Abstract 390: Automating a Cardiac Arrest Registry: Challenges and Opportunities

Introduction: A registry for out-of-hospital cardiac arrests facilitates cardiac arrest research, and emergency medical services (EMS) and community health quality improvement programs. Maintaining a cardiac arrest registry is labor intensive and costly, both of which could be reduced through automation. Objective: To determine the feasibility of automating data population of a cardiac arrest registry and to identify the components needed for and barriers to automation. Methods: This is a prospective feasibility study at the Dallas Fort-Worth (DFW) Center for Resuscitation Research. Our cardiac arrest registry was part of the multi-center Resuscitation Outcomes Consortium (ROC) Epistry from 2006 to 2016. Since 2016, we modified and maintained it separately from the ROC and over 20,000 cases have been enrolled. We identified the following critical elements necessary for automated data population of the registry: Create a registry dataset; create Business Associate Agreements with EMS agencies and hospitals; identify EMS and hospital electronic health record programs; develop a search strategy; search for appropriate cases in city servers where EMS patient care reports (PCRs) are stored and download data; move EMS data through our institutional firewall to a secure server; perform the same steps for hospital medical records; match EMS cases with hospital medical records, and automatically populate the registry with EMS and hospital data on a regular basis. Results: At the DFW site, EMS agencies use five different PCR programs and hospitals use two different electronic health record programs. A combination of 13 search terms captured 90% to 100% of appropriate cardiac arrest cases across six EMS agencies. Two different strategies can be used for streaming data across our firewall: A proprietary program entitled “Move-It” or a university generated file transfer protocol. We used a probabilistic logical approach for matching EMS cases with hospital cases. Conclusions: Automating a cardiac arrest registry is feasible. A cardiac arrest registry has many elements that must be considered to accomplish automation. The authors found that the most time consuming element is establishing Business Associate Agreements with all parties that provide data.