EMS to Hospital communication

[Citywide173]

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.

HIPAA specifically allows the transmission of information, as long as it is the minimum amount of information necessary to provide appropriate patient care. While entirely possible, the complexity required to intercept this information would have to require someone very proficient at scanner use. Dispatch on one channel, ambulance to hospital on a semi-duplex MED channel and the ambulance being on the input of that semi-duplex. Perhaps your hospitals need to re-evaluate what they get notified on. Here in Boston, the only time you get on CMED is if you need a trauma room upon your arrival, everything else is brought in through the doors and the first time any patient info is transmitted, it is face to face. The patient you described above would never require a CMED entry in our system.

 

[buddrousa]

I see your point if you are in a town of several hundred thousand. But we live in a town of 10 thousand and a Ambulance can be heard all over town on 155.340 simplex and this is why we have went to using cellphones for all patient to Hospital traffic just to be on the safe side. I have seen the legal opinion and agree with you but the people at the top above us lean way toward the safe side.

 

[Citywide173]

I see your point if you are in a town of several hundred thousand. But we live in a town of 10 thousand and a Ambulance can be heard all over town on 155.340 simplex and this is why we have went to using cellphones for all patient to Hospital traffic just to be on the safe side. I have seen the legal opinion and agree with you but the people at the top above us lean way toward the safe side.

VHF HEAR channels are an option I didn't consider. They are antiquated and definitely less secure that the UHF MED channels, but I still hold that the UHF MED channels are the defined national standard and that local agencies mandating other systems are just placing unnecessary costs on ambulance services for communicating with hospitals-if it is a requirement of that service obtaining a 9-1-1 contract to communicate with local public safety, that is a different case. It also impacts interoperability in the case of foreign units needing to contact a hospital or an ambulance task force response (possibly from many states away) from coming into the area in the case of a disaster.

 

[buddrousa]

Ed each unit has a Kenwood TK-790 radio for dispatch and to switch to local FD's or inbound Aircraft but Ambulance to ER is CELLPHONE only.

 

[Citywide173]

Ed each unit has a Kenwood TK-790 radio for dispatch and to switch to local FD's or inbound Aircraft but Ambulance to ER is CELLPHONE only.

I'm referring to the posts where local authorities are replacing the HEAR/CMED with hospital talkgroups on an encrypted TRS and then requiring all ambulance services to have those radios in the ambulance. Even where cell phones are the accepted practice, there has to be a backup. With the MED channels being an accepted national standard and most states requiring them in ambulances at the state Office of Emergency Medical Services level, I just don't understand why system managers would create a condition where companies now have to buy subscriber units in addition to what is already in place, especially if they don't have any public safety contracts. As I pointed out above, the MED channels were used extensively by foreign units during Katrina and I think these system managers who are trying to circumvent the MED Channel plan are too big for their britches.

 

[ecps92]

but for the rural areas, VHF works well.

Each hospital having it's own CTCSS tone eliminate the need for a patch to be initiated or channel assigned.

Atleast we have gone aware from the SELCAL dialing or even DTMF Ahhh the days of 280 fighting with the Bus Company

VHF HEAR channels are an option I didn't consider. They are antiquated and definitely less secure that the UHF MED channels, but I still hold that the UHF MED channels are the defined national standard and that local agencies mandating other systems are just placing unnecessary costs on ambulance services for communicating with hospitals-if it is a requirement of that service obtaining a 9-1-1 contract to communicate with local public safety, that is a different case. It also impacts interoperability in the case of foreign units needing to contact a hospital or an ambulance task force response (possibly from many states away) from coming into the area in the case of a disaster.

 

[ecps92]

Looks pretty standard. [Off Topic]
Had my a recent incident [911 transport] and was not billed by the local 911 Provider, the Transfer into Boston [18 miles] was
charged at $2240.00 for the Ambulance / EMT's [bet they charged extra for the Wife to ride along] and then $1105.00 for mileage
Now this a transport with No O2, not need for care other than visually monitoring the Patient and having a lovely conversation in Boston traffic

My Cost, thanks to a Plan not taken away by #44 thankfully is $279.64

$3000.00 for a 20 mile trip. I think that's a little steep. Came out of my wallet

 

[scanmanmi]

Around here they pay $10 / hour

 

[sefrischling]

The broadcasts do contain sensitive information. I'm not quite sure it meets the criteria of HIPPA since no names are used, but it doesn't take much effort to combine the original dispatch address with the consult unit number to figure out who the patient is.

It is HIPAA ... and ... info transmitted over MED radio is not protected by HIPAA. Dispatchers, for the most part, are not bound by HIPAA due to what HIPAA does and does not cover. Police in most instances are not legally bound by HIPAA. Legally many fire departments are not bound by HIPAA, unless they directly run and/or bill for EMS services.

I have never heard an inbound bus transmit an address to the ER. The ER doesn't care about that at all.

 

[PrivatelyJeff]

I have never heard an inbound bus transmit an address to the ER. The ER doesn't care about that at all.

or even a ton of information either. They just need to know the current vitals and anything emergent.

 

[KK4JUG]

I think we're beating a dead horse. I spent over 30 years in law enforcement (often working with medical personnel) and more years that that listening to a scanner. I think my first one was an RS with 4 crystals. In all that time, I've never heard a patient's name put out on the air. HIPAA or the lack of HIPAA notwithstanding, I think this is a moot issue.

 

[Citywide173]

I think we're beating a dead horse. I spent over 30 years in law enforcement (often working with medical personnel) and more years that that listening to a scanner. I think my first one was an RS with 4 crystals. In all that time, I've never heard a patient's name put out on the air. HIPAA or the lack of HIPAA notwithstanding, I think this is a moot issue.

I agree. The amount of effort that would have to be put into causing a HIPAA exposure from monitoring a scanner goes well beyond that of casual listening and probably passes into the realm of the listener willfully committing a criminal act.

 

[W5lz]

I started working ambulances front and back in the sixties and retired in the nineties. During that period of time the information we were 'supposed' to know had more to do with medical/mental state rather than personal information. I can't remember ever giving a name over the radio. Physical descriptions, general descriptions sure, but not names. It just wasn't 'done', you know? I don't think I was ever told to -not- give names, it was just assumed I guess. No identifying numbers either, that was all on paper. A time or two I let the hospital know in a 'round-about' way who the patient was but never by name or 'nickname'.
There were a couple of 'medical-terms' used also, such as the patient having a 'subdural-fecal-toma', or was suffering from 'ceramic-syndrome'. That's different though. I won't say what they mean, but you can figure it out... PD had there own set of describers.

 

[scanmanmi]

I've never heard a patient's name put out on the air.

Every month or two I hear a name after the address on EMS dispatch. The township people know each other. It's easier to find the McDermott house than go looking for 3425 Willow lane. I hear names on cop calls all the time.
Someone else was making the (somewhat ridiculous) point that they may be able to put the address on the dispatch together with the hospital call and figure out that Wilbur has diabetes.

 

[KK4JUG]

Every month or two I hear a name after the address on EMS dispatch. The township people know each other. It's easier to find the McDermott house than go looking for 3425 Willow lane. I hear names on cop calls all the time.
Someone else was making the (somewhat ridiculous) point that they may be able to put the address on the dispatch together with the hospital call and figure out that Wilbur has diabetes.

That wouldn't be improper. There's no medical information. That's dispatch information.

 

[W5lz]

Ha! I used to work in a town that had no street names or street numbers. You had to know where a few people lived because their house was used for directions. Along with schools, churches, that old burned garage and where ~that~ lady lives... you know, the grouch. I think there was only one street that ran N/S or E/W, so that was sort of out too. To be able to give directions you had to keep up with the gossip...

 

[dvendt]

Here where I live they either just say "patient" or use their initials.

 

[KK4JUG]

Here where I live they either just say "patient" or use their initials.

Around here, they often give initials because the ER is familiar with the patient because of frequent unnecessary visits. I guess it's some kind of warning.

 

[n3obl]

Love all the knowledgeable hipaa police in this thread. Ive never used initial. just age and sex and brief report, When i train new people less than 30 seconds tops.

 

[Citywide173]

Love all the knowledgeable hipaa police in this thread. Ive never used initial. just age and sex and brief report, When i train new people less than 30 seconds tops.

That's all that is really necessary. Age, sex, Chief Complaint is what I teach new recruits. There's more that is required here, but I drive home the fact that those three things are enough for the hospital to prepare and that everything else is gravy. If the patient walked through the ED door, the hospital would have less info and many patients do just that.