Computerworld
Ambos get world first mobile data app
Australia's state ambulance services break silos to share knowledge
Darren Pauli  03 June, 2008 13:40

Ambulance services across Australia are rolling out a new laptop data application to store clinical information on thousands of patients to improve paramedic training, patient care, industry standards and research.

The multi-million dollar Victorian Ambulance Clinical Information System (VACIS) is the latest in a series of initiatives across Australia to improve patient care in hospitals, surgeries and now ambulances.

It captures standard clinical information during paramedic emergency call-outs to provide an evidence base for clinical practice and training.

The project is the only system in the world that identifies a standard process for paramedics and supports information sharing with hospitals.

VACIS manager Noelle McCabe said the project will improve emergency care nationally by encouraging normally siloed ambulance services to share techniques and protocols with their interstate counterparts.

"Research on the data collected assists in improving techniques in clinical practice," McCabe said.

The research has led to improvements in the consistency of pain management, and dispatch protocols have also been changed to make better use of Mobile Intensive Care Ambulance (MICA) paramedics.

The superintendent of support services for Tasmanian Ambulance Service, Gary O'Keefe, said the project aims to send appropriate care to call-outs, saving resources for high care emergencies and reducing risk to ambulance officers.

"Instead of having to print a document at the hospital, we can upload it to the hospitals' systems. We want to think of an ambulance as continual care, so care starts at pick up which makes for a continual single process of treatment." O'Keefe said.

"We are standardising treatment regimes across the states by sharing techniques as we learn what protocols work better."

The system will eliminate the need to supply paper medical reports.

More interfaces will be created with VACIS cardiac monitoring devices, dispatch systems and hospital emergency department systems over the next two years.

For example, paramedics will be able to send Electrocardiogram readings to hospitals, speeding up delivery and eliminating duplication of manual data entry.

Each state is in various implementation stages of VACIS. Victoria's Metropolitan Ambulance Service has spearheaded the project and is using the system in its metropolitan and rural ambulance services.

Tasmania and Queensland also have an operational VACIS deployment, while all other states, except Western Australia are committed to implementation.

VACIS uses open standards architecture with off the shelf components such as Oracle Lite, and currently has about 2 million stored patient care records. Its user interface was built by development firm Eclipse.

A VACIS collaboration committee will meet in two weeks to discuss privacy laws in the health industry, with a view to establish data sharing protocols.

Each deployment of VACIS is identical, based on an approved clinical dataset, while features and functions can be customised to suit state requirements.

The project is the first of its kind in the world, according to McCabe, and has garnered interest from ambulance services internationally.

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Comments

Ambulance and VACIS

I have been using the VACIS system for nearly 3 months now and I, along with many of my co-workers, find it the most frustrating, annoying and unproductive piece of equipment introduced to our workplace. I consider myself an advanced computer user, so I empathise greatly with ppl who are not very computer savvy who must find it incredibly difficult.

VACIS is obviously going to be an entrenched part of our equipment and if the software is right it will be great, wit great potential - like adding scene photos (MCA's, etc ); mapping/GPS; MIMMs; Emergency Planning and management; & the list goes on.

BUT ...

The basic software is not in a logical sequence; repeats data entry; has hundreds of 'drop-downs' (heaps of them not relevant); missing relevant 'drop-downs'; increases our 'write-up time' by 30-40 minutes; easy to lose 'visual sequence' (i.e. can easily lose track of where your input information is going); easy to incorrectly input a drop-down and go unnoticed; cumbersome software; etc; etc.

The terminal is also very small and during night shift the keyboard is not illuminated so difficult to see without a bright light. The touch screen is sensitive increasing errors but at times you need to tap like driving a 4" nail into it to get it to work (???)

A lot of work needs to done on this program and preferably by on-road Ambos as primary determinants and not bureaucrats/statisticians/etc.

Cheers

Clive
Para
Ambulance Victoria

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