ASTM F1652-95(2007)
(Guide)Standard Guide for Providing Essential Data Needed in Advance for Prehospital Emergency Medical Services (Withdrawn 2016)
Standard Guide for Providing Essential Data Needed in Advance for Prehospital Emergency Medical Services (Withdrawn 2016)
SCOPE
1.1 This guide covers the functional elements and data records of prehospital Health Status Information Services (HSIS) needed to provide individual health status data for HSIS subscribers. When an HSIS subscriber experiences a medical emergency and becomes an EMS patient, a prehospital EMS care provider can rapidly access the individual's health status data by means of telecommunications. Access to this data will enable the EMS provider to improve patient assessment, and thereby render more appropriate treatments. This will improve the EMS provider's ability to stabilize trauma and other emergency medical conditions, and to restore and sustain vital functions, while avoiding treatments that may aggravate the severity of the medical emergency because of preexisting conditions.
1.2 In addition to improving on-site assessment, this guide will facilitate improved on-line medical direction of prehospital EMS care providers, particularly for persons experiencing life threatening medical emergencies.
1.3 Health status records provide a chronology of a person's health/medical data, including past diagnosis and treatments. The data in these records provide a vital link between the person experiencing a medical emergency, the EMS care provider, and subsequent emergency services. In order to provide the most informed care, EMS care providers and persons providing EMS medical direction need to be aware of the injured or ill person's health status.
1.4 This guide describes the minimum requirements for compiling, updating, computerizing, and storing individual's longitudinal health status data in authorized repositories, so as to protect patient privacy and confidentiality. This guide also describes requirements for providing authorized access and rapid transmittal of the data to attending EMS care providers in medical emergencies.
1.5 While this guide addresses data needed for prehospital EMS, there is also a recognized essential, but largely unmet need for similar patient health status records for emergency medical care of patients in hospital emergency departments and in definitive medical care facilities. Many development projects are in process to address this unmet need. When available, such patient records are reviewed by attending physicians, in advance of hospital emergency medical care, to quickly access patient health status data that is needed for improved patient assessment and treatment and avoidance of treatments which may be contraindicated by preexisting conditions.
1.5.1 Future changes to this guide will result in health status information records for prehospital emergency medical care and analogous information systems for hospital emergency medical care, harmonized with each other and with future standards for computerized longitudinal health care patient records (see Guides E 1744 and F 1629) which are being developed by ASTM Committee E31.
1.5.2 This guide describes requirements that are based on current ASTM medical informatics standards and will be updated to harmonize with future versions of these rapidly evolving standards.
1.6 The scope of this guide includes harmonization of the definitions of prehospital emergency medical services data element definitions used in this guide with definitions used in other ASTM standards. The definition of data elements in this guide will be the same as the definition of the data element in other ASTM standards. In cases where a data element used in this guide does not appear in another ASTM standard, the guide will use the definition specified for federal health services information systems (4, 5).
WITHDRAWN RATIONALE
This guide covered the functional elements and data records of prehospital Health Status Information Services (HSIS) needed to provide individual health status data for HSIS subscribers.
Formerly under the jurisdiction of Committee F30 on Emergency Medical Services, this guide was withdrawn in April 2016 in accordance with section 10.6....
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Standards Content (Sample)
NOTICE: This standard has either been superseded and replaced by a new version or withdrawn.
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Designation: F1652 − 95(Reapproved 2007)
Standard Guide for
Providing Essential Data Needed in Advance for Prehospital
Emergency Medical Services
This standard is issued under the fixed designation F1652; the number immediately following the designation indicates the year of
original adoption or, in the case of revision, the year of last revision. A number in parentheses indicates the year of last reapproval. A
superscript epsilon (´) indicates an editorial change since the last revision or reapproval.
1. Scope 1.5 While this guide addresses data needed for prehospital
EMS, there is also a recognized essential, but largely unmet
1.1 This guide covers the functional elements and data
need for similar patient health status records for emergency
records of prehospital Health Status Information Services
medicalcareofpatientsinhospitalemergencydepartmentsand
(HSIS) needed to provide individual health status data for
in definitive medical care facilities. Many development proj-
HSIS subscribers. When an HSIS subscriber experiences a
ects are in process to address this unmet need. When
medicalemergencyandbecomesanEMSpatient,aprehospital
available, such patient records are reviewed by attending
EMS care provider can rapidly access the individual’s health
physicians, in advance of hospital emergency medical care, to
status data by means of telecommunications. Access to this
quickly access patient health status data that is needed for
data will enable the EMS provider to improve patient
improved patient assessment and treatment and avoidance of
assessment, and thereby render more appropriate treatments.
treatments which may be contraindicated by preexisting con-
This will improve the EMS provider’s ability to stabilize
ditions.
trauma and other emergency medical conditions, and to restore
1.5.1 Future changes to this guide will result in health status
and sustain vital functions, while avoiding treatments that may
information records for prehospital emergency medical care
aggravate the severity of the medical emergency because of
and analogous information systems for hospital emergency
preexisting conditions.
medical care, harmonized with each other and with future
1.2 In addition to improving on-site assessment, this guide
standards for computerized longitudinal health care patient
will facilitate improved on-line medical direction of prehospi-
records (see Guides E1744 and F1629) which are being
tal EMS care providers, particularly for persons experiencing
developed by ASTM Committee E31.
life threatening medical emergencies.
1.5.2 This guide describes requirements that are based on
current ASTM medical informatics standards and will be
1.3 Health status records provide a chronology of a person’s
updated to harmonize with future versions of these rapidly
health/medical data, including past diagnosis and treatments.
evolving standards.
The data in these records provide a vital link between the
person experiencing a medical emergency, the EMS care 1.6 The scope of this guide includes harmonization of the
provider, and subsequent emergency services. In order to
definitions of prehospital emergency medical services data
provide the most informed care, EMS care providers and
persons providing EMS medical direction need to be aware of
Anumber of projects are in process to develop such information systems. One
Ref (1) is the Trauma Care Information Management System project funded under
the injured or ill person’s health status.
the Defense Technology Transfer Program that addresses health status data for both
1.4 This guide describes the minimum requirements for prehospital and hospital emergency medical care.Another companion development
project (2), also funded under the Defense Technology Transfer Program, is the
compiling, updating, computerizing, and storing individual’s
Development of Interoperability Platforms for the National Health Information
longitudinal health status data in authorized repositories, so as
System. In addition, in 1994 alone, the National Institute for Standards and
to protect patient privacy and confidentiality. This guide also
Technology awarded sixteen cooperative agreements totaling over $100M for
describes requirements for providing authorized access and applied research in related medical informatics (3). It is expected that scheduled
completion of these projects in three to five years will produce medical informatics
rapid transmittal of the data to attending EMS care providers in
products and processes that will enter competition in the next decade for adoption
medical emergencies.
for national healthcare use.
Each of these major development projects will impact on the evolution of
computerized patient health status information data bases for prehospital and
hospital emergency medical care.
This guide is under the jurisdiction of ASTM Committee F30 on Emergency It is planned that testing and evaluation of the results of these projects will lead
Medical Services and is the direct responsibility of Subcommittee F30.03 on to the development of standards for such hospital information systems. Such
Organization/Management. standards will in turn be harmonized with the standards now used and being
Current edition approved Feb. 1, 2007. Published February 2007. Originally developed regarding information preparatory to patient hospital admission for
approved in 1995. Last previous edition approved in 2002 as F1652 – 95(2002). non-emergent medical care. (See Specification E1238, Guide E1239, Guide E1384,
DOI: 10.1520/F1652-95R07. Specification E1633, and Guides E1744 and F1629.)
Copyright © ASTM International, 100 Barr Harbor Drive, PO Box C700, West Conshohocken, PA 19428-2959. United States
F1652 − 95 (2007)
element definitions used in this guide with definitions used in surrogate to an on-scene EMS provider or to an off-scene
other ASTM standards. The definition of data elements in this medical director to authorize access to an individual’s health
guide will be the same as the definition of the data element in status record for a particular emergency medical episode. (See
other ASTM standards. In cases where a data element used in Guide E1744.)
this guide does not appear in another ASTM standard, the
4.1.7 Provisions for updating and correcting an individual’s
guide will use the definition specified for federal health
health status record and for “refreshing” the individuals con-
services information systems (4, 5).
fidential HSIS access password (or number) after each use.
2. Referenced Documents
5. Significance and Use
2.1 ASTM Standards:
5.1 This is a guide for recording, computerizing, storing,
E1238 Specification for Transferring Clinical Observations
accessing, and transmitting data for an individual’s uniform
Between Independent Computer Systems (Withdrawn
health status record so as to enable pre-hospital EMS providers
2002)
to rapidly access the data for improved assessment and
E1239 Practice for Description of Reservation/Registration-
appropriate treatment of an individual experiencing a medical
Admission, Discharge, Transfer (R-ADT) Systems for
emergency.
Electronic Health Record (EHR) Systems
5.2 Lack of health status information on an individual’s
E1384 Practice for Content and Structure of the Electronic
preexisting medical conditions, such as data on allergies,
Health Record (EHR)
diseases, medications being used, previous medical care, and
E1633 SpecificationforCodedValuesUsedintheElectronic
so forth, may result in application of standard prehospital
Health Record
medical treatments that may be contraindicated and sometimes
E1744 Practice for View of Emergency Medical Care in the
fatally incorrect.
Electronic Health Record
F1629 Guide for Establishing Operating Emergency Medi-
5.3 At present, most people do not carry their health status
cal Services and Management Information Systems, or
data on their person.An individual’s health status data may be
Both
distributed at various locations such as in hospital records, in
physicians’ files in various formats including hand-written
3. Terminology
paper forms. Some organizations, such as health maintenance
3.1 Definitions:
organizations, schools, camps, and sports groups, attempt to
3.1.1 health status information services (HSIS)—a generic,
maintain specific sets of health status data. Retrieval and
non-proprietary term that describes the functional elements
transfer of selected information needed in emergencies from
(data, resources, procedures, and processes) that constitute an
such records is usually slow and incomplete.
information system designed, developed, and operated to
5.4 Currently, when a person suffers a medical emergency,
provide individual health status data for subscribers in accor-
pre-hospital EMS providers must rely on word-of-mouth
dance with this guide.
information from the patient or from on-scene relatives or
friends, for health status data that may be critical to selection
4. Summary of Guide
and outcome of appropriate pre-hospital treatment. Often such
4.1 This guide describes the standard functional elements
data are not available because the patient is unconscious,
that should exist to provide HSIS, namely:
otherwise unresponsive, or unaccompanied.
4.1.1 An inventory of data elements that should be ad-
dressed in compiling individual health status records. 5.5 Increasingly, individuals with serious allergies, disease,
4.1.2 Uniform data element definitions for health status
or other health problems are being advised by their doctors to
data. (See Guide F1629 and Refs (4, 5, and 6).) obtain and wear a tag (a durable bracelet or necklace) contain-
4.1.3 Guidance for encoding of HSIS computerized data.
ing selected health status information so as to help ensure that
(See Specifications E1238 and E1633.) in the case of a medical emergency, prehospital EMS providers
4.1.4 A computerized HSIS data base of the health status
will be alerted to preexisting conditions. Such tags may also
records of individuals who subscribe to a HSIS service. contain the wearer’s name, address, and phone number for
4.1.5 A template and uniform format for on-site display or
identification purposes; and may indicate the presence on the
print out of an individual’s health status data, for use by a wearer of a personal medical information card with further
prehospital EMS provider who has been authorized to access
health status data as well as the name and telephone number of
the record. (See Guide E1744 and Ref (6).) the wearer’s doctor or health care organization, or both. This
4.1.6 Aconfidential HSIS access password (or number) that
tag may also indicate the telephone number for accessing
can be made available by an individual or an authorized additionalhealthstatusdataforthewearer.Thus,thisguidecan
be used by providers of such health status tags, to give their
subscribers added safeguards from prehospital and hospital
For referenced ASTM standards, visit the ASTM website, www.astm.org, or
medical misadventure.
contact ASTM Customer Service at service@astm.org. For Annual Book of ASTM
Standards volume information, refer to the standard’s Document Summary page on
5.6 Use of this guide will lead to improved access by
the ASTM website.
prehospital EMS providers to health status data needed to
The last approved version of this historical standard is referenced on
www.astm.org. better assess a persons conditions and select the appropriate
F1652 − 95 (2007)
treatments while avoiding treatments that may be contraindi- individual or by the parent or legal guardian if the individual is
cated because of the individual’s preexisting health status. a minor or has a legally designated guardian, or otherwise in
Information needed by a prehospital EMS provider to access conformance with state law. This certification should include:
this health status data may be provided by word of mouth by
6.1.1.1 Name (of individual),
the person, through information provided on a health status tag
6.1.1.2 Date of birth (of individual), and
worn by the person, on a patient’s wallet card, or by interro-
6.1.1.3 Signature of individual, parent, or guardian.
gation of HSIS providers by means of the EMS communica-
6.1.2 Physician’s Certification—A physician, licensed in
tions system. (See 5.10.)
accordance with state law, should certify that the data in the
health status record are correct and are compiled from profes-
5.7 The lack of mobile communications and computer
sional medical records. This certification should include:
technology in ambulances, in some EMS systems, may make it
impossible for prehospital emergency medical care providers 6.1.2.1 Name (of certifying physician),
to directly access the injured or ill person’s health status
6.1.2.2 License number (physician’s),
records described in this guide. In such cases, the desired
6.1.2.3 Address (physician’s),
health status record may be accessed by the medical facility
6.1.2.4 Telephone number (physician’s),
providing prehospital medical direction by means of wire-line
6.1.2.5 Date (of physician’s certification),
computer modem connection, and used as a basis for providing
6.1.2.6 Date(oflastprofessionalmedicalrecordfromwhich
improved on-line medical direction, particularly in instances of
data is included), and
life threatening medical emergencies.
6.1.2.7 Signature (physician’s).
5.8 In addition to the primary use for EMS, existing HSIS
6.1.3 Individual Identification—The health status record
are being adapted to other applications that reduce duplication
should include the following data that identify the individual
of effort, help underwrite the costs of HSIS, and promote
and relates him/her to a particular record.
updating and accuracy of individuals’ health status data.
6.1.3.1 Individual’s Record Number—This number is used
5.8.1 For youth, HSIS record data may also serve as “ever
bytheHSISproviderforfiling/locatingtheindividual’srecord:
green” immunization records, and as the health status data
6.1.3.2 Name,
format for qualification for participation in school sports
6.1.3.3 Address,
programs, extra school athletic activities, and for other youth
6.1.3.4 Date of birth,
programs where health status registration is required.
6.1.3.5 Telephone number (home),
5.8.2 Organizations should meet these minimum require-
6.1.3.6 Telephone number (work),
ments for a preexisting inventory and history form.
6.1.3.7 Social security number,
5.8.3 Adaptations of HSIS for applications other than EMS
6.1.3.8 Religion,
requiredevelopmentofappropriatedatatemplatesbasedonthe
6.1.3.9 Medical insurance carrier name (primary),
needs of the HSIS users, the HSIS providers, and the informed
6.1.3.10 Medical insurance policy number (primary),
prior consent of HSIS s
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