Author: Jessica Hagins
Participants sharing their experiences using NC HealthConnex’s value-added services is our favorite holiday gift at the N.C. Health Information Exchange Authority. We recently spoke with a user of the NC HealthConnex Clinical Portal who works in Emergency Medical Services and has found access to patient data within the portal to be invaluable on emergency calls.
Justin Stewart is a training officer for Rockingham County EMS. He has 32 years of experience as a paramedic, 24 years as a firefighter and four years as a medical examiner. He has worked in administration for Rockingham EMS for the last 13 years where he does education and training. As a self-described “data nerd,” Stewart pushed to make Rockingham County the first to go live with NC HealthConnex for EMS workers.
“I like information, but I know connectivity has always been a challenge for our people,” said Stewart, “The NC HealthConnex Clinical Portal is a critical software that we’re trying to spread out throughout our community of paramedics and emergency services. It can make a life and death difference being able to have at your fingertips access to information that we never would have even been close to seeing before like allergies, medications and urgent care visits.”
Rockingham County started the first unique community paramedic program in the state about eight years ago with community paramedics that are embedded in the local health department.
Around that same time, Stewart met with a representative of the NC HIEA where he learned that the county health department had access to NC HealthConnex, the state-designated health information exchange. Because of their partnership, Stewart was able to get his community paramedics and truck medics access to the web-based Clinical Portal.
“I really worried about how much my crews would use it until we first got it, and then it just exploded. They were talking about how much they liked it, how much information there was,” said Stewart. “Even now, when we’re doing critical disease management and holistic 360 care to meet their Social Determinants of Health, it’s just such a great asset to be able to get in there and use it.”
Staff from the NC HIEA came to Rockingham County to do in-person training for the EMS workers, joined by staff from the health department. Stewart encouraged staff to use the portal, even adding Wi-Fi and cellular signals to their trucks to keep connectivity in marginalized areas without strong signals. Stewart says if he sees staff not using the portal as regularly, he shows them how much information is available that could improve their workflow.
“When we get on scene, we could get a patient where we just know the patient’s name and date of birth. We have no medical history on them because there’s no family there sometimes. So, we’re able to go in [to NC HealthConnex] and get that information,” said Stewart.
Because Rockingham EMS is embedded with their health department, they not only function as first responders to emergency 911 calls but also perform chronic disease management with their community partners.
“It’s almost two different worlds. We have the emergency 911 that needs to know what medications they’re taking, what they’re allergic to, but then the community paramedics need to know their lab values. What were their potassium levels, their A1C, are they taking care of themselves?” said Stewart.
“Say we have someone with congestive heart failure, and they just reduced meds because their potassium levels were low. Maybe they aren’t having a heart issue, but a medication issue. That would be something for paramedics to know and link in primary care providers.”
In addition to community paramedics, the integrated team at Rockingham EMS includes care and peer support, mental health specialists and social workers. Their team works together in one office that targets high utilizers of emergency services, patients with chronic disease, Substance Use Disorder (SUD) patients and those with high social determinants of health (SDOH) needs.
Because of their integrated care teams, and more streamlined access to data, Stewart said their patients are not siloed to just one community of provider type, “It’s like we have a digital medical chart we can take that is no longer segregated between EHRs. Now, we have access to a great global health record. We don’t have to go through three layers of data sources.”
Stewart’s team has seen some significant wins.
While NC HealthConnex does not accept SUD data, Stewart does have that data in local systems. While cross-referencing Narcan deployment with clinical data found in NC HealthConnex, Stewart’s team was able to see that there was a 65% occurrence of hypertension with those in opioid crisis situations. This data made it easier to help providers know who should not be prescribed opioids for pain management or what populations were possibly not getting treatment for chronic hypertension.
Rockingham was the first EMS system in the country to deploy antibiotics for sepsis in the field. Stewart’s team used NC HealthConnex to see the sepsis diagnosis and use an antibiotic while on the call, before transferring the patient to the hospital. According to Stewart, instead of a 65% mortality rate, they are seeing an 85% discharge rate to send patients home.
Stewart saw a patient who went to an urgent care facility and was given a medication. The patient knew he had an allergy to penicillin, but when asked if he was allergic to this medication, the patient did not realize it was in the same family. He was treated for an anaphylactic reaction. Now, Stewart said they can see that information and make sure that patient does not receive that medication again.
“This is a great tool to be able to answer questions that we get on scene. If it’s a 911 call, of course, your time to go looking for this is very short. Do they have time to look all this information up? No. But when they do, when they can put that medical detective hat on, it’s very useful.”
Stewart said the reaction to the recent upgrade to the NC HealthConnex environment has been very positive. Over their time using the Clinical Portal, they have seen improved connectivity with other providers and a wider variety of data available. Stewart said the team is excited about the upcoming addition of Health-Related Social Needs data.
See more about participating in this forthcoming use case on this page.
NC HIEA executive director Sam Thompson recently met with the Office of Emergency Medical Services to talk about how more EMS providers can get connected to NC HealthConnex. If your EMS office is interested in connecting, reach out to our Business Development Team at hiea@nc.gov or call 919-754-6912.