First Responders Use HIE for Quality Improvement

First Responders Use HIE to Improve Patient Care, Respect Patient Wishes 

Grand Junction Fire Department (GJFD) is the emergency and prevention service provider for Grand Junction, Colorado and the surrounding area. Its operation includes 5 stations, employing more than 125 firefighters and other personnel, covering a service area of 77 square miles. Health and Safety staff responded to 10,474 calls in 2014.  

Initially the impetus to explore connectivity to Quality Health Network’s (QHN) Health Information Exchange (HIE) was to access patient advance directives in the system in order to prevent unwanted medical procedures.  However, the EMT supervisors have found that using the system for quality assurance purposes and training to improve patient care has provided additional value in their connection to QHN’s HIE. 

Utilizing HIE for Quality Assurance Program

“We have watched the physician providers use the QHN system for years and wondered why we are not also using this amazing community resource,” says GJFD Health & Safety Chief John Hall. “We are very excited to be able to use the system to access advance directives in the HIE. However, we have found that using QHN for our quality assurance (QA) program to improve patient care and provide immediate feedback to responders for after-call training of tremendous benefit.” 

Instant Feedback Creates Instant Educational Opportunities  

The GJFD utilizes dual-role (EMS and Fire) personnel and single role personnel (EMS only) in the delivery of fire and emergency medical services. All GJFD firefighters are also trained to function in a medical role and are trained Emergency Medical Technicians (EMTs); each primary response vehicle is also staffed with a paramedic. 

Prior to connecting to the QHN systems in order to complete their QA and provide ongoing medical team training, the GJFD had to call hospitals and ask for follow-up patient information. “Every one of our service calls is reviewed for quality assurance for submission to our medical director; after review of the incident report often more information on the care provided in the Emergency Department is required. In the pre-hospital world, if you need follow-up you have to track down the providers at the hospital and ask them for the patient information, which can take months, now doing our follow-up work using QHN it is almost instantaneous. Not only is our team now getting instant quality of care feedback, but instant education. This has improved patient care tremendously.”  

Because GJFD is now on the QHN network they can query for data on what happened to a patient after an emergency call. The department is able to tailor EMT/paramedic training based on this real-time patient information. “The use of the HIE now touches a whole new sub-set of providers that were not being touched before. If we were a hospital based EMS system the process would be totally different. They get instant feedback from the providers in the ED. Being a government entity we don’t get that immediate feedback. With the data we get from QHN, our follow-up is now more relevant and actionable. This is helping to dramatically improve patient care.” 

Plans for Additional Improvements Using HIE

GJFD is playing their part in filling in information gaps to improve patient care. “The medical field is now starting to bring in the pre-hospital side into their trauma review committees. We now sit in on the reviews of all the cases in which we were involved. We are also very close to being able to utilize QHN at the scene to pull up advance directives and real-time medical information. It’s like we came out of the stone ages, into the 21st century.