title: An open, interoperable, and scalable prehospital information technology network architecture.
abstract: Some of the most intractable challenges in prehospital medicine include response time optimization, inefficiencies at the emergency medical services (EMS)-emergency department (ED) interface, and the ability to correlate field interventions with patient outcomes. Information technology (IT) can address these and other concerns by ensuring that system and patient information is received when and where it is needed, is fully integrated with prior and subsequent patient information, and is securely archived. Some EMS agencies have begun adopting information technologies, such as wireless transmission of 12-lead electrocardiograms, but few agencies have developed a comprehensive plan for management of their prehospital information and integration with other electronic medical records. This perspective article highlights the challenges and limitations of integrating IT elements without a strategic plan, and proposes an open, interoperable, and scalable prehospital information technology (PHIT) architecture. The two core components of this PHIT architecture are 1) routers with broadband network connectivity to share data between ambulance devices and EMS system information services and 2) an electronic patient care report to organize and archive all electronic prehospital data. To successfully implement this comprehensive PHIT architecture, data and technology requirements must be based on best available evidence, and the system must adhere to health data standards as well as privacy and security regulations. Recent federal legislation prioritizing health information technology may position federal agencies to help design and fund PHIT architectures.
authors.affiliation: Robert Wood Johnson Foundation Clinical Scholars Program, Yale University, New Haven, Connecticut 06520, USA. adam.landman@yahoo.com
authors.forename: Adam B
authors.initials: AB
authors.lastname: Landman
authors.forename: Ivan C
authors.initials: IC
authors.lastname: Rokos
authors.forename: Kevin
authors.initials: K
authors.lastname: Burns
authors.forename: Carin M
authors.initials: CM
authors.lastname: Van Gelder
authors.forename: Roger M
authors.initials: RM
authors.lastname: Fisher
authors.forename: James V
authors.initials: JV
authors.lastname: Dunford
authors.forename: David C
authors.initials: DC
authors.lastname: Cone
authors.forename: Sandy
authors.initials: S
authors.lastname: Bogucki
mesh_terms: D003199:Computer Systems; D003226:Congresses as Topic; D004562:Electrocardiography / Q000295:instrumentation; D004632:Emergency Medical Services / Q000458:organization & administration*; D006801:Humans; D008490:Medical Informatics / Q000458:organization & administration*; D016347:Medical Records Systems, Computerized / Q000458:organization & administration*; D005791:Patient Care; D018907:Privacy; D013995:Time; D014481:United States; D059015:Wireless Technology / Q000458:organization & administration*