Prehospital Informatics
UW EMS Consortium agencies produce more than 9 million data elements per year. Effectively leveraging this data requires both technical expertise and domain knowledge in EMS. While most medical directors do not possess the technical skills necessary to extract, transform, and analyze the data produced by EMS systems, UW employs one of the few physicians in the United States with board certification in both EMS and clinical informatics. This in-house expertise significantly expands the services that our medical directors can provide to support operational decision-making, quality improvement initiatives, and meaningful research.
Informatics Capabilities
Consult on Data Safeguarding and HIPAA Compliance
Understand Prehospital Registries and Data Standards
(e.g., NEMSIS, CARES, etc.)
Export Data from Prehospital Software
(e.g., Elite, ESO, EMSCharts, etc.)
Retrieve and Review Data from Monitor/Defibrillators
(e.g., Stryker, Zoll, etc.)
Clean and Integrate Data from Multiple Sources
Perform Statistical Analyses
(e.g., Excel, STATA, SPSS, R, etc.)
Perform Geospatial Analyses
(e.g., ArcGIS, R)
Develop Interactive Dashboards
(e.g., Tableau, PowerBI)
Generate Effective Data Visualizations
(e.g., Photoshop, Illustrator, Excel, R, etc.)
Design Electronic Data Capture Instruments
(e.g., REDCap, Qualtrics, etc.)
Transfer Data via Application Programming Interfaces
Understand Interoperability Standards
Meet Our Prehospital Informaticist
Without data, you’re just another person with an opinion.
What is clinical informatics?
Informatics is the science of information, and informaticists use data centered approaches to help solve problems. Unlike similar fields, such as data science or data engineering, informatics is especially focused on applications of data. For example, a clinical informaticist is not only concerned with the data itself, but with using the data as a driver of change and improvement in the health care setting.
How did you become interested in informatics?
When I started my EMS fellowship at the University of New Mexico in 2021, I had never heard of informatics. At that time, the world was in the midst of the COVID-19 pandemic, and many activities were being done remotely. With an unexpected amount of time to work independently, I became entranced with trying to tease actionable insights from large amounts of EMS data. With close mentorship from UNM EMS physicians, I decided to focus on UNM’s prehospital extracorporeal cardiopulmonary resuscitation (eCPR) program. There was a need to predict which EMS incidents would benefit most from this precious resource. To help answer this question, I developed a model of low-flow time for different eCPR strategies. This project affirmed my interest in informatics. Since that time, I have gained board certifications in both clinical informatics and EMS.
What have you done to promote prehospital informatics since joining UW?
When I was hired by the University of Wisconsin in 2021, I championed the creation of a departmental leadership position focused on developing and executing strategies to enhance the use of prehospital data for operational, quality improvement, and research initiatives. This role is unusual amongst academic departments, and reflects the strong support of the Department of Emergency Medicine for prehospital clinicians. In 2024, I was honored to receive a career development award from the National Association of EMS Physicians, in recognition of the novelty and importance of this type of work. Currently, my two largest projects are the creation of an EMS-hospital health data exchange and the development of a cloud-based database that will become the backbone of a powerful prehospital data ecosystem.
Notable Informatics Initiatives
EMS-Hospital Health Information Exchange
The Problem
Patient care spans the time of EMS contact through hospital discharge, yet EMS and hospital data are often siloed in systems that do not communicate. As a result, hospital clinicians have limited insight into prehospital care, EMS providers lack feedback on patient outcomes, and it can be difficult to develop patient-centered quality measures tied to meaningful outcomes.
Our Approach
We implemented an EMS-hospital bidirectional health information exchange (HIE) that uses an iterative record-linkage strategy – automated probabilistic matching with a manual backup – to maximize successful data matches while reducing staff workload. Using multiple HL7 interfaces, we transmit both structured documents and discrete data elements, which enables data analysis, hospital application integration, and use of EMS data in predictive models and decision-support tools. By developing our HIE in this way, we are maximizing the value of EMS data.
To ensure that EMS can participate in this system, we worked closely with Dane County Emergency Management to secure subsidies that reduce financial barriers for Dane County agencies.
Prehospital Database
The Problem
Most prehospital EHR vendors make their data accessible through a browser-based report writer that exports flat files, such as Excel or comma-delimited text files. This method of data access is labor-intensive, limits advanced analysis, and introduces potential security risks.
Our Approach
To support advanced analytics and research, we partnered with the Emergency Care Systems Laboratory to secure funding to create a prehospital database within the UW School of Medicine and Public Health’s secure cloud computing environment, Platform X.
This highly secure, scalable platform enables linkage of EMS and hospital data to support outcomes-based quality improvement and research. Its cloud-based architecture supports complex analytics, including machine learning and natural language processing pipelines.
This database will become the bedrock of a harmoniously interconnected data ecosystem, capable of integrating data from prehospital EHRs, hospital EHRs, clinical quality registries, and more.