PATIENT MOVEMENT WORKGROUP September 22, 2015

1. Reviewing substantially revised standardized bed category document for sending facilities + piloting them 2. Finalizing recommendations document for inclusion of standard data elements in hospital inter-facility transfer forms & patient face sheets 3. Streamlining emergency credentialing – path forward 4. Adding Emergency Management Issues and Voices to the HIT Conversation Today’s Agenda 2

□ Since last meeting □ Further developed bed category sections with SMEs □ Reviewed forms with staff involved in HICS Patient Tracking Units and redesigned sending hospital form with these units as target users □ Today –seeking your feedback! □ Next steps – revising receiving facility form + testing the tools □ Can they be integrated into upcoming eFinds/Evacuation exercises? □ Separate pilot? Standardizing Bed Definitions 3

Sending Facility Receiving Facility Sharing Critical Medical Information 4 Sending Facility Receiving Facility LEVEL 1: Best source of minimum clinical information (likely in paper format) to facilitate patient transfer and stabilization (i.e. downtime report, transfer form) LEVEL 2: Ensure access to full (electronic) medical record to support ongoing care of patient once transferred

□ Since last meeting □ Made minor adjustments to recommendations document based on feedback received □ Involved in preliminary discussions with ONC about pilot project to support development of an EHR template containing our recommended standard data elements □ Next steps □ Communication pushing out recommendations document and support materials; most impactful way to do this to maximize buy in? Facilitating Sharing of (Limited) Critical Medical Information During Transfer Process 5

Transport-related Information  Patient Mobility Level (Ambulatory, Wheelchair, Non-ambulatory)  If an ambulance required, ALS or BLS  IV Medication requirements during transport  If on ECMO or IABP, is team needed?  Oxygen Requirements (eg. BiPAP, CPAP)  Ventilator Settings  Settings/Sizes of lifesaving equipment (eg. trach)  Behavioral Concerns/Safety Risks  Fall Risk/Restraints  Hospital Bed Number at sending and, if known, at receiving facility  Nurse or physician contact Information at sending and receiving facility  Date and time of departure and arrival with signature lines Suggested Additions to Standard Data Elements List 6

Streamlining Emergency Credentialing for Providers Moving from One Hospital to Another During a Prolonged Emergency Incident 7 Goal: Collaboratively develop guidance document with input from: Patient Movement Workgroup members, GNYHA, HANYS, DOHMH and NYS DOH Approach: Have been in conversation with and collected information and work products from medical staff specialist leadership at NYU Langone, Mt. Sinai and North Shore-LIJ Based on those conversation have developed a draft outline document Next Steps: 1.Get feedback from workgroup members and make adjustments to outline 2.Share outline with NYS DOH and HANYS for input 3.Begin to work on initial draft

Sending Facility Receiving Facility Sharing Critical Medical Information 8 Sending Facility Receiving Facility LEVEL 1: Best source of minimum clinical information (likely in paper format) to facilitate patient transfer and stabilization (i.e. downtime report, transfer form) LEVEL 2: Ensure access to full (electronic) medical record to support ongoing care of patient once transferred

□ EM needs to engage HIT staff in planning related to EMR remote access capabilities □ Large-scale patient evacuation is one (compelling) interoperability use case among many now being worked on in the HIT world □ Because of DSRIP, major focus in NYS is on safe transitions of care □ What we can do – some ideas: □ Facilitate better understanding of HIT landscape by emergency management □ Upcoming DOHMH meeting will address this. What else can be done? □ Encourage EM staff to have detailed conversations with internal IT colleagues regarding remote access to EMRs in the event of patient evacuation; how can we help? □ Inject this use case into “safe transitions of care” conversation; especially powerful if our contributions also improve day-to-day transfers/transitions □ Discuss integration of HIT variables into SDOH Healthcare Facility Profile applicatio n Adding Emergency Management Issues and Voices to the HIT Conversation 9

Design your Own Deliverable - ED5 Design a deliverable tailored to the unique preparedness needs of your hospital. This activity must be tied to a previously identified gap, corrective action from a hospital exercise or a real-world event. AND Participate in one of the offered workgroups convened by DOHMH, GNYHA, or other planning partner focusing on challenges to preparedness/ response. DOHMH Hospital Core Contract: Design Your Own Deliverable (ED5) 10

□ Thursday, October 22 nd – 9-10:30am □ Thursday, November 19 th – 9:30-11am □ Wednesday, December 16 th – 9:30-11am Upcoming Meetings 11