Welcome to another session of H&H Impact. My name is Charles Hall. I’m one of the principals at H&H Leadership Solutions. Today we have a great opportunity in spending time with Mr. John Snow from ImageTrend. Welcome, John.

Thank you. So happy to be here. We are here at NEMSMA National Conference, the National EMS Management Association inaugural conference in Washington, D.C., and we have kicked off- NEMSMA kicked off our first conference where we bring together leaders, EMS leaders across the nation. For thought partnership, to learn, to share, to network, how to strengthen who we are as an industry and who we are as leaders. And this past week, I bumped into Mr. Jon Snow from Image Trend, and we sat down a number of times really thinking about how we can impact our industry, our EMS industry, and the work that maybe both of our entities are doing together.

Yeah. John, tell me a little bit about ImageTrend. We’ll start out there. So ImageTrend, ImageTrend’s been in the EMS and fire space for over the last 25 years. We have RMSs for fire, EMS, as well as integrations with hospitals.

We are the state repository for 43 of the 50 states. And to date, we’ve managed over the billion records with a B. Wow. That’s crazy. And the company’s goal is to empower leaders, EMS agencies to have easy access to data so they can transform that into a usable process for better patient outcomes, analysis of performance of their providers, and just generally making the health of the country better. Yeah, I was probably- so I’ll give you some kudos here.

Probably the best conversation I’ve had all week was with you, and I’ll call it brain candy a little bit. Um, I have a history of EMS, and in some of my chapters, building EMS ground and air models in our industry. Started out as a medic myself and So there’s a warmness in the roots of who I am as a healthcare provider. And through this journey on two sides, from the EMS side of my background, but also I was an ER and trauma director for many years, working closely with my EMS partners. And one of those challenges over the last, I’m going to say, 20 years, it’s probably a good way to say it, we always struggled on how to share the same EMR.

EMS has an EMR or a charting system, and the hospitals do too. And in order to improve care for our patients, we had to be able to track the care or measure the care and the outcomes. And it’s evolved over the last 20 years tremendously to that word called integration. Do you want to really talk about integration and then what types of metrics we’re talking about? Yeah, it’s fun to think back.

I mean, this is year 32 for me in EMS, and I think if I had to do a paper chart today, I’d probably have a hand cramp. And I always wondered how our trauma systems back then tracked data, um, compared to what we have today. But with, with the robust offerings that we have, our goal is to tie the hospitals in with EMS. So we have bidirectional sharing of information. So that the siloed nature of what historically has been EMS and hospital are merged together with a common goal of, can we make society healthier?

Yeah, I- so I’ll go regulatory and geeky just for a little bit. I remember sitting in- I was in those years over the trauma program, over the sepsis program, over the cardiac program. All those worlds that we shared. And the regulatory for quality improvement asks us to track as simple as 911 to arrival to transport. And time was life.

And I think that’s something that has stuck with me all these years. Time is brain, time is heart, time is muscle, time is life. And so how do we the documentation side of it all kind of tracks this. How do we assure that our patients get the best chance of survival, number one, and recovery, number two? And so for the stroke world back then, and still we struggle in our industry, is straight to CT, straight to tPA, straight to interventional med, in a hard place, or analytics in the field, blood products in the field, lactate draws or point of care in the field.

See, I’m now getting geeky on this part. And how we can, especially as the healthcare industry, empower frontlines. All of those initiatives are based on our ability to measure and track and integrate the healthcare record. Yeah. So ImageTrend, where we manage so much of the data in the country, felt it was our duty to make sure that we had interoperability with everyone, including the healthcare agencies or any of these apps to help take information from the field and send it to the hospital, whether it’s Cerner, Epic, or whatever the other EHRs are out there.

And then to give visibility, especially when it comes to certain stroke and cardiac programs where, you know, we may, uh, have a CARES dashboard that’s collecting this information on a hospital side. So when they are looking at performance metrics, tracking patient outcomes, that they don’t have to go searching for that information, that we will overlay it and scrub our EMS data and present that to the appropriate person at the hospital. So I’ll continue translating on the operational side, which is really great. I also remember the times where our EMS medical director was one of our ER physicians. And so I attended plenty of EMS meetings as a hospital representative, but my medical director also was your medical director for medical control.

And back then, you can’t improve anything unless we measure it. And so we struggled back in the day to get the data to self-reflect on lessons learned and how do we reinvest in our frontline leaders, our frontline EMS responders. And today that’s less the case. That’s a better way of saying it, less the case. The data is now available.

It’s, do we know how to use it? Yeah, and we offer a bunch of data solutions for anybody that is on our ImageTrend platform, such as our Continuum Dashboard, which is an analytics platform that runs over your your data that you’re collecting in the field. And you can separate out the specific dashboards based on the stakeholders and what their needs are. You as an operations manager may want to look at certain aspects of clinical performance in the field while your medical director, he may want to know, he or she may want to know when a sentinel event happens. Is there a narcotic and Narcan used in the same call?

Do we have multiple cardiac arrests happening in a small geographic area? So we have the technology to provide that information in a near real-time setting so that the stakeholders on the end of that data in the hospital have visibility to it. And it’s configured based on the metrics that they want to measure. Yeah, I- so I’m going to simplify it a little bit, putting huge shoutouts because definitely one of my memorable moments here spending time with you, because I’m a little bit of a data geek in some of this stuff. So your platforms allow for incident reporting, analytics, CQI, billing, interoperable.

For broader platform use, you’re talking about scheduling and pre-incident planning, reporting, reporting post-incident analysis. It has all this capability. All of that, and you’ve got personal management, training activities, checklists. We, we try to offer an all-in-one platform, and that includes some integrations with external programs that people may use in the field, but we want everybody to have a single platform, and we even offer a single sign-on option because no one wants to have multiple usernames and passwords where if you have one you used every day, will allow you to use that to gain entry into ImageTrend. AI-assisted features as well?

AI. So a few years ago, ImageTrend got with Microsoft and we purchased our own Azure instance of AI. And for the last 3 years, it’s been developed and learning, and it recently won the EMS Innovation Award at at EMS World this year. It’s designed to decrease time for documentation, because we know that documentation fatigue is real, while simultaneously increasing the accuracy of data. And we’ve seen some incredible results from this.

And the really neat part is each agency has their own instance. So there’s never any cross-contamination of data for any contiguous agencies that may be transporting to the same hospital. You know, I’m gonna put a shout out out there at the two audiences that I believe we’re speaking to, ’cause one supports the other, right? Patient care documentation and monitoring of the quality of the care provided comes from two, aspects of care, prehospital, EMS, and hospitals, and both stakeholders want each other’s information. Correct.

And so from an EMS side, we’ve talked about documenting care, monitoring and measuring care. From a hospital’s point of view, we can also grab that care from the field and put that into the bigger picture of quality management of that patient. And from the EMS, I can see what occurred with our patient down the road. Is that correct? Correct.

So we’ve got several different methods to communicate bidirectionally using HL7 VPN tunnels with the hospital so that the information that we are entering into the system is appropriately placed within the EHR at the hospital and subsequently patient outcomes will be returned to the providers that can be used in a CQI model to make sure that we are providing the best care possible outside of the hospital. And it’s regulatory compliant. It is regulatory compliant. Uh, SOC 2, HIPAA, HITECH, if you can name it, um, we felt that that third-party validation and vetting for protected health information and security met the highest standards available. Beyond impressive.

All right, so let’s talk about Vision Fund stuff, right? We’ll talk about our national industry, right? It could be international too, because I think it applies to different countries as well as we think about this.

You know, where we’re talking about is at this stage is how to impact our industry. So we brainstorm a little bit about that and go, hmm, many states have a state database. There’s a couple national databases out there, especially on the hospital side. And for our audience, I’ll give a handful of examples. Certain states have that.

Association that all hospitals or healthcare entities submits the data to. It’s actually brought together, turning into benchmarking that allows me as an operator of a healthcare entity like a hospital to see how well I’m doing against my region or my state or my nation. Is there a product like that nationally? Yes. Or state?

Yes. Or region. Yes. For EMS. Yes.

We have a product called BioSpatial. BioSpatial was an acquisition by ImageTrend maybe within the last year. It’s primarily used as a patient registry, trauma registry, hand registry. But the interesting piece with this is where we collect so much data on a national level, that you can analyze and utilize that data to compare yourself against neighbors, whether it’s in the state, whether it’s regionally or nationally to see, am I doing good, bad, or am I kind of on par? So it’s becoming a very powerful tool so that we’re not just measuring ourself against ourself, that we’re using nationally recognized benchmarks to measure it against, to bring the care in this country up across the board.

And so I, I go back to our beginning of our statements. If it is all about the patient, two audiences we’re speaking to, here is an amazing platform, a product, a service that can bring two entities to one team for the wellness and the benefit of the patient. Correct. Across our industry, what are our gaps in data management in caring for our patients? Any idea?

That’s an interesting question. Um, if everybody was on a single system, I would say, boy, this would be easy. So we have the upper edge as we are the state repository for 43 of the 50 states. So we get visibility into a lot of the data, but I’m not sure that we will ever have a completely unified system unless they’re all feeding into a, I’d say, a national database that includes every EPCR in this country and not just our 90%. I think from there, we would be able to look at everything in its totality.

And so maybe that’s an initiative. I think it’s a great idea. Here at the National EMS Management Association Conference, where we’re thinking about impact of initiatives that can give our EMS frontline leaders tools, not only to help them document the care, but to benchmark the care against the industry, against others. And I go back to that patient, back to that patient for the wellness and benefit of that patient. Correct.

You know, a national repository that people could readily use to analyze their individual performance against would be the consummate product. I’m all over the country in one way or another. And what I find in different states or different regions, we have some national benchmarking tools. Many leaders go, ready for it, I’m different, we’re different. Meaning I want it to be rural, but I want it to be local rural.

And there is some benefit to local rural, and I understand that as well. But the reality of it all is how we deliver care has a level of standardization to it. [Speaker:JOSH] Correct. [Speaker:CHUCK] And best practice against protocols. So tell me about protocol work Is that integrated in your platform?

No, we are more the documentation platform, and we would leave the individual protocols or guidelines to the states to determine, you know, based on what the needs are of their state, to determine how they will practice medicine. And there’s other groups, including, you know, medical directors and EMS physicians that will help guide that. We provide the avenue for collection and data analysis for those documents. So I’ll probably work to end this by wondering, is there an initiative that we can grab thought leaders together across our nation to think about centralizing a single point of knowledge that we can benchmark each other off of for the wellness of that patient? I think a national patient repository where people are allowed to or have the ability to data mine information from there, because I think there’s some hesitation in EMS and FHIR and all these allied health agencies is to measure themselves against others.

The goal is not to tell you you’re doing a good job or a bad job. The goal is to increase patient care. And without a known benchmark, it’s theoretic on how we actually are doing. It’s a novel idea that could actually change the direction of prehospital care in this country. You bring up a very valid point there.

It’s scary to go transparent. Yeah. That first step may make some of our care or care models not look good or unsafe. And that fear that leaders have of taking that first step and going, “I want to improve the care. I may understand that some of my care is not where it needs to be.” But the goal is to take that courageous step of benchmarking myself off of the industry standards or best practices to drive quality care to my own communities.

Yeah, the, the goal should not be to blame or ostracize people that may not be meeting what you feel is the standard, but rather empower them to make the change, knowing that this is for the benefit of the people that we serve. Well, John, thank you for taking the time to spend with me. This is John Snow from ImageTrend. I’m awed by the product that you have. I know that sounds for some like, hmm, but living in that world for so long, knowing, trying to connect the right hand to the left hand and deliver the best possible care and then reflect on that care and say, how could we have done it better?

This tool is the cornerstone of reflection. Benchmarking and process improvement for great patient care. Correct. That’s our goal, is to bring everything together with a common goal of increasing the health of everyone in this country. Great.

Thank you, John. My pleasure. Very much enjoyed our time. We’re signing out of Washington, D.C., shortly from the Capitol. Yeah, a beautiful place.

Great conference. Spring? Spring-ish. Sure, sure. It’s coming.

It’s nice out there. Spring’s coming. Good stuff. But thank you so much for joining, and looking forward to our relationship. Awesome.

Thank you so much for the opportunity.