Follow up on patients

[50-65 205]

I was wondering how some of you go about following up on patient condition, outcome, or even survival. This is coming more from the standpoint of a non-transporting first response agency such as a fire department.

We have often wondered what happened to those we extricated or otherwise treated.

Not having any personal contacts at hospitals, how does one get information on extent of injuries and treatments to a patient?

[JetPhoto 626]

Sometimes the ambulance crews find out a little bit but not too much. Otherwise, hope it makes the paper and they MIGHT have something

[Bnechis 3,961]

Your agency is required by DOH to have a medical director. Generally the medical director is your ER director. This should be part of your QI/QA program.

[50-65 205]

Your agency is required by DOH to have a medical director. Generally the medical director is your ER director. This should be part of your QI/QA program.

Maybe I misled/mispoke with the "non-transporting first responder" thing. No. We are just a fire dept that happens to run a fair amount of mva's. We are NOT (any more) a BLSFR agency. So, no, we do not have a medical director.

[Bnechis 3,961]

Maybe I misled/mispoke with the "non-transporting first responder" thing. No. We are just a fire dept that happens to run a fair amount of mva's. We are NOT (any more) a BLSFR agency. So, no, we do not have a medical director.

Sorry, I did not get that. But whats preventing you from going to the ER Director and asking him to still be a medical director for you?

[firemoose827 324]

Maybe I misled/mispoke with the "non-transporting first responder" thing. No. We are just a fire dept that happens to run a fair amount of mva's. We are NOT (any more) a BLSFR agency. So, no, we do not have a medical director.

Correct me if I am wrong, and this is a sincere question for all and not a jab at 50-65;

If you provide medical aid to patients, are'nt you required to be a certified BLSFR agency with a medical director? It sounds to me like you guys are providing aid to patients, so you should all be at least a basic EMT, and be required to be a certified response agency for legal reasons. Thanks in advance for all your input.

I have always relied on friends that work in the local ER as nurses, or ER Technicians. If they go to other hospitals we rarely find out anything about their condition unless we ask a nurse or doc during another call when we get tot he ED. Most will tell us basic info so we know, but you will get the strict people who refuse to give out info, which is understandable in todays litigious society all suing each other. But most understand that we are just caring first responders who want to know if our patients made it or not.

[JetPhoto 626]

I think what he asked was if his department responds to an accident and as an example extricates a victim, he wants to know how to get info. No medical director is required for that. In addition your department can respond to EMS assist calls with out being registered as a BLSFR department. Now if your EMT's want to rapid re-cert your department needs to participate in order to get reimbursed or if they want to take an EMT or First Responder class with out paying out of pocket your department needs to be registered with the state.

[mvfire8989 22]

I think what he asked was if his department responds to an accident and as an example extricates a victim, he wants to know how to get info. No medical director is required for that. In addition your department can respond to EMS assist calls with out being registered as a BLSFR department. Now if your EMT's want to rapid re-cert your department needs to participate in order to get reimbursed or if they want to take an EMT or First Responder class with out paying out of pocket your department needs to be registered with the state.

No medical director is required for that, but per HIPAA they should not be receiving information on the disposition of that patient without the permission of the patient in question. In the context of QA/QI information can be released, but the "minimum necessary" rule applies, so generally things like names should not be included in this either.

[helicopper 1,050]

No medical director is required for that, but per HIPAA they should not be receiving information on the disposition of that patient without the permission of the patient in question. In the context of QA/QI information can be released, but the "minimum necessary" rule applies, so generally things like names should not be included in this either.

HIPAA is often thrown around but it is very often out of context. A fire department that is not a certified FR or EMS agency is usually not a "covered entity" under HIPAA regulation. The hospital is probably a "health care provider" under the definition in HIPAA but they can still participate in a QA/QI program with EMS agencies. Identifying patient information is seldom required to have a useful discussion about a call in the QA/QI setting so HIPAA shouldn't be an issue.

50-65, I would say work with your local EMS agency and participate with them in the QA/QI process and you should be able to get most of your questions answered.

Of course this pre-supposes that your local EMS agency has a bonafide QA/QI program but that's another issue for another thread.

Good luck!

[NJMedic 96]

Try reaching out to the Trauma Center you deal with. My hospital's Trauma Program office routinely provides feedback to the EMS agencies involved in a trauma patients care. A letter is generated about a week into the patient stay. It might take some steps to refined a process to make sure your agency is recorded on the patient care report but not impossible. Most of the Information in is compliance with HIPPA and standard patient confidentially standards.

[ny10570 745]

HIPAA is often thrown around but it is very often out of context. A fire department that is not a certified FR or EMS agency is usually not a "covered entity" under HIPAA regulation. The hospital is probably a "health care provider" under the definition in HIPAA but they can still participate in a QA/QI program with EMS agencies. Identifying patient information is seldom required to have a useful discussion about a call in the QA/QI setting so HIPAA shouldn't be an issue.

50-65, I would say work with your local EMS agency and participate with them in the QA/QI process and you should be able to get most of your questions answered.

Of course this pre-supposes that your local EMS agency has a bonafide QA/QI program but that's another issue for another thread.

Good luck!

Exactly. As far as what a hospital is legally allowed to disseminate basic info such as severity (critical, stable, etc), discharged, or deceased are all allowed. Details such as diagnosis, procedures, and test results are the protected information.