Guest guest Posted September 21, 2002 Report Share Posted September 21, 2002 Simple answer. Data collection makes jobs. Good paying jobs. The more data you manage to get collected, the more people it takes to deal with it. When you're the first person hired, the best way to move up is to build an empire. Hire others to be under you. The more people you manage the higher your budget. The higher your budget the better it looks on your resume`. Data collection is a particularly good place to " hide " the fact that you can't really do anything also. Nobody else understands what you do, so there is that mystery that surrounds you. You MUST be important. And nobody wants to challenge you. Because in order to challenge you, they have to bother to learn what you do. See, it's the perfect job. And it's very easy to hide the fact that you're not doing anything meaningful with the data because it's so easy to create charts and reports that nobody understands but are afraid to question because they're afraid they'll look stupid. Higher education is the hands down leader in this charade. No wonder ny can't read. All the money that ought to be spent teaching ny to read goes to the Office for Mental Masturbation. When I was at TJC I saw, in 12 years, data collection mushroom. We were constantly being required to report all kinds of stuff with names like Outcomes Verification and so forth. As the demands on me as an administrator to provide more and more mindless drivel to faceless offices increased, I got more and more bitter about having to do it, and finally it virtually killed my enthusiasm for being an administrator. I often spoke out about that, which didn't exactly endear me to the BIG Kahunas, the ones making big money for doing nothing much meaningful. One of my colleagues who was particularly prone to announce that The Emperor Has No Clothes finally got the ax because he wasn't a " team player. " Much data collection is utter hogwash because it doesn't lead to any changes in the way we do things. It is data collection for its ownself, and it supports meaningless jobs. Now, before you roast me, think about what I've said. Can any of you name a single benefit that you've ever seen from the data that you have been sending in for years? I'm not talking about legitimate research to see what works and what doesn't. We need more of that. But every time a new PhD is looking for a topic for a dissertation, we run the risk of having more data collection rammed down our throats. Me, I'm going to gather data on the mating habits of Two Headed Dutch Orphans in Brazil. That should get me a nice grant. Cynically yours, Gene Gandy Gene Gandy, JD, LP 4250 East Aquarius Drive Tucson, AZ 85718 home and fax cell wegandy@... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 21, 2002 Report Share Posted September 21, 2002 Simple answer. Data collection makes jobs. Good paying jobs. The more data you manage to get collected, the more people it takes to deal with it. When you're the first person hired, the best way to move up is to build an empire. Hire others to be under you. The more people you manage the higher your budget. The higher your budget the better it looks on your resume`. Data collection is a particularly good place to " hide " the fact that you can't really do anything also. Nobody else understands what you do, so there is that mystery that surrounds you. You MUST be important. And nobody wants to challenge you. Because in order to challenge you, they have to bother to learn what you do. See, it's the perfect job. And it's very easy to hide the fact that you're not doing anything meaningful with the data because it's so easy to create charts and reports that nobody understands but are afraid to question because they're afraid they'll look stupid. Higher education is the hands down leader in this charade. No wonder ny can't read. All the money that ought to be spent teaching ny to read goes to the Office for Mental Masturbation. When I was at TJC I saw, in 12 years, data collection mushroom. We were constantly being required to report all kinds of stuff with names like Outcomes Verification and so forth. As the demands on me as an administrator to provide more and more mindless drivel to faceless offices increased, I got more and more bitter about having to do it, and finally it virtually killed my enthusiasm for being an administrator. I often spoke out about that, which didn't exactly endear me to the BIG Kahunas, the ones making big money for doing nothing much meaningful. One of my colleagues who was particularly prone to announce that The Emperor Has No Clothes finally got the ax because he wasn't a " team player. " Much data collection is utter hogwash because it doesn't lead to any changes in the way we do things. It is data collection for its ownself, and it supports meaningless jobs. Now, before you roast me, think about what I've said. Can any of you name a single benefit that you've ever seen from the data that you have been sending in for years? I'm not talking about legitimate research to see what works and what doesn't. We need more of that. But every time a new PhD is looking for a topic for a dissertation, we run the risk of having more data collection rammed down our throats. Me, I'm going to gather data on the mating habits of Two Headed Dutch Orphans in Brazil. That should get me a nice grant. Cynically yours, Gene Gandy Gene Gandy, JD, LP 4250 East Aquarius Drive Tucson, AZ 85718 home and fax cell wegandy@... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 21, 2002 Report Share Posted September 21, 2002 Simple answer. Data collection makes jobs. Good paying jobs. The more data you manage to get collected, the more people it takes to deal with it. When you're the first person hired, the best way to move up is to build an empire. Hire others to be under you. The more people you manage the higher your budget. The higher your budget the better it looks on your resume`. Data collection is a particularly good place to " hide " the fact that you can't really do anything also. Nobody else understands what you do, so there is that mystery that surrounds you. You MUST be important. And nobody wants to challenge you. Because in order to challenge you, they have to bother to learn what you do. See, it's the perfect job. And it's very easy to hide the fact that you're not doing anything meaningful with the data because it's so easy to create charts and reports that nobody understands but are afraid to question because they're afraid they'll look stupid. Higher education is the hands down leader in this charade. No wonder ny can't read. All the money that ought to be spent teaching ny to read goes to the Office for Mental Masturbation. When I was at TJC I saw, in 12 years, data collection mushroom. We were constantly being required to report all kinds of stuff with names like Outcomes Verification and so forth. As the demands on me as an administrator to provide more and more mindless drivel to faceless offices increased, I got more and more bitter about having to do it, and finally it virtually killed my enthusiasm for being an administrator. I often spoke out about that, which didn't exactly endear me to the BIG Kahunas, the ones making big money for doing nothing much meaningful. One of my colleagues who was particularly prone to announce that The Emperor Has No Clothes finally got the ax because he wasn't a " team player. " Much data collection is utter hogwash because it doesn't lead to any changes in the way we do things. It is data collection for its ownself, and it supports meaningless jobs. Now, before you roast me, think about what I've said. Can any of you name a single benefit that you've ever seen from the data that you have been sending in for years? I'm not talking about legitimate research to see what works and what doesn't. We need more of that. But every time a new PhD is looking for a topic for a dissertation, we run the risk of having more data collection rammed down our throats. Me, I'm going to gather data on the mating habits of Two Headed Dutch Orphans in Brazil. That should get me a nice grant. Cynically yours, Gene Gandy Gene Gandy, JD, LP 4250 East Aquarius Drive Tucson, AZ 85718 home and fax cell wegandy@... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 21, 2002 Report Share Posted September 21, 2002 Simple answer. Data collection makes jobs. Good paying jobs. The more data you manage to get collected, the more people it takes to deal with it. When you're the first person hired, the best way to move up is to build an empire. Hire others to be under you. The more people you manage the higher your budget. The higher your budget the better it looks on your resume`. Data collection is a particularly good place to " hide " the fact that you can't really do anything also. Nobody else understands what you do, so there is that mystery that surrounds you. You MUST be important. And nobody wants to challenge you. Because in order to challenge you, they have to bother to learn what you do. See, it's the perfect job. And it's very easy to hide the fact that you're not doing anything meaningful with the data because it's so easy to create charts and reports that nobody understands but are afraid to question because they're afraid they'll look stupid. Higher education is the hands down leader in this charade. No wonder ny can't read. All the money that ought to be spent teaching ny to read goes to the Office for Mental Masturbation. When I was at TJC I saw, in 12 years, data collection mushroom. We were constantly being required to report all kinds of stuff with names like Outcomes Verification and so forth. As the demands on me as an administrator to provide more and more mindless drivel to faceless offices increased, I got more and more bitter about having to do it, and finally it virtually killed my enthusiasm for being an administrator. I often spoke out about that, which didn't exactly endear me to the BIG Kahunas, the ones making big money for doing nothing much meaningful. One of my colleagues who was particularly prone to announce that The Emperor Has No Clothes finally got the ax because he wasn't a " team player. " Much data collection is utter hogwash because it doesn't lead to any changes in the way we do things. It is data collection for its ownself, and it supports meaningless jobs. Now, before you roast me, think about what I've said. Can any of you name a single benefit that you've ever seen from the data that you have been sending in for years? I'm not talking about legitimate research to see what works and what doesn't. We need more of that. But every time a new PhD is looking for a topic for a dissertation, we run the risk of having more data collection rammed down our throats. Me, I'm going to gather data on the mating habits of Two Headed Dutch Orphans in Brazil. That should get me a nice grant. Cynically yours, Gene Gandy Gene Gandy, JD, LP 4250 East Aquarius Drive Tucson, AZ 85718 home and fax cell wegandy@... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 21, 2002 Report Share Posted September 21, 2002 Simple answer. Data collection makes jobs. Good paying jobs. The more data you manage to get collected, the more people it takes to deal with it. When you're the first person hired, the best way to move up is to build an empire. Hire others to be under you. The more people you manage the higher your budget. The higher your budget the better it looks on your resume`. Data collection is a particularly good place to " hide " the fact that you can't really do anything also. Nobody else understands what you do, so there is that mystery that surrounds you. You MUST be important. And nobody wants to challenge you. Because in order to challenge you, they have to bother to learn what you do. See, it's the perfect job. And it's very easy to hide the fact that you're not doing anything meaningful with the data because it's so easy to create charts and reports that nobody understands but are afraid to question because they're afraid they'll look stupid. Higher education is the hands down leader in this charade. No wonder ny can't read. All the money that ought to be spent teaching ny to read goes to the Office for Mental Masturbation. When I was at TJC I saw, in 12 years, data collection mushroom. We were constantly being required to report all kinds of stuff with names like Outcomes Verification and so forth. As the demands on me as an administrator to provide more and more mindless drivel to faceless offices increased, I got more and more bitter about having to do it, and finally it virtually killed my enthusiasm for being an administrator. I often spoke out about that, which didn't exactly endear me to the BIG Kahunas, the ones making big money for doing nothing much meaningful. One of my colleagues who was particularly prone to announce that The Emperor Has No Clothes finally got the ax because he wasn't a " team player. " Much data collection is utter hogwash because it doesn't lead to any changes in the way we do things. It is data collection for its ownself, and it supports meaningless jobs. Now, before you roast me, think about what I've said. Can any of you name a single benefit that you've ever seen from the data that you have been sending in for years? I'm not talking about legitimate research to see what works and what doesn't. We need more of that. But every time a new PhD is looking for a topic for a dissertation, we run the risk of having more data collection rammed down our throats. Me, I'm going to gather data on the mating habits of Two Headed Dutch Orphans in Brazil. That should get me a nice grant. Cynically yours, Gene Gandy Gene Gandy, JD, LP 4250 East Aquarius Drive Tucson, AZ 85718 home and fax cell wegandy@... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 22, 2002 Report Share Posted September 22, 2002 We have been collecting and sending data in for about 12 years now. As far as I can tell, it has been a great waste of time and resource. Nothing has been done with this data to my knowledge. Unfortunately, due to the data info and format they request, not much could be done with it. In a message dated 9/21/02 4:05:32 PM Central Daylight Time, je.hill@... writes: > Maybe if someone from that section of the department would answer these > questions you raised and shed a little light on the " why's " of all this > extra > information gathering that is mandated, we could palate it a little better. > Of > course, that STILL wouldn't help us with the expense of having someone > enter > all this stuff. > > Jane Hill > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 22, 2002 Report Share Posted September 22, 2002 I have asked TDH why they needed this info. The response was that they occasional are requested to provide numbers for the public and the legislation. BUT, as said earlier, the information they have is far from the real picture. If they are looking for actual response numbers, not everyone is providing data. If they are looking for response times, the system cannot differentiate between rural, urban or frontier. For that matter, the TEXEMS reports cannot separate emergency vs non-emergency. I had rather they say " we don't know " other than provide less than accurate information to those requesting it. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 22, 2002 Report Share Posted September 22, 2002 Our local hospital still has some of that radio equipment! In a message dated 9/22/02 12:09:33 PM Central Daylight Time, bbledsoe@... writes: > Just a bit of history (as we old timers like to say). In 1979, immediately > after I got out of the field, I went to work for Trinity EMS. It was a > federal grant agency that was charged with development and integration of > EMS in 7 counties in the Fort Worth area (Tarrant, , , Palo > Pinto, Wise, Somervell, and Hood). We bought a few defibrillators, set up a > crdue radio system, and provided a few ambulances and provided some > education. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 22, 2002 Report Share Posted September 22, 2002 Just a bit of history (as we old timers like to say). In 1979, immediately after I got out of the field, I went to work for Trinity EMS. It was a federal grant agency that was charged with development and integration of EMS in 7 counties in the Fort Worth area (Tarrant, , , Palo Pinto, Wise, Somervell, and Hood). We bought a few defibrillators, set up a crdue radio system, and provided a few ambulances and provided some education. One of the contraints of the grant money was that there had to be a centralized database of EMS runs. We printed and distributed tens of thousands of runs sheets. Once completed, they were forwarded to our office where a data entry clerk entered them onto punch cars (remember those). They then went to the University of Texas at Arlington were they were processed. We got back reams of 11 X 17 sheets with run data. We promptly put them into storage. In 1981, when the grant money ran out, and the counties would not pick up the cost of the organization, all off the assets were given away to EMS agencies and some went into storage in a City of Euless building. I personally, under direction of the administator, filled a dumpster with punch cards and data sheets. As far as I know, nothing was ever done with the material--prbably not even looked at. While I beleive centralized data for certain things is important (ambulane accidents, resuscitations, and perhaps total number of calls). there has to be a bonafide reason for it and it must not be an unfunded mandate. EMS is barely sqeeking by financially. Adding costs will affect the only cost center variable that most EMS services can adjust--employee salaries and benefits. Hence, you all, the field providers, will ultimately bear the costs of this endeavor (maybe even that required by the RACs. Just my thoughts--your mileage may vary, Re: FW: Ground ambulance accident data > We have been collecting and sending data in for about 12 years now. As far > as I can tell, it has been a great waste of time and resource. Nothing has > been done with this data to my knowledge. > > Unfortunately, due to the data info and format they request, not much could > be done with it. > > > > > > In a message dated 9/21/02 4:05:32 PM Central Daylight Time, je.hill@... > writes: > > > > Maybe if someone from that section of the department would answer these > > questions you raised and shed a little light on the " why's " of all this > > extra > > information gathering that is mandated, we could palate it a little better. > > Of > > course, that STILL wouldn't help us with the expense of having someone > > enter > > all this stuff. > > > > Jane Hill > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 22, 2002 Report Share Posted September 22, 2002 My question remains, what does/did the TDH say they were going to do with these data? If there is no expectation or requirement for the TDH to provide summary reports, then why is EMS required to submit them? So we can prop up FTE's at the TDH? I realize that these raw data have a Viagra-like effect on the beaners and propeller heads, but what might be " good for them " may not be " good for us " . They should at least be required to take us out to dinner and a movie. BK TX1@... wrote: > We have been collecting and sending data in for about 12 years now. > As far > as I can tell, it has been a great waste of time and resource. > Nothing has > been done with this data to my knowledge. > > Unfortunately, due to the data info and format they request, not much > could > be done with it. > > > > > > In a message dated 9/21/02 4:05:32 PM Central Daylight Time, > je.hill@... > writes: > > > > Maybe if someone from that section of the department would answer > these > > questions you raised and shed a little light on the " why's " of all > this > > extra > > information gathering that is mandated, we could palate it a little > better. > > Of > > course, that STILL wouldn't help us with the expense of having > someone > > enter > > all this stuff. > > > > Jane Hill > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 22, 2002 Report Share Posted September 22, 2002 Dr. Bledsoe, this is exactly what I was talking about. I have never been a thorn in the rose bush about doing things that need to be done. (The key word there is " need " , of course.) But I really would like to know exactly WHAT is going to be done with this volume of information. In what ways will it be used? Who all in the state AND federal government will have access to this data (which includes personal patient information)? And WHAT exactly are they going to use this information to accomplish? What are they BARRED from doing with this information? And HOW will this information help prehospital and emergency department healthcare in the future? Or are we wool gathering for justification for jobs as Gene states could be a possibility? What are we attempting to accomplish here and is it worth the burden? Or will part or all of the information eventually end up in the shredder because it is found much later to be useless data as per your example? I, for one, would hate to see ANY of these things be the case. I guess I am always slightly suspicious of things that are not clear in my mind - especially when it has to do with any section of the government. But if I am given solid facts justifying the WHY of such things, I am generally ok with it. Unless that WHY is something that I feel is either morally or ethically wrong, or possibly an invasion of privacy. Even though this type of information gathering is mandated by law making it legal despite HIPAA and the state privacy rule, does that make it RIGHT to gather this kind of data? I don't know...... I guess my whole point in all of this thread is, " Are we thinking enough here and are we asking enough of the right questions to ensure that following through with this type of unfundated mandate is for the public health best interests..... or not? " Of course, until this is resolved, we can't refuse to gather it. We just need to see what needs to be done to ensure that we are doing the best thing. It think most of the officials in the BEM understand our concerns. But I am not sure that THEY even know the WHY's of some of these issues. Somehow I think the issue is larger than the BEM. Jane Hill > Just a bit of history (as we old timers like to say). In 1979, immediately > after I got out of the field, I went to work for Trinity EMS. It was a > federal grant agency that was charged with development and integration of > EMS in 7 counties in the Fort Worth area (Tarrant, , , Palo > Pinto, Wise, Somervell, and Hood). We bought a few defibrillators, set up a > crdue radio system, and provided a few ambulances and provided some > education. One of the contraints of the grant money was that there had to > be a centralized database of EMS runs. We printed and distributed tens of > thousands of runs sheets. Once completed, they were forwarded to our office > where a data entry clerk entered them onto punch cars (remember those). > They then went to the University of Texas at Arlington were they were > processed. We got back reams of 11 X 17 sheets with run data. We promptly > put them into storage. In 1981, when the grant money ran out, and the > counties would not pick up the cost of the organization, all off the assets > were given away to EMS agencies and some went into storage in a City of > Euless building. I personally, under direction of the administator, filled > a dumpster with punch cards and data sheets. As far as I know, nothing was > ever done with the material--prbably not even looked at. While I beleive > centralized data for certain things is important (ambulane accidents, > resuscitations, and perhaps total number of calls). there has to be a > bonafide reason for it and it must not be an unfunded mandate. EMS is > barely sqeeking by financially. Adding costs will affect the only cost > center variable that most EMS services can adjust--employee salaries and > benefits. Hence, you all, the field providers, will ultimately bear the > costs of this endeavor (maybe even that required by the RACs. Just my > thoughts--your mileage may vary, > > > > Re: FW: Ground ambulance accident data > > > > We have been collecting and sending data in for about 12 years now. As > far > > as I can tell, it has been a great waste of time and resource. Nothing > has > > been done with this data to my knowledge. > > > > Unfortunately, due to the data info and format they request, not much > could > > be done with it. > > > > > > > > > > > > In a message dated 9/21/02 4:05:32 PM Central Daylight Time, > je.hill@a... > > writes: > > > > > > > Maybe if someone from that section of the department would answer these > > > questions you raised and shed a little light on the " why's " of all this > > > extra > > > information gathering that is mandated, we could palate it a little > better. > > > Of > > > course, that STILL wouldn't help us with the expense of having someone > > > enter > > > all this stuff. > > > > > > Jane Hill > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 22, 2002 Report Share Posted September 22, 2002 Jane, Bob, and others, The issue with " state-wide " data collection is that most people have no idea what it is they are asking for...when epidemiology calls for submission of all Texas EMS runs, in their office in Austin is probably doesn't seem like a problem. I mean after all, no one considers that there are 733 licensed EMS providers (downloaded the file from TDH just now) and if all 733 of them did ONE (1) call per day (remember although some of the 733 may not do one call a day...many others like SA, Houston, Dallas, El Paso, MedStar, Amarillo, etc do many many more than one) over a year that is 733*365=267,545 EMS calls. IF it takes ONE minute to enter in each call, it is over 4,450 hours per year.....but if you increased it to 5 minutes a call, it goes to 22,295 hours per year....that's 10.7 FTE's per year to enter in one call per day from each of the licensed EMS Providers in Texas (no wonder it was necessary to have EMS agencies do it instead of TDH personnel). In another location where I participated in state-wide data collection, the state prepared a " State-Wide Patient Care Report " and mandated that everyone use it. It cost our agency 1000's of dollars to educate our employees on this new form. The date came to send them all to the State (again...not Texas) and within 6 weeks we received a certified letter from the State EMS Dept to cease and desist following the mandate for submission of each run report because the state could not handle our submissions much less the other 350 or 400 agencies submissions (we sent them over 20,000 PCR's in those 6 weeks and we were not the largest EMS in the state). Now, I should not complain too loudly because with the money our RAC received, we are in the process of going on-line with electronic run reports....but what of those agencies who did not do this? What of those who took the money to buy " a computer capable of submitting runs via the internet " and they are now looking at how to actually make it happen everyday. The question comes up what happens if an agency doesn't comply and doesn't submit? Chances are the first impact will be their ability to get LPG and EMS funds from TDH...of course this will only hurt the agencies who will have the toughest times complying with the mandate (like Jane's example) since these are the easiest EMS funds to get..... Anyway, now we have a mandate and now we have to find a way to comply...unfortunately, when a large number of agencies find this mechanism...the pain and difficulty will not be seen at the regulatory level where the success of this mandate will only encourage more. Just my $0.02, Dudley Wait Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 22, 2002 Report Share Posted September 22, 2002 Hi everyone, I just saw this thread and have a thought or two as well. I agree with everything Dudley said below, since I work at the RAC he mentioned. I attended every JRP/JAD session that I could back when TRAC-IT was being kicked around with the consultant/vendor. I harped (and harped and harped, btw) that we _really_ needed to look at ways to " help EMS help them " . There was this incredible amount of focus on the database, the " back-end " if you will, where the data resides and most importantly where the reports that we have wanted for so long will come from. Unfortunately, there was almost no discussion on the front-end, where the data actually gets entered, which is what everyone is now realizing where the problem is and the unfunded mandate part comes into play. At that time, the only way I could see to avoid the incredible fiscal demand (or time demand for volunteer agencies) of the front-end data entry problem was to have the actual data collection become transparent. Electronic charting allows the paramedic to do the data collection entry transparently as he creates his patient run report to turn in to the ER. Granted there is a significant learning curve having to train every medic versus getting some data collection software and training one person to enter all the charts, but you end up with this time/financial burden that everyone is now so frustrated with. We have already seen that medics with decent training and some time to play with the software are either as fast or faster than when they filled out paper, so the time spent entering data is already being allocated today if they write on paper. Using electronic charting just means that the same amount of time they would be writing is now being used to punch pulldown menus on the screen. Electronic charting allows for more complete run reports, legible run reports (what a concept), increased reimbursement, ability to pull management reports that otherwise would not be available easily, and perhaps even improve care with some of the wizards that ask for pertinent data depending on the C/C (PQRST pops up if the C/C is chest pain for example). Now I am not saying our region would have gone to electronic charting if TRAC-IT had not come along, probably we would not. However, since the TRAC-IT project did come along, we were able to use the funding and work collaboratively, instituting EMS Pro from pinpoint technologies. The question that really helped clarify things for the EMS directors was " How many people thought they would be using paper charts in the year 2010 " The answer was not a single person, including the smallest volunteer providers. Everyone seemed to realize in the atmosphere of data-capable phones, PDAs, 2-way pagers, laptops, handheld GPSs, electronic mapping, and internet access, no one felt that 9 years from that day they would be using paper for charting. The question then becomes not if but _when_ will we transition from paper to electronic charting. Having TRAC-IT money to use instead of the agency's seemed to make a fair amount of sense, much more sense than using the TRAC-It funds to buy a computer that will be out of date in 24 months and unable to run the software that will be available then.. We used TRAC-IT funds to get each and every agency that wanted to get involved with electronic charting to do that. The agencies that chose not to were provided other software for free or chose to use the internet. Those that chose not to were also purchased a computer if they didn't have one in-house that met the spec sheet provided from TDH. The thing was, the agencies that wanted to do EMS Pro had to buy the ruggedized toughbooks to allow that to happen since we didn't have enough TRAC-IT funding to buy the software _and_ all the ruggedized hardware necessary. Almost all of them did buy their own laptops and we were also able to buy 5 laptops to use for agencies that wanted to try it first without the initial expense, sort of like a scholarship. We also purchased 3 extra laptops for regional spares so if a smaller agency had maintenance on their primary laptop, we can get them one of the spares rapidly and they are back in shape. Doing it this way allowed each agency not to buy a " spare " for their department, a significant cost savings. Although electronic charting is still not picture perfect, it is light-years ahead of where it was even 2 years ago and it sure beats having to sit and enter all those charts by hand after the medics put the data onto a piece of paper the day before. The other benefit was that those agencies that use billing companies can now provide their data in electronic format, so the billing company isn't doing the expensive data entry piece anymore, which will be interesting to follow when they renew contracts. I have been very pleased so far with our agencies ability to learn and use the EMS Pro software. It remains to be seen if the project will be viable for the long-term, but my bet is that as long as this data mandate is in place, this will be the better option, even for very small agencies. See ya, Epley Executive Director Southwest Texas Regional Advisory Council for Trauma TSA-P - office - fax eepley@... www.strac.org Re: FW: Ground ambulance accident data Jane, Bob, and others, The issue with " state-wide " data collection is that most people have no idea what it is they are asking for...when epidemiology calls for submission of all Texas EMS runs, in their office in Austin is probably doesn't seem like a problem. I mean after all, no one considers that there are 733 licensed EMS providers (downloaded the file from TDH just now) and if all 733 of them did ONE (1) call per day (remember although some of the 733 may not do one call a day...many others like SA, Houston, Dallas, El Paso, MedStar, Amarillo, etc do many many more than one) over a year that is 733*365=267,545 EMS calls. IF it takes ONE minute to enter in each call, it is over 4,450 hours per year.....but if you increased it to 5 minutes a call, it goes to 22,295 hours per year....that's 10.7 FTE's per year to enter in one call per day from each of the licensed EMS Providers in Texas (no wonder it was necessary to have EMS agencies do it instead of TDH personnel). In another location where I participated in state-wide data collection, the state prepared a " State-Wide Patient Care Report " and mandated that everyone use it. It cost our agency 1000's of dollars to educate our employees on this new form. The date came to send them all to the State (again...not Texas) and within 6 weeks we received a certified letter from the State EMS Dept to cease and desist following the mandate for submission of each run report because the state could not handle our submissions much less the other 350 or 400 agencies submissions (we sent them over 20,000 PCR's in those 6 weeks and we were not the largest EMS in the state). Now, I should not complain too loudly because with the money our RAC received, we are in the process of going on-line with electronic run reports....but what of those agencies who did not do this? What of those who took the money to buy " a computer capable of submitting runs via the internet " and they are now looking at how to actually make it happen everyday. The question comes up what happens if an agency doesn't comply and doesn't submit? Chances are the first impact will be their ability to get LPG and EMS funds from TDH...of course this will only hurt the agencies who will have the toughest times complying with the mandate (like Jane's example) since these are the easiest EMS funds to get..... Anyway, now we have a mandate and now we have to find a way to comply...unfortunately, when a large number of agencies find this mechanism...the pain and difficulty will not be seen at the regulatory level where the success of this mandate will only encourage more. Just my $0.02, Dudley Wait Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 22, 2002 Report Share Posted September 22, 2002 You .02 cents in this case, Dudley, is worth at least a dollar. Jane Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 22, 2002 Report Share Posted September 22, 2002 : So what you are saying is that we need more technology? BEB E. Bledsoe, DO, FACEP Midlothian, Texas All outgoing email scanned by Norton Antivirus and guaranteed " virus free " or your money back. Re: FW: Ground ambulance accident data > > > Jane, Bob, and others, > > The issue with " state-wide " data collection is that most people have no > idea > what it is they are asking for...when epidemiology calls for submission > of > all Texas EMS runs, in their office in Austin is probably doesn't seem > like a > problem. I mean after all, no one considers that there are 733 licensed > EMS > providers (downloaded the file from TDH just now) and if all 733 of them > did > ONE (1) call per day (remember although some of the 733 may not do one > call a > day...many others like SA, Houston, Dallas, El Paso, MedStar, Amarillo, > etc > do many many more than one) over a year that is 733*365=267,545 EMS > calls. > IF it takes ONE minute to enter in each call, it is over 4,450 hours per > > year.....but if you increased it to 5 minutes a call, it goes to 22,295 > hours > per year....that's 10.7 FTE's per year to enter in one call per day from > each > of the licensed EMS Providers in Texas (no wonder it was necessary to > have > EMS agencies do it instead of TDH personnel). > > In another location where I participated in state-wide data collection, > the > state prepared a " State-Wide Patient Care Report " and mandated that > everyone > use it. It cost our agency 1000's of dollars to educate our employees > on > this new form. The date came to send them all to the State (again...not > > Texas) and within 6 weeks we received a certified letter from the State > EMS > Dept to cease and desist following the mandate for submission of each > run > report because the state could not handle our submissions much less the > other > 350 or 400 agencies submissions (we sent them over 20,000 PCR's in those > 6 > weeks and we were not the largest EMS in the state). > > Now, I should not complain too loudly because with the money our RAC > received, we are in the process of going on-line with electronic run > reports....but what of those agencies who did not do this? What of > those who > took the money to buy " a computer capable of submitting runs via the > internet " and they are now looking at how to actually make it happen > everyday. > > The question comes up what happens if an agency doesn't comply and > doesn't > submit? Chances are the first impact will be their ability to get LPG > and > EMS funds from TDH...of course this will only hurt the agencies who will > have > the toughest times complying with the mandate (like Jane's example) > since > these are the easiest EMS funds to get..... > > Anyway, now we have a mandate and now we have to find a way to > comply...unfortunately, when a large number of agencies find this > mechanism...the pain and difficulty will not be seen at the regulatory > level > where the success of this mandate will only encourage more. > > Just my $0.02, > > Dudley Wait > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 22, 2002 Report Share Posted September 22, 2002 I am not very familiar with EMS Pro, its capabilities, etc. Does it allow the medic to enter their own narrative as well as the drop down menu information? If that is the case, I am all for it. However, that does not alleviate the problem for us out here where this was not brought to the forefront. We are still on the " front end " of the problem with computers that will be extinct in a year or so and still with the same problem - money to address the underlying problem. At this point, many of us - I dare say MOST of the smaller services - cannot afford to bear the brunt of expense to go to the electronic charting. We can't afford either to bear cost increases from our billing agencies to do it for us nor can we afford to hire more personnel to do it the traditional way. The vicious circle continues here. WHY can't we afford to do these things? Would it have anything to do with the fact that our reimbursements for our runs from Medicare, Medicaid, and private insurance just keep getting smaller? The insurance companies continue to look for more and more ways to pay us less and less for medically justified transports. Meanwhile, the general public sincerely feels that if they need an ambulance that their insurance will pay for most or all of the bill. Then when they discover " that ain't happenin " they cannot find the resources to pay what remains - typically 50 - 75% of the overall bill. So they don't pay either. Why can they get away with paying a mileage pay for a rural transport of $2/mile when Medicare will allow $8.21/mile (supposedly)? Why if the base rate for a BLS emergency is $500 can they get away with only reimbursing $150 or $200 because the amount charged was " greater than the allowable amount " - but their " allowable " amount is based on figures from 10 years ago? If I remember, this is supposed to be addressed " immediately " according to the Strategic Planning Document. OK, person assigned to that task, jump in here and tell us what we are doing to solve this. HELP!!!!!!!! Jane Hill Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 22, 2002 Report Share Posted September 22, 2002 Ms. Hill, Yes, EMS Pro has complete narrative functions where the medic can enter as much as he wants to, the box just keeps expanding. The medic can print the chart out at the hospital if he is finished using infra-red to the hospital printer, or he can take it back to the station, finish it then the server will fax it to the ER instead. It will also electronically capture the patient's signature, even for refusals and has 7 or 8 different languages that it can place the refusal language into to help with the language barrier we sometimes bump into. As far as the financial situation, I agree 100% and wish I had more answers for you. The legislative session will start soon, but with a 7 billion dollar deficit, I think there is a low chance for radical funding improvements. Regards, Epley Executive Director Southwest Texas Regional Advisory Council for Trauma TSA-P - office - fax eepley@... www.strac.org RE: FW: Ground ambulance accident data I am not very familiar with EMS Pro, its capabilities, etc. Does it allow the medic to enter their own narrative as well as the drop down menu information? If that is the case, I am all for it. However, that does not alleviate the problem for us out here where this was not brought to the forefront. We are still on the " front end " of the problem with computers that will be extinct in a year or so and still with the same problem - money to address the underlying problem. At this point, many of us - I dare say MOST of the smaller services - cannot afford to bear the brunt of expense to go to the electronic charting. We can't afford either to bear cost increases from our billing agencies to do it for us nor can we afford to hire more personnel to do it the traditional way. The vicious circle continues here. WHY can't we afford to do these things? Would it have anything to do with the fact that our reimbursements for our runs from Medicare, Medicaid, and private insurance just keep getting smaller? The insurance companies continue to look for more and more ways to pay us less and less for medically justified transports. Meanwhile, the general public sincerely feels that if they need an ambulance that their insurance will pay for most or all of the bill. Then when they discover " that ain't happenin " they cannot find the resources to pay what remains - typically 50 - 75% of the overall bill. So they don't pay either. Why can they get away with paying a mileage pay for a rural transport of $2/mile when Medicare will allow $8.21/mile (supposedly)? Why if the base rate for a BLS emergency is $500 can they get away with only reimbursing $150 or $200 because the amount charged was " greater than the allowable amount " - but their " allowable " amount is based on figures from 10 years ago? If I remember, this is supposed to be addressed " immediately " according to the Strategic Planning Document. OK, person assigned to that task, jump in here and tell us what we are doing to solve this. HELP!!!!!!!! Jane Hill Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 22, 2002 Report Share Posted September 22, 2002 Dr. Bledsoe, As weird as it sounds, in this instance, yes, more technology is less costly and provides many more benefits. The reality is that Dudley's math is right on target, and if each run takes 5 minutes to enter by anyone besides the medic on the call, it is very expensive, in time and/or money. The agency already has to account for the medic's time (15-20 min or more) to fill out a run report. If he does it on paper, then someone (a data entry person, the billing clerk, the medic himself when he gets back to the station..) has to re-enter the data to meet the requirements. The really weird part of this is if the medic does the entry on the call, the data is almost always better since he was the one taking care of the patient, and if using full electronic charting, the software has a great deal of direct management functionality since the entire run report is in the database, not just the data points TDH wants. Performance Improvement, inventory tracking and restocking, and even infection control measures are improved. Austin EMS already did the math and could potentially have to hire 4-5 FTE's just to do the data entry. Even if they had to buy every truck a new laptop each year and add 3 hrs training to each employee (average time to learn it is much less, btw), it would still be much cheaper that 5 FTE's that would enter fewer data points. Our sense is the laptops will last much longer, perhaps 2-3 years although replacement costs will be an on-going thing. Dudley has done the math for his service and if his reimbursement goes up just 1% next year with electronic charting, he will have paid for _all_ the laptops he had to buy to participate in the EMS Pro project. One of the things we are really excited about in our scenario is that the management reports can easily be blindly compared to other like entities (given their permission obviously) so real comparative analysis is possible. The example of comparative data analysis I liked the most was watching a video of a race horse running at breakneck speed, muscles straining and the ground just whizzing by, until the camera zooms out and you realize the horse is running dead last in a pack of 8 horses. If we cannot compare ourselves to other similar agencies, in size, structure, provider type, and other pertinent factors, then we can never really know if we are doing a good job given the circumstances we face. Imagine the satisfaction of an ad-hoc report that you and 8-10 other agencies agree to run, where 3rd service EMS volunteer agencies in counties less than 50,000 could compare response times, intubation success rates, scene times, whatever. Finally a way to know if you your agency is measuring up, ahead of the pack, or needs to concentrate on certain areas to improve the service to their citizens. And best of all they automatically meet the TDH reporting requirements because the data is already collected! I for one feel that the bigger bang for the buck is in doing the full smash, electronic charting, not just data collection. Then and only then does the EMS Director have a more complete picture and has it under his complete control, not in a state database somewhere with less data points. Just my thoughts, See ya, Epley Executive Director Southwest Texas Regional Advisory Council for Trauma TSA-P - office - fax eepley@... www.strac.org Re: FW: Ground ambulance accident data : So what you are saying is that we need more technology? BEB E. Bledsoe, DO, FACEP Midlothian, Texas All outgoing email scanned by Norton Antivirus and guaranteed " virus free " or your money back. Re: FW: Ground ambulance accident data > > > Jane, Bob, and others, > > The issue with " state-wide " data collection is that most people have > no idea what it is they are asking for...when epidemiology calls for > submission of > all Texas EMS runs, in their office in Austin is probably doesn't seem > like a > problem. I mean after all, no one considers that there are 733 licensed > EMS > providers (downloaded the file from TDH just now) and if all 733 of them > did > ONE (1) call per day (remember although some of the 733 may not do one > call a > day...many others like SA, Houston, Dallas, El Paso, MedStar, Amarillo, > etc > do many many more than one) over a year that is 733*365=267,545 EMS > calls. > IF it takes ONE minute to enter in each call, it is over 4,450 hours per > > year.....but if you increased it to 5 minutes a call, it goes to > 22,295 hours per year....that's 10.7 FTE's per year to enter in one > call per day from each > of the licensed EMS Providers in Texas (no wonder it was necessary to > have > EMS agencies do it instead of TDH personnel). > > In another location where I participated in state-wide data > collection, the state prepared a " State-Wide Patient Care Report " and > mandated that everyone > use it. It cost our agency 1000's of dollars to educate our employees > on > this new form. The date came to send them all to the State (again...not > > Texas) and within 6 weeks we received a certified letter from the > State EMS Dept to cease and desist following the mandate for > submission of each run > report because the state could not handle our submissions much less the > other > 350 or 400 agencies submissions (we sent them over 20,000 PCR's in those > 6 > weeks and we were not the largest EMS in the state). > > Now, I should not complain too loudly because with the money our RAC > received, we are in the process of going on-line with electronic run > reports....but what of those agencies who did not do this? What of > those who took the money to buy " a computer capable of submitting runs > via the internet " and they are now looking at how to actually make it > happen everyday. > > The question comes up what happens if an agency doesn't comply and > doesn't submit? Chances are the first impact will be their ability to > get LPG and > EMS funds from TDH...of course this will only hurt the agencies who will > have > the toughest times complying with the mandate (like Jane's example) > since > these are the easiest EMS funds to get..... > > Anyway, now we have a mandate and now we have to find a way to > comply...unfortunately, when a large number of agencies find this > mechanism...the pain and difficulty will not be seen at the regulatory > level where the success of this mandate will only encourage more. > > Just my $0.02, > > Dudley Wait > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 22, 2002 Report Share Posted September 22, 2002 The issue rmains this; 1. Will data gleaned from these reports help funding? Perhaps, from the odd grant. However, in this country, most EMS is funded locally and patient outcomes and other data are rarely recognized, requested, or used. Instead they buy as much EMS (or as little) as they feel they can afford. Thus, while we are generating reams of paper--to what purpose will it be used? 2. Is there going to be a national or state clearing house to evaluate the data and make recomendations? If the data was being gathered in concert with a University or Medical School with experience looking at data, it might be more meaningful. Likewise, will the " business " aspect of the data be evaluated by our business schools so as to help the individual EMS managers. The TDH and other state agencies are underfunded and have little capacity or experience managing large quantities of EMS and medical data. It will sit in a stoage facility rented at excessive cost to the taxpayers/ 3. Should the data indicate a change is needed, will the EMS system react to the change? Currently, the RACS and similar entities have established protocols based on the standard dogma--including the Golden Hour (which we now know does not really exist). If the data were to show that a particular EMS methodology (i.e., 12-lead ECGs) made little difference in patient outcome--would we be willing to eliminate that practice or are we going to remain subservient to the medical device manufacturers and drug companies? The bottom line is, " Don't ask the question if you don't want to know the answer. " A similar parallel exists in emergency medicine: " Don't order the test if it will not change your treatment plan. " 4. Is the gathering of data simply bureaucratic dogma that will do little other to statisfy the bureaucrats? Obviously a rhetorical question. If we really wanted to gather meaningful data, a consensus panel of managers, paramedics, EMTs, first responders, ED nurses, medical directors, research-types, and a few politicians thrown in for flavor (one of which os BOUND to be a lawyer) would be gathered to determine what data is needed, how the data will be gathered, and to what end the data will be for. To date, none of the information I have seen has any relationship to anything I have thrown out. BEB Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 22, 2002 Report Share Posted September 22, 2002 Amen. " Dr. Bledsoe " wrote: > The issue rmains this; > > 1. Will data gleaned from these reports help funding? > Perhaps, from the odd grant. However, in this country, most EMS > is > funded locally and patient outcomes and other data are rarely > recognized, > requested, or used. Instead they buy as much EMS (or as little) as > they > feel they can afford. Thus, while we are generating reams of > paper--to what > purpose will it be used? > > 2. Is there going to be a national or state clearing house to > evaluate the > data and make recomendations? > If the data was being gathered in concert with a University or > Medical > School with experience looking at data, it might be more meaningful. > Likewise, will the " business " aspect of the data be evaluated by our > business schools so as to help the individual EMS managers. The TDH > and > other state agencies are underfunded and have little capacity or > experience > managing large quantities of EMS and medical data. It will sit in a > stoage > facility rented at excessive cost to the taxpayers/ > > 3. Should the data indicate a change is needed, will the EMS system > react > to the change? > Currently, the RACS and similar entities have established > protocols > based on the standard dogma--including the Golden Hour (which we now > know > does not really exist). If the data were to show that a particular > EMS > methodology (i.e., 12-lead ECGs) made little difference in patient > outcome--would we be willing to eliminate that practice or are we > going to > remain subservient to the medical device manufacturers and drug > companies? > The bottom line is, " Don't ask the question if you don't want to know > the > answer. " A similar parallel exists in emergency medicine: " Don't > order the > test if it will not change your treatment plan. " > > 4. Is the gathering of data simply bureaucratic dogma that will do > little > other to statisfy the bureaucrats? > Obviously a rhetorical question. > > If we really wanted to gather meaningful data, a consensus panel of > managers, paramedics, EMTs, first responders, ED nurses, medical > directors, > research-types, and a few politicians thrown in for flavor (one of > which os > BOUND to be a lawyer) would be gathered to determine what data is > needed, > how the data will be gathered, and to what end the data will be for. > > To date, none of the information I have seen has any relationship to > anything I have thrown out. > > BEB > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 22, 2002 Report Share Posted September 22, 2002 Dr. Bledsoe, I gotta sign off after this but I think you and I are closer in thinking than you think. I can assure you that Zane and Carol would not say that I have been a huge proponent of this project, however, I do support data collection to provide information for evidence-based practice. Our RAC simply took an unpalatable situation that was thrust upon us and made the best of it, although I don't think any of us would have opted to do it if the mandate and the initial dollars not been there. If you are frustrated with the TRAC-IT project and not our improvised solution to it, then I misunderstood. I entered the discussion (and will be dropping back into obscurity afterward) to mention that there are some lemonade answers to the lemons that people are talking about. BTW, our data servers are residing at the South Texas Injury Prevention Research Center, which is a part of the UT Health Science Center - San . We have already entered into an MOU to have their expertise assist us in our review of the data. With respect to the endpoint of data collection to improve funding, again, I guess my take home point is that the issues you raise I think apply to TRAC-IT and I think are valid. I do not know what the initial purposes of TRAC-IT were, although I don't think they were to improve funding as its primary mission. We continue to be under-funded in EMS but I am unsure how to argue the point without objective information. We do not currently have a state or national clearinghouse of the full electronic chart but I am in discussions with other like-sized entities using EMS Pro around the country that are interested in collaborating in the future if there is benefit. I also agree with you that pre-hospital and hospital practice should be evidence-based, but that requires evidence and then we are back to the beginning of this discussion. As far as your personnel list for data collection consensus panel, absent the lawyer/politician, you have described our regional registry committee makeup, to include the research folks from the Health Science Center and 2 of the Level I trauma center medical directors as well. Signing off. See ya, Re: FW: Ground ambulance accident data The issue rmains this; 1. Will data gleaned from these reports help funding? Perhaps, from the odd grant. However, in this country, most EMS is funded locally and patient outcomes and other data are rarely recognized, requested, or used. Instead they buy as much EMS (or as little) as they feel they can afford. Thus, while we are generating reams of paper--to what purpose will it be used? 2. Is there going to be a national or state clearing house to evaluate the data and make recomendations? If the data was being gathered in concert with a University or Medical School with experience looking at data, it might be more meaningful. Likewise, will the " business " aspect of the data be evaluated by our business schools so as to help the individual EMS managers. The TDH and other state agencies are underfunded and have little capacity or experience managing large quantities of EMS and medical data. It will sit in a stoage facility rented at excessive cost to the taxpayers/ 3. Should the data indicate a change is needed, will the EMS system react to the change? Currently, the RACS and similar entities have established protocols based on the standard dogma--including the Golden Hour (which we now know does not really exist). If the data were to show that a particular EMS methodology (i.e., 12-lead ECGs) made little difference in patient outcome--would we be willing to eliminate that practice or are we going to remain subservient to the medical device manufacturers and drug companies? The bottom line is, " Don't ask the question if you don't want to know the answer. " A similar parallel exists in emergency medicine: " Don't order the test if it will not change your treatment plan. " 4. Is the gathering of data simply bureaucratic dogma that will do little other to statisfy the bureaucrats? Obviously a rhetorical question. If we really wanted to gather meaningful data, a consensus panel of managers, paramedics, EMTs, first responders, ED nurses, medical directors, research-types, and a few politicians thrown in for flavor (one of which os BOUND to be a lawyer) would be gathered to determine what data is needed, how the data will be gathered, and to what end the data will be for. To date, none of the information I have seen has any relationship to anything I have thrown out. BEB Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 23, 2002 Report Share Posted September 23, 2002 Thanks for the info. And the cost? Jane Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 23, 2002 Report Share Posted September 23, 2002 Thanks, . Your analogy makes sense. But it still doesn't set up the areas who are all now behind the power curve on this issue. I wish ideas and suggestions such as yours had been evaluated and distributed BEFORE we were all under the gun and our RAC's had already spent money on other ways to meet the requirements. Maybe then the majority wouldn't be in our situation, huh? Jane Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 23, 2002 Report Share Posted September 23, 2002 Please don't drop back into obscurity, . You have valid points and information. Jane Hill Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 23, 2002 Report Share Posted September 23, 2002 I don't now, nor will I ever subscribe to notion that we're stuck with anything - including the yzantine practice of EMS " data collection " or similar forms of bureaucratic self-gratification. Bob Kellow wrote: Maybe not again or while you are sleeping or when you take a shower, or on days that end in Y or months that have a R in them or during Daylight Savings Time or during the fall of the year or get my point yet. We may not like or agree with it but we will end up having to do it. We certainly must try and change the things we don't agree with. At some point where we can't change it we should try and turn it to our advantage and make it as painless as possible. Bob I fully agree with you once again. > Henry, > > In the past, I have seen at least four " minimum essential EMS data sets " > that were developed by national coalitions, associations and government > agencies. I have even participated in the development of a couple of > them myself. Following days of ruminating, chin stroking and > pontificating, someone invariably asks. " O.K., so how can we make sure > that this is uniformly implemented and maintained? " > > Because no rational human would knowingly engage in the collection of > data that is destined for nowhere, the answer was always, " Link the > requirement (mandate) to funding or state administrative codes. " Jam it > down their throats. Make it a licensure requirement. Or, cut off their > funding if they don't comply. In other words, shift the burden of > compliance, maintenance and proof to the EMS providers, thereby > absolving the creator's of the document from responsibility, > accountability and fiscal consequences (obligations). > > Henry, you've seen this kind of thing happen repeatedly throughout EMS > history. Once these " monsters " are created, they assume a life of their > own - roaming the countryside killing everything in sight. Given enough > time and attrition, EMS people will eventually stop questioning the > necessity or practicality of the requirements (aka: stump broke). Two > more examples of this include the GSA's KKK-A-1822-D vehicle standards, > and the NHTSA/ASTM-hatched F-30 Committee on EMS. > > The EMS industry has suffered from these and other forms of predatory > intrusion and pernicious manipulation at the behest of entities that had > everything to gain and nothing to lose. I don't now, nor will I ever > subscribe to notion that we're stuck with anything - including the > byzantine practice of EMS " data collection " or similar forms of > bureaucratic self-gratification. > > Bob Kellow > > Henry Barber wrote: > > > Bob, Bob, Bob > > > > You and I both know that we will be required to send the data no > > matter what. > > We could talk all day about it being good data, bad data or whatever. > > The end > > result is that we will still be required to send it. I served on the > > Trac-It > > committee and voiced all the same concerns that you have offered. > > Myself and > > others knowing that we were going to be forced to send in the data, > > attempted > > to steer it into something that would at least be minimal painful to > > the > > provider and that would provide feedback to the provider in regards to > > data > > that is being sent in to TDH. > > > > Speaking of TDH: We are not dealing with the TDH that works with EMS. > > We are > > dealing with a totally different department of TDH. Mr. Zane is > > the > > leader of the Epidemology department. Kathy is working very hard to > > assure > > that our concerns are heard by Mr. Zane. > > > > I have found that Mr. Zane has minimal staff who deal with data and > > have no > > real understanding of EMS. Trac-It has been a struggle from the > > beginning in > > regards to EMS and input from EMS. The NSR group that developed the > > program > > was very knowledgeable and open minded. Once they were out of the > > picture, > > things seemed to bog down. > > > > Do I think the Trac-It system will work. Hell I don't know. What I do > > know is > > that EMS has had about as much input as possible into the program. We > > have > > had to badger, complain and request information over and over so that > > we can > > upload data that we didn't want to upload in the first place. If > > Trac-It ever > > comes to fruition it will surprise me. I really do not think that > > Epidemology > > has the ability to manage and oversee the program. I say this because > > of > > their track record so far. > > > > What have we done in Calhoun County? We implemented computer reports > > in 1998 > > using a very inexpensive program (StatCo) that provides us all the > > data that > > we need for budgeting and at the same time provides TDH their > > information. > > The crew members type their reports and upload to our file server when > > that > > get back to the station. With this system they also can print out a > > copy of > > the report at the E.R. prior to leaving. We have no need to hire new > > office > > staff to manage the data. Simply speaking we chose to implement the > > program > > because we knew it was required. By doing so we were able to do it on > > our > > terms and within our time frame. > > > > Even if Trac-It were to go away and I don't think it will, we are > > better off > > as a department because we now have reports that are printed,easy to > > read, > > complete, spell checked, user friendly and that provides data that we > > need. > > > > My friend you are absolutely right in your comments. Right does not > > always > > enable change. > > > > Henry Barber > > > > Bob Kellow wrote: > > > > > Jane, > > > > > > You're exactly right. Many states collect run data, but few provide > > any > > > meaningful outcomes. In other words, the collection of data becomes > > the > > > " end " , rather than the " means " to an identified end. > > > > > > What can we expect to change as a result of collecting and reporting > > > > > these data? What will be the frequency and reliability of the > > state-wide > > > reports? Will they be statistically valid? What elements are marked > > for > > > trend analysis? How will these data specifically influence rule > > making? > > > Can uniform comparisons be made: by population? - by setting? - by > > > outcomes? Is there a provision for dropping this requirement if the > > data > > > proves unusable, unreliable or invalid? Or will it just go on > > forever, > > > regardless of utility or practicality? Was the fiscal impact on EMS > > > providers ever considered? These are just a few of my questions. > > > > > > Bob Kellow > > > > > > je.hill@... wrote: > > > > > > > The sad thing that I have been told over and over by other > > ambulance > > > > services > > > > that many are having to try and find money in the budget to hire > > extra > > > > staff > > > > members to enter the required data because of the VOLUME of data. > > I > > > > talked to > > > > our new billing agent the other day, and he implied that he will > > be > > > > forced to > > > > raise what he charges to accomodate the MANY extra key strokes > > that he > > > > will now > > > > be forced to do - he will be submitting our data. I have always > > told > > > > my > > > > students that on any intervention that they perform, they must > > balance > > > > the > > > > potential adverse effects versus the benefit. Which is better? > > The > > > > disease or > > > > the cure? Can we also apply that to this subject? I realize that > > > > > > epidemiological studies are necessary sometimes to help us improve > > > > > > what we do > > > > by identifying problems etc. But when the route to doing that > > study > > > > incurs > > > > more expense and problems for an already overburdened and > > overwhelmed > > > > system, I > > > > am not sure that the benefit outweighs the adverse effects. Can > > > > somebody help > > > > me out with this? > > > > > > > > Jane Hill > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
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