Being an Emergency Responder in the era of Personal Health Records

Just I was getting ready to post a conversation I had with Larry Williams, CEO and President of Roadside Telematics Corporation about the view of personal health records from the emergency responder perspective, I became one, again.

This time, it was this morning on a busy Washington, DC sidewalk, where an individual was face down on the sidewalk, in significant distress, with several other people frantically calling 911, and two colleagues with no medical training holding them. There were no other medical personnel around – just me. These were the few minutes before emergency medical services arrived. The person was unable to speak, and his colleagues had very limited English speaking ability. The best I could do was offer some stabilization and protection from people walking by, watch closely for any signs of arrest, and wait, and hope for help.

When EMS arrived shortly after, I identified myself as a physician and gave my presumptive diagnosis. The EMS person said, “Is that what you think is going on?” Even as a physician, in my mystical appreciation of EMS I almost thought the question was sarcastic, but he was genuinely interested in the history I had taken. And my history was limited at best.

The EMS personnel asked the colleagues if the patient had ID. They said, “No ID.” So, no identity and no medical history probably meant a trip to the hospital as as John Doe.

As you walk away from a situation like this, there’s no mistaking the feeling of having your breath taken away for a few minutes. It’s the same feeling I had when I was an emergency responder earlier this year, and several other times on various plane flights (I posted about those events too – they leave a mark – see them here).

The thing I picked up from talking to Larry about myself is identification with the emergency responder role. In my last few events, I always related the meaning to my role as a primary care physician, about how the primary care system could prevent these situations and how patient access would support that in happening. However, that’s going to be some time in coming, and various States and industries (notably the auto industry) are already developing solutions to help people.

Tomorrow I’m going to post what I learned about emergency responders, interoperability, and the role of PHRs in helping people in emergencies, as well as in preventing them in the first place.

In the meantime, I think it’s useful to think about all of the times you are somewhere, in public, in a workplace, in your car, on a plane, where people who are strangers to you (co-workers, fellow travelers, the EMS system) might need to help you in an emergency. Would you want there to be a way for them to have access to medical information about you if they needed it to help you?

Ted Eytan, MD