EPIC and disaster triage

1. EPIC and Disaster Triage
Isabel T Gross, MD PhD MPH, Ryan F Coughlin, MD, Allen S Hsiao, MD, David C
Cone, MD, Sandy Bogucki, MD PhD, Marc Auerbach, MD MSc, Yauheni Solad,
MD MHS, Mark X Cicero, MD
Yale School of Medicine
INSPIRE @ IMSH 2017 – Orlando, FL, USA
International Network for Simulation-based Pediatric Innovation, Research and Education

2. • Improved communication has helped Emergency Departments to
prepare for disaster victims
• It is challenging to organize pre-triaged victims who arrive at the hospital
• Registering patients in the field will allow hospitals to prepare for
patients before they arrive
Goals:
1. Tracking patients from the first contact with a healthcare provider in the
field to hospital discharge
2. Improving care efficiency
3. Anticipating healthcare needs
International Network for Si mulation-based Pediatric Innovation, Research and Education
Background

3. When disaster responders in the field use an
electronic medical record (EMR), such as EPIC,
is disaster triage effectiveness and efficiency
improved compared to triage using color-coded
tags?
International Network for Simulation-based Pediatric Innovation, Research and Education
Research Question

4. Population: Tweed airport disaster drill first responders
Intervention:
- EPIC-assisted triage via mobile App in the field
- Triage level assignment, picture of injury taken
- Registration into EPIC in the field
Comparison:
– Tag triage level assignment
– Registration into EPIC as patient arrives at the facility
Outcomes:
– Primary: time from triage to treatment
– Secondary: time of triage per patient on scene, time of arrival to
hospital to treatment, provider perception
International Network for Simulation-based Pediatric Innovation, Research and Education
PICO

5. International Network for Simulation-based Pediatric Innovation, Research and Education
Design
Assessment for
eligibility
Randomization
prior to drill
EMS provider
allocation to
intervention
EMS provider
allocation to control

6. International Network for Simulation-based Pediatric Innovation, Research and Education
Design
EPIC Triage
(intervention)
Demographic data collection
Triage using EPIC
Outcome assessment
Tag Triage
(control)
Demographic data collection
Triage using Tags
Outcome assessment

7. International Network for Simulation-based Pediatric Innovation, Research and Education
Timeline & Current progress
Jan 2017
INSPIRE
ALERT
Apr 2017
Data
collection
May 2017
Data
analysis
Jun 2017
INSPIRE
Progress
ALERT
Jul 2017
Manuscript
preparation

8. 1. How can we optimize our study design?
2. What other secondary end points should
we consider?
3. Funding?
International Network for Simulation-based Pediatric Innovation, Research and Education
3 questions to improve study

9. • At INSPIRE @ IMSH 2017
- Obtain feedback
• By February 2017
- Finish IRB process and start study
International Network for Simulation-based Pediatric Innovation, Research and Education
Goals to accomplish

10. Isabel T Gross, MD PhD MPH
Yale School of Medicine
Isabel.gross@yale.edu
(203) 824-8108
International Network for Simulation-based Pediatric Innovation, Research and Education
Contact Information