Poul Anders Hansen's (Manager, North Denmark Region) presentation from the Hospital + Innovation Congress 2015 in Odense, Denmark.

1. Prehospital treatments –
starting in the ambulance
Poul Anders Hansen
MD, Head of the Prehospital Care Organisation,
North Denmark Region.

2. Different ambulance service
• Ambulance only for transport – non or minimal treatment by
ambulancpersonnel
• Treatment in ambulances at different levels (EMT and/or Paramedics) and
transportation
• Ambulance is an hospitalbed on wheel

3. Why is treatment in ambulances necessary ?
Aalborg
Univ. hospital
Sygehus Vendsyssel
Hjørring
Sygehus Himmerland
Hobro
Sygehus Himmerland
Fane
Sygehus Thy-Mors
Thisted
Nordjylland
Midtdjylland
Syddanmark
Sjælland
Hovedstaden
University Hospital
Hospital with emergency departments
Hospital without emergency department
Sygehus Vendsyssel
Frederikshavn
Distance
Timedependent disease

4. You must have medical support to guide the
ambulancepersonnel in treating patients?
You can use
– Phone
– ECG, communication
– Electronic prehospital patient record
– ECG, vitals, medication, triage, photo ect.
– Video contact with emergency departments and physician
– Livestream video of the patient in ambulance

5. North Denmark Region
• Have EMT and Paramedic in ambulances
• We use
– Phone
– Electronic prehospital patient record
– Video conference

6. The developement plan was designed in a dialog between JUDEX,
The Prehospital Organisation and Falck A/S.
There were two defined problems:
1) A clinical need to optimize the prehospital care of the patient.
2) A need to optimize the communication between the prehospital staff
and the hospital staff, and to improve the documentation in the
patients medical record.
Electronic prehospital patient record
amPHI

7. National solution in Denmark
Organisation:
• 5 Regions in Denmark (5.6 millioner inhabitant)
Projekt:
• CSC won a national tender for a elektronic prehospital
patient record solution
• amPHI in a new version from North Denmark Region is
now implemented in Denmark and it include about
500 ambulancer, Docters cars and 3 helicopters.
• One solution means that any ambulance i Denmark
can hand over a patient to any ED in Denmark, giving
the same information to the ED personel.
Nordjylland
Midtdjylland
Syddanmark
Sjælland
Hovedstaden

8. amPHI™ evolution
8

9. Wireless transmission from ambulances of sound clinical
data, ECG as well as an ongoing video transmission
Prehospital telemedicine ( Doctor at distance )
ECG
VIDEO
Internet hot spot
Hot spot
PHONE
RECORD

10. Dispatch centre
PAS/EPR
Interactive boards
Prehospital
record
Central services
2) Patient history
4) Prehospital record
Emergency solution overview
1) Transport information:
• Accident and possible patient information
2) Patient history: admission
• Person id and demographics
• Previous hospital admissions and diagnosis
• Critical medical data (i.e. conditions and allergies, medicine)
3) Prehospital treatment information:
• Status / diagnosis, treatments, medications
• Various scores related to patient condition (i.e. trauma, triage)
• Vital signs (i.e. hart rate, blood pressure, pulse) and other
measurements from patient monitor
4) Prehospital record information:
• Complete prehospital record
• Various scores (i.e. trauma, triage)
• Vital signs (i.e. hart rate, blood pressure, pulse)
• ECG’s

11. Dispatch centre
PAS/EPR
Interactive boards
Data flow:
• Complete prehospital record to the EPR
• Various scores to the ERP
• Vital signs to the EPR
• ECG’s to the EPR
Prehospital
record
Central services
4) Prehospital record
Export to acute EPR

12. Correct treatment and visitation are the key-words
• ECG is sent directly from the ambulance to the
doctor in the cardiology department
• the result can be seen in the electronic journal
128 km between
patient and doctor

13. Mobilt hotspot
Docters terminal
Video konference from location and during transport to hospital
Video based communication between ambulance and relevant medical speciality at hospital
Ambulance

14. “Doctor at distance”

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