Prehospital OnLine Active Reporting Information System
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Utah has a long and successful history of prehospital data collection. POLARIS extends that success into the future. Here's a quick look at the history of prehospital data in Utah:
|—1973:||EMS System Act created the emergency medical services field.|
|—1985:||Automated Incident System (AIS): Utah's Bureau of EMS contracted for the development of the state's first computerized data collection system. AIS has been used non-stop until today to collect and analyze Utah's prehospital data.|
|—1991:||Utstein Style for Uniform Reporting of Data: This international conference attempted to create universal nomenclature for prehospital data.|
|—1994:||NHTSA Uniform Pre-Hospital EMS Dataset version 1: This dataset was the precursor to today's NEMSIS dataset.|
|—1996:||EMS Agenda for the Future: NHTSA published this vision document for the future of EMS. Among other things, it stressed the importance of improving EMS information systems in order to facilitate overall EMS system improvement.|
|—1998:||EMS Agenda for the Future: Implementation Guide: NHTSA published this guide as a roadmap for realizing the Agenda for the Future.|
|—2001:||EMS National Research Agenda: NHTSA published this document on the status of EMS research, stressing the importance of improved data for advancing the quality of research.|
|—2001:||GAO EMS Report: The US General Accounting Office issued this report for Congress and subtitled it, "Reported needs are wide-ranging, with a growing focus on lack of data."|
|—2001:||National EMS Information System project: The NEMSIS project, which developed today's NEMSIS dataset, was created.|
|—2003:||NEMSIS Memorandum of Understanding: Along with 52 other states and territories, Utah signed this MOU, promising to adopt the NEMSIS dataset in its information systems. This MOU necessitated that Utah move beyond AIS.|
|—2003:||NEMSIS dataset: The NEMSIS project published version 2 of the NHTSA Uniform Pre-Hospital EMS Dataset.|
|—2004:||NEMSIS schemas: The NEMSIS project published XML-based dataset schema definitions for the transfer of NEMSIS prehospital data.|
|—2004:||Pre-Hospital OnLine Active Reporting System: Shortly after the final NEMSIS dataset and schemas were published, Utah contracted for the development of POLARIS, Utah's NEMSIS-compliant prehospital data system.|
|—2006:||POLARIS go-live: POLARIS began accepting data. Development of additional features is ongoing.|
|—2008:||NEMSIS mandate: Utah Administrative Rule R426-7 was changed to require prehospital data in the NEMSIS standard.|
POLARIS is needed for the following reasons:
- AIS was outdated: AIS put Utah at the forefront of data collection for many years. However, the DOS-based program became difficult to install and use on newer computers. AIS offered no interface for integrating with other systems, such as commercial data collection systems and computer-aided dispatch systems. AIS also provided limited reporting and analysis capabilities for today's EMS environment.
- NEMSIS has been adopted nationally: POLARIS serves as our NEMSIS-compliant state data repository and also provides a data collection interface available free of charge to all EMS agencies in the state. Utah began providing NEMSIS-compliant data to the National EMS Database in 2007.
POLARIS is a key component of Utah's overall EMS system, as illustrated in the following diagram:
Data lifecycle of prehospital patient care
Many people participate in the system:
- EMTs and paramedics submit run reports (PCRs), and can also view any reports they’ve submitted and perform analysis on them.
- Computer-aided Dispatch (CAD) systems can provide dispatch data that will create a “stub” of a PCR for EMS personnel to complete, requiring less data entry and providing more accuracy (this is a future capability).
- Agency administrators submit information about their agency (“demographics”) to POLARIS. They also use POLARIS to do analysis for quality assurance and quality improvement.
- Hospital personnel have access to PCRs for patients delivered to their hospital as soon as the EMS personnel start a PCR and designate the hospital as the destination.
- The Utah Bureau of EMS houses data as the regulatory agency designated by statute. The burau uses data for analysis and statewide reporting.
- The State Epidemiologist is notified when possible bioterrorism events are detected, and a public health investigation is initiated.
- A subset of POLARIS data is sent to the National NEMSIS Database, which makes summary data available to researchers and federal and state governments for analysis and system improvement.
Features and Benefits
POLARIS brings several benefits to the EMS system at the local, state, and national levels:
- Accuracy: POLARIS validates each data element entered on a PCR, and it also checks over 60 cross-element validation rules. This higher level of error checking allows personnel to correct accidental data entry mistakes immediately, resulting in more accurate records.
- Patient care: Effective patient care is improved when each caregiver has access to relevant information. POLARIS will link PCRs from different units responding to the same patient on the same incident, and it will also make prehospital care information immediately available to hospitals, prehospital agency administrators, billing agencies, and the bureau.
- Improved Payment Recovery: "The first invoices and insurance claims should be mailed within 72 hours form the time of service. Quick information processing, prompt insurance claims filing, and invoice mailing have the greatest positive impact on collection rates." (Fitch, J, 2004, Prehospital Care Administration, p. 386). By enabling real-time electronic data collection and by providing real-time biller access to patient care reports, POLARIS can help agencies to greatly improve the speed with which they prepare billing statements.
- Data import/export: Data can be imported into POLARIS and exported from POLARIS in NEMSIS format.
- Third-party software integration: Agencies can purchase NEMSIS-compliant software from vendors and use POLARIS's back-end web service to upload and download data behind the scenes.
- Incident and patient linkage: When two crews initiate PCRs for the care of the same patient on the same incident, the data entered by the first crew is used to reduce the data entry required from the second crew. When the second crew starts their PCR, all of the data that would be common to the two PCRs (such as incident location and patient information) is pre-filled based on what the first unit entered.
- Epidemiological surveillance: The Bureau has identified 13 epidemiological indicators. If a particular indicator is flagged on an unusually high number of calls within a certain geographic area during a period of time, POLARIS triggers a notification to the state epidemiologist so that a public health investigation can be initiated. With effective epidemiological surveillance, the bureau can quickly mobilize state assets to respond to critical incidents.
- Staging locations: By reviewing response times through POLARIS, agency administrators can identify geographical areas that need better coverage and then move unit staging locations to eliminate gaps in service.
- Real-time analysis: The day after a PCR is completed, it will become available for analysis at the agency, hospital, and state levels. Analysis will no longer need to wait until the end of the year.
- Training improvement: Agencies can use POLARIS's analysis tool to identify training needs specific to their agencies. Nationally, NHTSA can use nationwide NEMSIS data to implement changes in the national standard curricula.
- Justifying EMS: EMS is "the last bastion of healthcare to prove that what it does makes a difference." The rest of the healthcare industry justifies its value by using data that shows that it makes a difference in patient outcomes. EMS is now being asked to show its value, and data analysis is one way to do so.
POLARIS is designed to be highly reliable, available, and secure. POLARIS is hosted in state-owned computer facilities, and the POLARIS servers are not shared by any other systems.
POLARIS system architecture diagram
The production data center houses multiple load-balanced servers. If one server goes offline, POLARIS will continue to function. If all production servers go offline, a backup server will handle POLARIS traffic from a remote data center location. POLARIS also has a development server, used to test system enhancements before they are published to the production system.
Regardless of the status of the individual POLARIS servers, POLARIS will always be available at polaris.utah.gov.
Here are some screenshots of POLARIS.
Login using single sign-on via the Utah-ID service
General agency information in Agency Demographics
Initial information on a patient care report (PCR)
Transport/Patient information on a patient care report (PCR), with a hospital selected as destination
Patient care report narrative
Data Exchange area for importing/exporting NEMSIS-compliant data
Form to search for patient care reports (PCRs)
Printable patient care report (PCR)
Multidimensional analysis of data in the POLARIS Analysis Suite
Configure Data Elements area to turn on additional NEMSIS elements for collection within an agency
User Administration area to manage the roles of users within an agency
Online help with integrated NEMSIS data dictionary
Updated December 30, 2010