Time Sensitive Emergency System of Care for Idah0 Getting the right patient to the right place in the right time.

Background Rural/Frontier State Only a Few States With Systems Trauma, Stroke or Heart Attack Attempts to Develop Trauma System Only result was a trauma registry Local Collaboratives Exist However, no statewide system Getting the right patient to the right place in the right time.

BAckground 2012 Health Quality Planning Commission (HQPC) trauma system discussion modeled after Montana’s trauma system stroke and heart attack added House Concurrent Resolution 010 (HCR010) Time Sensitive Emergencies System of Care Getting the right patient to the right place in the right time.

HCR010 Legislature Directed DHW to: Convene Workgroup Develop: Elements of System Structure Funding Mechanisms Implementation Plan Create Enabling Legislation Trauma then Stroke & Heart Attack Getting the right patient to the right place in the right time.

Work Group Members Inclusive Stakeholder List 40+ “Regulars” Hospitals Providers & EMS Payers Rehabilitation & Community Public Health Advocacy & Legislative Inclusive Stakeholder List 40+ “Regulars” Monthly Meetings May - November, 2013 Getting the right patient to the right place in the right time.

Schedule of Work Meeting Topic/Milestone Schedule Locations Kickoff Meeting May 14, 2013 8:00 -5:00 Oxford Suites Overland Road, Boise System Design: Part I June 11, 2013 10:00 – 3:00 Saint Alphonsus Regional Medical Center, Boise System Design: Part II July 9, 2013 St. Luke’s Regional Medical Center, Statewide Registry and Performance Measures August 6, 2013 Qualis Health, System Funding and Other Supports September 4, 2013 Recommendations, Legislation and Implementation Plan September 30, 2013 Recommendations Finalization & Presentation Development October 30, 2014 Report Finalization November 19, 2013 Ada County Paramedics Presentation of Recommendations Various The TSE workgroup first met in May of this year. This slide gives you an idea of the work plan that we have followed. As you can see in the table, we are down to the last two meetings which are planned for this month. We have covered all of the items identified in HCR 10 and now have a near final draft of legislative language. Getting the right patient to the right place in the right time.

Work To Date FAQs Website www.tse.idaho.gov Mailbox tse@dhw.idaho.gov Presentations Final Report Monthly Meetings and Ad Hoc Subcommittees Engaged & Active Workgroup Other State Consultation MT, UT, WA, Other State System Review Draft Legislation Rule Recommendations Some of the specifics of our work to date include: This slide gives you an idea of the work that the TSE group has completed to date. As I mentioned on the last slide, we have a very active and engaged workgroup that has met monthly since May. We have consulted with a number of other states to learn from their experiences. We have relied heavily on the experiences and advice our counterparts in Montana and Utah as we have developed the recommended system structure, enabling legislative language and rule recommendations. We have developed several tools that focus on communicating the current status of the workgroup’s efforts. A comprehensive “Frequently Asked Question” document that we have worked hard to maintain so that it reflects the most contemporary information regarding the TSE system. The TSE workgroup now has a web-site that contains the most current information concerning the TSE workgroup. The website also provides a viewer with email addresses and phone numbers for contacts if a reader has questions or wants more information. We have also set up a dedicated TSE email account that people can use to easily communicate with us about the TSE system. Workgroup members have also presented information about the proposed TSE system to interested groups throughout Idaho. The final element that are working to complete is the final report that details the efforts of the workgroup. Getting the right patient to the right place in the right time.

Continuum of Evidence-Based Care This diagram depicts the continuum of care that we envision for a patient of any of the time sensitive emergencies. As you can see the circle includes all of the major elements that we would expect a comprehensive system of care to include. We have used this diagram as a foundation for our work on the system to make sure that we have the right people at the table and that all of the critical system elements are addressed. Getting the right patient to the right place in the right time.

Structure TSE System of Care for Idaho

State Board 18 Member Board Appointed by Governor Getting the right patient to the right place in the right time. State Board Time Sensitive Emergency System of Care 18 Member Board Appointed by Governor Hospital, EMS & Public Rehabilitation Trauma, Stroke, Heart Attack Establish Standards Designation & Certification

Regional TSE Committees

Regional Committees Regional Representation Education Getting the right patient to the right place in the right time. Regional Committees Time Sensitive Emergency System of Care Regional Representation Education Quality Improvement Coordination in the Region Technical Assistance

Designation and Certification Trauma National Standards and Best-Practices Five Levels of Designation State Designation Utilization of Billing Code Stroke/Heart Attack National Standards and Best-Practices Types of Certification; i.e., receiving and or treatment State Certification Getting the right patient to the right place in the right time.

Legislation and Rules Legislation Rules Developed in year 1 & year 2 Establish TSE system at all levels including state board, regional advisory committees, authority to designate/certify Include stroke and heart attack data collection in existing trauma registry to and create a registry for time sensitive emergencies Rules Developed in year 1 & year 2 Define the components or guidelines for trauma, stroke and heart attack; detail level of the system Trauma rules to 2015 legislature Stroke & heart attack rules to 2016 legislature Getting the right patient to the right place in the right time.

Questions? tse@dhw.idaho.gov www.tse.idaho.gov