Abstract W P312: Pre-Hospital and Hospital Data Linkage in an Organized Stroke System of Care: A Pilot Study
Objective: Quality improvement within organized stroke systems of care, where policies such as diversion to primary stroke centers (PSC) integrate pre-hospital strategies with hospital performance and patient outcomes, are dependent on accurate linkage of emergency medical services (EMS) and hospital patient data. Currently, such linkage is difficult due to patient privacy concerns, heterogeneous and discrete databases, and variability in data collection. The objective of this pilot project was to create and validate a linkage algorithm for EMS and hospital data from 2 primary stroke centers (PSC) in Chicago.
Methods: A retrospective analysis of the Get With The Guidelines (GWTG) Stroke registry identified confirmed stroke patients treated at 2 regional PSCs during the first 2 months of 2013. Data from the EMS SafetyPAD database on all patients arriving to those 2 PSCs during the same period were also retrieved. These datasets were provided in CSV format without patient identifiers and inserted it into the Oracle Database for schema matching. We then used a deterministic matching process using 4 non-identifying variables (destination hospital, arrival date/time, age, and gender) in both pre-hospital (EMS) and hospital (GWTG) datasets to create an algorithm for probabilistic matching. A time difference of 30 minutes was used for arrival time to allow for the human error in the time documentation. The algorithm was first evaluated at PSC 1 then validated against data from PSC 2.
Results: At PSC 1, there were 13 EMS arriving stroke patients during the study period. Of these, 11 were matched (84.6%) to EMS records using the deterministic matching algorithm. At PSC 2, there were 7 EMS arriving stroke patients during the same period, of which 5 (71.4%) were matched to EMS records. The overall matching rate was 80%. In the 4 non-matches, inaccurate date/time entry occurred.
Conclusions: Implementing a pre-hospital to hospital data linkage system is feasible using 4 commonly included non-identifying data elements. Quality improvement initiatives such as decreasing scene-to-hospital time and assessing pre-hospital stroke assessment tools would be greatly facilitated by having these databases linked.
Author Disclosures: R. Chennupati: None. G. Trajcevski: None. K. O'Neill: None. L. Stein-Spencer: None. M. Kiely: None. E. Beck: None. S. Mehotra: None. S. Prabhakaran: None.
- © 2014 by American Heart Association, Inc.