longitudinal, and unified patient record for seamless continuity of care.
+EMS SAFR is an effort by the EMS Agency, in close coordination with San Mateo County Health’s Connected Care HIE (SMCCC HIE) program. Also involved in this collaboration are American Medical Response, the San Mateo County Pre-Hospital Emergency Medical Services Group (Fire Joint Powers Authority), South San Francisco Fire Department, and EMS-designated 9-1-1 receiving hospitals participating in the County’s EMS system.
The resolution contains the County’s standard provision allowing amendment of County’s fiscal obligation by a maximum of $25,000 (in aggregate).
The agreement and resolution have been reviewed and approved by County Counsel as to form.
A separate Memoranda of Understanding is being drafted by the State to allow for County Health to participate in the effort, with $99,999 of matching funds that will come from Health Intergovernmental Transfer funds within the FY2019-20 budget.
It is anticipated that 100% of +EMS SAFR project participants will have agreements in place with SMCCC HIE by the end of FY 2019-2020.
PERFORMANCE MEASURE:
|
Measure |
FY 2018-19 Actual |
FY 2019-20 Projected |
|
Percentage of +SMC SAFR project participants that have agreements in place with SMCCC HIE. |
0% 0 +EMS SAFR participants |
100% 8 +EMS SAFR participants |
FISCAL IMPACT:
The term of the agreement is November 1, 2019 through September 30, 2021. The amount of the agreement is not to exceed $1,500,000 for the two-year-term. This agreement is 100% funded by EMSA SAFR grant funds, with no associated Net County Cost.