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

2. 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.

3. 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.

4. 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.

5. 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.

6. 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.

7. 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 addresses and phone numbers for contacts if a reader has questions or wants more information.
We have also set up a dedicated TSE 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.

8. 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.

9. Structure
TSE System of Care for Idaho

10. 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

11. Regional
TSE
Committees

12. 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

13. 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.

14. 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 legislature
Stroke & heart attack rules to 2016 legislature
Getting the right patient to the right place in the right time.

15. Questions?