It is critical to incorporate two often-overlooked components of the health care system into the HIE landscape - disaster response and emergency medical services (EMS). It is necessary to exchange clinically relevant patient information both in response to widespread disasters and during daily emergency medical treatment to improve patient transitions of care between ambulances and receiving hospitals. ONC is funding an approach in California that applies principles of health information exchange in the disaster and emergency medical services areas; areas not previously addressed in either California or the United States on any significant scale. In this project has two components.
 
In the first, bring developed is an interoperable disaster response patient lookup system with direct connections to community HIEs and hospital-system EHRs, and implement a secure, web-based portal for eligible professionals who are California Disaster Healthcare Volunteers (nationally known as ESAR-VHP) and using Single Sign On capability. The intent is to help address the health information needs of providers rendering care for patients transferred from hospitals in an affected area, victims of the disaster transported by first responders, victims transported by family for friends, walking wounded in need of urgent care, and evacuees in need of routine care. The system will be examined through a drill in early 2017. In the second, a system is being developed for daily Emergency Medical Services (EMS) interoperable exchange and demonstrating it in production as part of patient care. The system must be able to Search for patient information from a community HIE using the EMS ePCR, Alert the ED of critical patient information before arrival, File all treatment information from the ePCR into the hospital’s EHR after the patient arrives, and Reconcile the ultimate patient treatment with the ePCR following discharge.