Tracking of patients is important. Here's a presentation describing the first application of electronic technologies for patient tracking - that I authored as an employee of the City and County of San Francisco in 2004.

1. Electronic Patient Tracking
San Francisco EMS &
Emergency Operations
Section
April 7, 2005

2. Lessons Learned…
 Experience shows that current practices are inefficient
and inaccurate
 Current practices are problematic with mini-disasters but
would be impossible with large disasters
 Field to hospital communications may be improved
 Current alerting procedures are cumbersome
 Loved ones frequently distraught waiting for identification
and triage number cross-referencing

3. Current Procedure:
1. MCI Level I, II, or III is called
2. First Responders arrive, locate and triage
with numbered triage tag
3. ECD queries Hospitals for status/capability-notifies ME
4. FR and ECD/Hospitals notify Transport Unit Leader
5. TUL assigns destinations to transport units-ME notified
6. TUL notifies ECD and/or Hospitals
7. Public starts calling all hospitals looking for loved ones
8. Hospitals attempt to identify, treat and notify loved ones

4. Data on Paper
 Triage tags with tear-off numbered corners
– To Transport Unit Leader
– To Hospital patient tracking officer
 TUL creates log of patients to be faxed to ECD
 ECD accumulates logs to be faxed to hospitals &
DPH DOC
 Hospitals to match numbers with medical
records/demographics
 Loved ones call hospitals looking for patient, tracking
officer matches info to tracking sheet
– This may be assisted by Red Cross in larger incidents once
volunteers are available
– May not be coordinated for several/many hours

5. Simplified for Disasters
 Improved Triage tag with bar codes
 PDA with bar code scanner
– Minimize Errors
– Quick Data Entry

6. Communications
Once Data is in
electronic form
it is transmitted
to central servers
 WiFi Internet
 WLAN with Satellite
 Cellular

7. Secure Sharing of Information
Data access is HIPAA Compliant
through Secure Internet Site
 Encrypted for privacy
 Password protected
 User only has access to permitted
functions
 Keeps detailed access log for auditing

8. Technology
 Wireless communications
– WiFi/802.11b
 Primary (first line) where available (i.e. SBC Park, Union Sq, “Hot
Spots”)
 Backup (third line) through WLAN Satellite uplink
– Cellular for second line communications/access
 Provides immediate real-time notification to EMS, ECD,
DOC, Hospitals and Medical Examiner
 Hospital status can be updated real-time
 Single call center can be setup immediately anywhere

9. Frequent use for practice
 Paramedics may notify hospitals via PDA
– Field providers familiar with device and functions
– Hospital staff familiar with software
– Communications tested and issues addressed
 Medical Examiner may use frequently
– Policies and procedures updated/improved
– Fatality tracking process similar to patient tracking
 Regional collaboration
– Other counties familiar with SF procedures
– For instant interoperability
 Alerting/Notification processes improved

10. The accelerated timeline…
12/04 Assigned to project manager
RFP written & released to 60 vendors
1/05 10 vendors submitted proposals
Review committee scored proposals
SFFD Rescue Captain and Deputy Chief
Private EMS Provider
Regional LEMSA
SFGH Disaster Coordinator
SF Community Clinic Consortium
Technical/Expert Review by Dr. Lenert UCSD & SDVA
2/05 Four vendors invited for presentation
One vendor selected unanimously

11. EMSystem, LLC.
 Has been awarded similar RFP in Bay Area
 Have been working with Project Manager to
determine best practices for San Francisco
 Is providing all sub-contracted services and
products at their cost!
 Cellular/Satellite services are being directly
negotiated outside the scope of this award

13. Projected Benchmarks (2005)
3/05 PDA available for general testing
6/05 First applications available for testing
Beta testing during area exercises
Hospital tracking goes live
7/05 Training begins
Hospital notification goes live
Patient tracking goes live
8/05 Volunteer/Disaster tracking beta release
Community/stakeholder outreach for database
Patient tracking drills conducted
11/05 Golden Guardian and CA EMSA statewide drills

14. Funding Source
 UASI 2003 originally to provide $272,000
– Sub-optimal patient tracking system
– May 2005 deadline difficult to achieve
 Modified request for UASI 2004 to provide $1.2 million
– Provides adequate supplies, equipment, and services to
complete project
– Includes EMSystem contract, wireless services, training
reimbursement for EMS, hospitals, and clinics.
– Comfortably extends deadline to November 2005
– System can be fully exercised prior to deadline
 Recent news: HRSA 2001 may provide up to $102,000
– To encourage regional interoperability

15. Project Summary
 Contract with EMSystem, LLC for $914,465 from
April 15, 2005 through May 30, 2008
 EMSystem will provide equipment:
– 200 PDA’s equipped with bar code scanner, cellular/wi-
fi/bluetooth communications
– 30,000 WMD Triage tags w/bar codes
– 20 Ruggedized touch screen computers in a hardened
carry case with power supply and router
– 40 Satellite telephones w/data kits & antennas
 EMSystem will provide software services:
– EMSystem Resource Manager hospital tracking module
– EMTrack patient tracking module
– EMSystem volunteer/DSW/employee tracking module

16. EMSEOS Project Team
 Medical Director – John Brown, MD
 Project Manager – Nikiah Nudell
 DPH Contracts Officer – Judith Matranga
 EMSystem, LLC.
– President – Chris Felton, MD
– CEO – Andy Nunemaker
– CTO – Bob Hedgcock
– Operations Mgr. – Patrick Greischar

17.  For more information contact:
Nick Nudell
nick@priorihealth.com
(760) 405-6869