EMS to Hospital communication

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PrivatelyJeff

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How would it be any different than if the region switched to VHF or DMR or anything else. It’s the same as what it equipment and supplies are required to have: there are policies on what you have to have and if you don’t then you are out of service. And I can’t speak for every area, but you don’t need to worry about what other agencies are doing when there is a call. If you need to know, your dispatch tells you. When PD clears a scene for you, they either tell you directly or tell their dispatch to tell yours to tell you.
 

Citywide173

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How would it be any different than if the region switched to VHF or DMR or anything else. It’s the same as what it equipment and supplies are required to have: there are policies on what you have to have and if you don’t then you are out of service. And I can’t speak for every area, but you don’t need to worry about what other agencies are doing when there is a call. If you need to know, your dispatch tells you. When PD clears a scene for you, they either tell you directly or tell their dispatch to tell yours to tell you.

You're obviously not an EMT, or at least not one that works in a busy urban system. In Boston, we get more from listening to the police and fire than we do from our dispatcher. 140,000 calls per year on our channel, 85,000 on Boston Fire's channel and 750,000+ on the five Boston Police Channels. The update may or may not get entered depending on how busy the dispatcher is and then it may or may not get relayed to the responding crew for the same reason. If you aren't concerned with what is going on at the scene you are responding to, you're an idiot. I have had two occasions where listening to the PD kept me from going into scenes with active shooting well before my dispatcher said a word about it and countless others where we were much better prepared for the call from the info we received directly over the scanner in the truck, which usually got to us well after we were on scene from our own dispatcher. NM has a robust UHF MED system, which it appears that every ambulance must have. If their Office of Emergency Medical Services makes the decision to move, that is one thing, but if the managers of the statewide 700 TRS made the decision it would be entirely different as the 460 MED channels would be required in addition to the 700 TRS and that is expensive for smaller services.

https://nmhealth.org/publication/view/guide/1957/ (admittedly old, but still on their website as current)

https://nmhealth.org/publication/view/general/1961/
 

PrivatelyJeff

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I was on both those accounts and it still wasn’t our concern to monitor what everyone else is doing. If your dispatch isn’t doing their job keeping everyone updated then your dispatch is failing everyone. And if there is a change, it’s discussed with everyone involved. If the statewide managers want EMS on it, they will work through the OES to try and convince them to do it but they can also probably say GTFO, we do things our way for a reason and it works.
 

Citywide173

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I was on both those accounts and it still wasn’t our concern to monitor what everyone else is doing.
Then your situational awareness needs improvement

If your dispatch isn’t doing their job keeping everyone updated then your dispatch is failing everyone.
We are consistently considered one of the best EMS models in the country

And if there is a change, it’s discussed with everyone involved.
Keep telling yourself that, I'm sure the 700 TRS managers view everything from their own little silo and what is already in place and required to be on ambulances is not in their knowledgebase.

If the statewide managers want EMS on it, they will work through the OES to try and convince them to do it but they can also probably say GTFO, we do things our way for a reason and it works.

If they think they are powerful enough to do that, good for them. When businesses start complaining about the extra costs or go out of business because they can't compete anymore because of government mandates who suffers? The people of the communities that those companies served. A single radio may not seem like a lot, but when you suddenly have to buy 15-20 TRS radios (of someone else's spec and system,) it hits hard. The UHF MED channels are part of the DHS interoperability plan-what do you think the task forces communicated on during the Katrina and Rita responses? To phase out the UHF MED channels in one state makes that state an island if they were to experience a disaster on that level.
 

PrivatelyJeff

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Not really. It’s worked fine for 40+ years here. Every unit has a UHF and a VHF analog and that works fine. There hasn’t been an incident where having access to LE communication would have helped.

Our dispatch center covers 4000 square miles and about a dozen or so fire and EMS services. And 15-20 radios? In our area thats nothing, it would be close to 100+ for one service and it’s just the cost of doing business. They were just forced to upgrade their HTs because they were out dated (HT1250) and no one blinked. They just bought a whole bunch of dual band band P25 capable radios and this is a private service.

And you probably wouldn’t phase out the UHF with the intro of some other system, since it’s good to have a backup for when the system fails.
 

Citywide173

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Not really. It’s worked fine for 40+ years here. Every unit has a UHF and a VHF analog and that works fine. There hasn’t been an incident where having access to LE communication would have helped.

Our dispatch center covers 4000 square miles and about a dozen or so fire and EMS services. And 15-20 radios? In our area thats nothing, it would be close to 100+ for one service and it’s just the cost of doing business. They were just forced to upgrade their HTs because they were out dated (HT1250) and no one blinked. They just bought a whole bunch of dual band band P25 capable radios and this is a private service.

You're being purposefully obtuse. 15-20 radios could potentially run a small ambulance service or services out of business if they suddenly had to fork out the money to replace the radios without any public sector funding.

And you probably wouldn’t phase out the UHF with the intro of some other system, since it’s good to have a backup for when the system fails.

I agree that redundancy is important, but this was the post that got me on the tangent:

With above said with a few, plus why open that can of worms? NM is in a slow process to do away with the uhf med channels onto the state 700 trs down the road with you know what E.
 

PrivatelyJeff

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You're being purposefully obtuse. 15-20 radios could potentially run a small ambulance service or services out of business if they suddenly had to fork out the money to replace the radios without any public sector funding.

Not really. The private company had to buy the radios and they knew they would have too and planned for it. And so did the smaller company that had to as well. If it’s happening suddenly, then someone screwed up: either the ambulance company wasn’t paying attention to what’s going on and didn’t plan accordingly or the state managers did and they need to be brought to task and ask why they were being so secretive and not including the all the stakeholders.

I don’t get how you don’t understand that it’s the cost of doing business. It’s the same when the EMS authority requires a new piece of equipment. When they went from 4 lead EKG to 12, everyone had to get new monitors. The authority decided that, issued the new protocols and policies and everyone said ok and bought new 12 lead monitors.
 

Citywide173

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Not really. The private company had to buy the radios and they knew they would have too and planned for it. And so did the smaller company that had to as well. If it’s happening suddenly, then someone screwed up: either the ambulance company wasn’t paying attention to what’s going on and didn’t plan accordingly or the state managers did and they need to be brought to task and ask why they were being so secretive and not including the all the stakeholders.

I don’t get how you don’t understand that it’s the cost of doing business. It’s the same when the EMS authority requires a new piece of equipment. When they went from 4 lead EKG to 12, everyone had to get new monitors. The authority decided that, issued the new protocols and policies and everyone said ok and bought new 12 lead monitors.

You're right, I don't understand. I know the Commonwealth of Massachusetts has tried multiple times to make changes by unfunded mandate and are met with pushback every time that usually results in the state caving. I am lucky to work for a service that is moderately well funded, and was implementing 12 leads long before they were mandated, Piloted the BLS nasal narcan in the region, initiated BLS albuterol in the 90's, well before it was considered a BLS skill, introduced RSI to ground transport units in the area, has an Utstein percentage that is only rivaled by Seattle and is smart enough to see the value of being able to monitor other agencies that every new truck has a 996P2 in it. That doesn't mean that I haven't seen companies fail because the cost of doing business was increased by state mandated changes. The UHF MED channels are what the state requires and that purchase is factored into every truck purchased-a sudden change to the 700 TRS is a cost that might overburden the service, especially if it is the 700 TRS managers saying you have to do it and the sate OEMS office still saying you have to have the MED channels.
 

ecps92

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CT did as well
https://portal.ct.gov/-/media/Depar...umOperationalReqsforUHFMedRadiospdf.pdf?la=en

This is much more what I was getting at. In Massachusetts, all ambulances must have the UHF MED channels, as well as radios with enough capacity to have every regions PL tone in its own channel (radios required by the state must have a minimum of 160 channels.)

https://www.mass.gov/files/documents/2016/07/un/radio-communications-plan.pdf

If you put them onto a trunked system by force, who pays to replace whatever they are currently using, and what access do they have? If they are a 9-1-1 provider, do they have access to the other public safety agencies for monitoring (scene safety/patient update) purposes? If the agencies that are the other first responder agencies are encrypted, will they allow that potential security exposure since they don't control the radios?
 

buddrousa

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This is why we have to pay the high prices we have to pay is because of all the freeloaders on government healthcare (not the elderly that worked all their life just the ones that have never worked at all and drawing free healthcare)
 

Citywide173

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$3000.00 for a 20 mile trip. I think that's a little steep. Came out of my wallet
An inside tip....ask about their "Compassionate Billing Policy" If they have one, there's your answer. The ones I'm familiar with indicate that 9-1-1 transports (not routine transfers) that do not have insurance reimbursement get a certain number of attempts (usually 3 bills mailed) and are then written off.
 

scanmanmi

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Back to the OP about the policy, I never for one second considered it to be HIPPA. The jist of HIPPA is personal information, none of which is given out ambulance to hospital (ok sometimes). It's about tying up air time and missing other monitoring instead of listening to vital signs and vomitting.
 

KK4JUG

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Back to the OP about the policy, I never for one second considered it to be HIPPA. The jist of HIPPA is personal information, none of which is given out ambulance to hospital (ok sometimes). It's about tying up air time and missing other monitoring instead of listening to vital signs and vomitting.
You're right. The hospitals don't care about names, they care about symptoms and vital signs. (And it HIPAA, not HIPPA.)
 

buddrousa

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Well think about this I am sent to your house someone with a scanner knows your address I pick you up and I leave for the Hospital I key up my radio and report to the Hospital this is unit 123 I have a 45 YOM BP120/80 HR 85 RR 16 Patient has a history of Hypertension, HIV, HEPATITIS B, and NARCOTIC DRUG USE. Now how do you see the information from Ambulance to Hospital if this was you as the Patient.
 

KK4JUG

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Well think about this I am sent to your house someone with a scanner knows your address I pick you up and I leave for the Hospital I key up my radio and report to the Hospital this is unit 123 I have a 45 YOM BP120/80 HR 85 RR 16 Patient has a history of Hypertension, HIV, HEPATITIS B, and NARCOTIC DRUG USE. Now how do you see the information from Ambulance to Hospital if this was you as the Patient.
That's a one-in-a-million occurrence and, yes, it's certainly possible but very highly improbable. No system is perfect and there are so many exemptions to HIPAA that it probably doesn't matter in the end.
 
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