Medical Emergency Data and Networks: A German-Canadian Comparison.

A significant number of problems in emergency care are caused by a lack of provider access to pre-existing patient information at the point of care. Medical Emergency Datasets (MEDs) are brief summarizations of an individual's medical history, providing vital patient information to emergency medical providers. The German MED was validated by German physicians and - based on an international research project - also by Canadian physicians. Physicians in both countries considered the content very useful. The MED is currently being introduced in Germany as part of the Telematic Infrastructure. At the same time, the COVID pandemic forced healthcare professionals around the work to optimize the digital information exchange among different healthcare providers. While the exchange of data is important, additional personal expert advice is sometimes vital. Real time virtual support systems (RTVS) were introduced in Germany and Canada to support team-based healthcare delivery, independent of the actual location. Such systems have been implemented for intensive care, emergency medicine, primary care and several other medical specialties. These systems serve as a safety net, a funnel (appropriate utilization; linking patients back to primary care networks - thus reducing fragmented or disrupted services) and a medical network by building interprofessional relationships.

Medical Emergency Datasets Can Improve the Comprehensiveness of Handover Information: A Simulation Study.

Background: Access to patients' medical histories can be of vital importance to ensure proper treatment in an emergency. Germany is planning to introduce a medical emergency dataset (MED), accessible through an electronic health card, and comprising important patient information, such as diagnoses, medications, and allergies. Introduction: This article evaluates the effect of MEDs on the comprehensiveness of a physician's documentation and handover process to the emergency department of a hospital. Materials and Methods: In 2 randomized, crossover simulation studies, 72 emergency physicians participated in 2 emergency scenarios, either with or without access to an MED. Subsequently, they had to document the key information (pre-existing conditions, medications, and allergies) and hand it over to a fictional hospital. The influence of the MED on the documentation of key information was analyzed using the two-sided Prescott's exact test. Sensitivity analyses adjusting for scenario were conducted. Results: The results show that in scenarios with an MED, documentation of key information in the handover process was more complete. In the first trial, 2 of 3 key items (pre-existing conditions/information and allergies) presented a statistically noticeable difference in scenarios with the MED. The second trial confirmed these results for all key items. Discussion: The findings indicate that the use of MEDs in emergency care could be beneficial since documentation and handover in scenarios with an MED were superior to current real-world practices. Conclusions: Access to more complete patient information through an MED could help to improve the patient's treatment.

Great Help for Small People - The Development of a Children's Emergency App.

In order to assist parents in providing rapid first aid to children in case of emergency, a mobile emergency application was developed. The children's emergency app works with intuitive graphics and checklists and combines several functions such as tips for preventing accidents, easy-to-understand instructions for first-aid actions and a search function for the next pediatrician or hospital. This app is not intended to be a substitute, but rather an addition to first aid courses.

Canadian Validation of German Medical Emergency Datasets.

Medical Emergency Datasets (MEDs) are brief summarizations of an individual's medical history, providing vital patient information to emergency medical providers. A recent German study [1] evaluated whether MEDs are useful to local emergency physicians and paramedics, and which health data were relevant to their medical management. To validate of the German study internationally, Canadian physicians and paramedics were recruited to provide feedback on the utility of the German MEDs as well as their specific content. Original documents and surveys were translated to English directly, with a goal of collecting quantitative and qualitative feedback. Overall, physicians and paramedics found the MEDs to be useful in their evaluation of hypothetical medical scenarios. Most of the MED content was very useful, with some items appearing extraneous. The findings of this study will be used to inform future development of MEDs as well as to drive future research.

A Secure Architecture to Provide a Medical Emergency Dataset for Patients in Germany and Abroad.

The ongoing fragmentation of medical care and mobility of patients severely restrains exchange of lifesaving information about patient's medical history in case of emergencies. Therefore, the objective of this work is to offer a secure technical solution to supply medical professionals with emergency-relevant information concerning the current patient via mobile accessibility. To achieve this goal, the official national emergency data set was extended by additional features to form a patient summary for emergencies, a software architecture was developed and data security and data protection issues were taken into account. The patient has sovereignty over his/her data and can therefore decide who has access to or can change his/her stored data, but the treating physician composes the validated dataset. Building upon the introduced concept, future activities are the development of user-interfaces for the software components of the different user groups as well as functioning prototypes for upcoming field tests.

Emergency Data Management - Overcoming (Information) Borders.

BACKGROUND: In order to improve access to critical patient data in case of emergency, many countries have begun or intend to implement emergency datasets. In Germany, the German Medical Association developed a medical emergency dataset (MED), which provides the possibility to store information on prior diagnoses, medications, allergies and other emergency-relevant information on the German Electronic Health Card. OBJECTIVES: The aim of the study is to evaluate how the MED can be used internationally. METHODS: A total of 64 paper-based emergency data sets were completed by primary care physicians in Germany, and were then evaluated by German clinicians, emergency physicians, and paramedics on the basis of fictitious emergency scenarios. Thirty randomly selected MEDs were then translated into English and will be evaluated by international emergency physicians and paramedics. RESULTS: In Germany, clinicians, emergency physicians and paramedics rated the emergency data set as very useful or useful in more than 70% of the reviewed cases. The international evaluation will start in September 2016, so these results are pending at this time. CONCLUSION: The first study results from Germany indicate high potential benefits of the emergency data set in real patient care situations. The subsequent tests will show whether the MED is also suitable for international use.

The emergency data set for the German Electronic Health Card--which benefits can be expected?

BACKGROUND: In order to improve access to pre-existing patient information in case of emergency, the German Electronic Health Card (EHC) is supposed to hold emergency data. As a basis, the German Medical Association developed an emergency data set, which provides the possibility to store information on prior diagnoses, medications, allergies and other emergency-relevant information. OBJECTIVES: One main objective of the study is to evaluate the usefulness of the emergency data in specific emergency situations. METHODS: Within a two-phase exploratory study, a total of 64 paper-based emergency data sets were completed by primary care physicians, and then were evaluated by clinicians, emergency physicians, and paramedics. RESULTS: Clinicians, emergency physicians as well as paramedics rated the emergency data set in more than 70% of the reviewed cases as very useful or useful. The greatest benefit was attributed to the information on diagnoses and medication. CONCLUSION: The implementation of an emergency data on the EHC has the potential to improve safety, quality and efficiency of emergency care.

In Case of Emergency - Are ICD-10 Codes Enough?

In an acute emergency, the knowledge of the patient's medical history, allergies, implants, and medication can be crucial. ICD-10 code to document medical diagnoses alone often does not contain enough information. Our comparison of 388 documented diagnoses (ICD-10 codes as well as free text) showed that almost 20% of all coded ICD-10 codes contained less information than the documented free text. Thus, if using ICD-10 codes, free text diagnoses must be a necessary item in the upcoming German Medical Emergency DataSet.