DISCLAIMER ~ CREDITS The information presented here has been - PDF document

4/12/2013 Powerful Discovery Tools Through Technology M. Thomas Quail, MS Ed, R.N. LNC, NREMT May 1, 2013 Quail MT 2013 NOTE This handout does not include all slides and examples shown during webinar. 2 DISCLAIMER ~ CREDITS The information presented here has been obtained from expert resources. References have been included if available, to provide credit where credit is due. The content of such pages are in no way an official publication of the lecturer’s employer, or agency the lecturer may be affiliated. The opinions expressed in this presentation are solely that of the lecturer and not of the lecturer’s employer, or agency the lecturer may be affiliated with. 3 1

4/12/2013 Today’s Technology   Cell Phones Transponders  Event Data Recording  Text Messaging  Photography  Time & Time Devices  Photographs  Land Lines (Fixed Phone)  FOI Requests  PSAPs  E-Mail  Audio Tapes  Hand Held Devices  CMED  ECG  Air Medical Units  Pyxis  Cameras  EMR   GPS Media   Geo-Tagging Incident Location 4 Quail MT 2013 Cell Phones 911 Calls  Routing  Call Transferred  Recorded  Delays  GPS-after 2005 5 Subscriber Identification Module SIM Card • Microchip • Removable • Contact Names • Phone Numbers • Text Messages*- Privacy Laws • Retrievable Quail MT 2013 6 2

4/12/2013 Itemized Cell Phone Bill 7 Quail MT 2013 Official U.S. Time  Synchronized  Atomic Clock or  Greenwich Mean Time (GMT).  Accuracy =Nano-Seconds  State Police & Aircraft (Air medical units)  Cell Phone Bill - rounded up 1-2 minutes 8 Official U.S. Time  WARNING: Many agencies use different methods to record time  Accuracy: Important  Investigating allegations of delay in a patient’s treatment, transfer, or transport of care. Quail MT 2013 9 3

4/12/2013 Synchronizing Clocks/Watches Inquire  How the time recorded was determined?  Are the clocks synchronized?  Who performs that task?  How often are the clocks synchronized?  Are there logs to determine when the clocks were last synchronized?  What reference source is used to accomplish this task? (ie GMT, Atomic Clock) 10 Synchronizing Clocks/Watches  Personal Watch  Actual Time 10:08 Quail MT 2013 11 Fixed Telephone Line (Land line) 911 calls  Rural: Regional Dispatch Center Routed  Dispatcher in the same community.  Captures Callers Address / Number • PSAP : Public Safety Answering Point • 24 hr. Switchboards 12 4

4/12/2013 Public Safety Answering Point (PSAP)  Capture: Name, Number & Address.  Emergency units: Dispatched  Voice  Text  Pager  Laptop Quail MT 2013 13 Public Safety Answering Point (PSAP)  Electronic Log  Entering Text  Backup System Quail MT 2013 14 Audio Tapes/ Recorded Calls All 911 Calls  Tape Cassette  CD  Encrypted  Storage 15 5

4/12/2013 RECORD REQUEST  Electronic & Paper Records/Logs  Time Discrepancies – How Determined  Multiple Dispatchers  Raw Voice Data-NO Edits  Include Encryption Files Quail MT 2013 16 Coordinated Medical Emergency Direction (CMED)  CMED Centers  Network of Radio Towers  Entry Notification  Recorded 17 Air Medical Units Photo:labelscar.com Quail MT 2013 18 6

4/12/2013 CAMERA TECHNOLOGY EXAMPLES: Quail MT 2013 19 CAMERAS Homeland Security Quail MT 2013 20 PUBLIC 21 Quail MT 2013 7

4/12/2013 Business Quail MT 2013 22 Photo: REUTERS Business Banks / ATMs Residential Photo: pysih.com Photo:cctvcamerapros.com Photo:consumerist.com 23 Traffic 24 Quail MT 2013 8

4/12/2013 25 Police Micro-Cameras Dashboard Cameras 26 Facial Recognition Photo:CBS.com 27 Quail MT 2013 9

4/12/2013 AIRPORTS Photo:pentagonmemorial.org Photo:technologynews.com Photo:FaceIt software 28 Photo:mysanantonio.com Photo:jaunted.com Transit System Boston Metro (July 17, 2012) 29 Quail MT 2013 Transit System 30 Quail MT 2013 10

4/12/2013 Transit System 31 Quail MT 2013 Transit System Quail MT 2013 32 CAMERAS  Owner  Security Supervisor  Raw Data Footage  10-15 minutes before/after event  Still photographs  How is the time determined Quail MT 2012 33 11

4/12/2013 Global Positioning System (GPS)  GPS: Developed DOD  Current Location  Time  Velocity  Public Safety Departments  Captured Electronic Record 34 Dispatch Center GPS Map 35 GEO-TAGGING  G eographical Identification Data added:  Photographs & Video .  Coordinates: Latitude &Longitude  Altitude, Bearing, Distance  Accuracy: 1 meter (~3 feet) Quail MT 2013 36 12

4/12/2013 GEO-TAGGING 37 Photo:en.wikipedia.org GEO-TAGGING Photo:en.wikipedia.org 38 GEO-TAGGING Photo:en.wikipedia.org 39 13

4/12/2013 GEO-TAGGING 40 Photo:en.wikipedia.org TRANSPONDERS Photo: flicker.com Photo:zug.com Photo:zug.com Photo:howstuffworks.com 41 TRANSPONDER STATEMENT 42 Quail MT 2013 14

4/12/2013 Event Data Recorder (EDR) Since 1998 Photo:jean-jabari.blogspot.com Photo:cdc.gov 43 Quail MT 2013 Event Data Recorder (EDR) Quail MT 2013 44 Event Data Recorder (EDR) Quail MT 2013 45 15

4/12/2013 Event Data Recorder (EDR) Quail MT 2013 46 Event Data Recorder (EDR) 47 Quail MT 2013 Event Data Recorder (EDR)  Vehicle Demographics  "x" seconds of pre-crash data  Speed of vehicle (MPH)  Crash severity (delta-V)  Safety belt status (buckled/unbuckled)  Engine throttle % & speed  Accelerator pedal %  Brake switch status (on/off)  Brake lamps status Quail MT 2013 48 16

4/12/2013 Event Data Recorder (EDR)  Time between events  Cruise control status  Yaw rate (deg/sec) (if equipped)  Traction control button (if equipped)  Shift gear position (if equipped)  Seat track position (if equipped)  Airbag Warning Lamp "On" Time Before Event (min)  Tire pressure  Many other valuable parameters 49 Quail MT 2013 Event Data Recorder Report 50 Quail MT 2013 Photographs/ Photography Image 1 Image 2 51 17

4/12/2013 Complaint Investigations Freedom of Information Act (FOI) Many state agency documents are public records and are available through a FOI request  Closed Investigations  Closed Complaints against the Licensee  Service Records (Ambulance)  Inspection Records ( Hospitals & Nursing Homes )  Surveyors Reports Quail MT 2013 52 E-Mail Records  Discoverable  Specific Request 53 Handheld Devices  Complex “mini” computers  Information  Sophisticated multimedia messaging  Internet access history  GPS  Pictures-Tagged  Records  Text Data  Much More Photo:sangeethamobiles.com 54 18

4/12/2013 Hospitals  Electronic Time Clocks Photo:fotolia.com  Paging System  Specific Equipment  Patient Medications  Supplies  Access Rooms & Specialized Areas  EMRs esp. Psyc. records  Online Training  Cell Phones, Texting, etc. 55 EQUIPMENT~ CLOCKS Cardiac Monitor-Defibrillator Electrocardiogram (ECG) Clock  Internal clock  Checked every shift  Time Accuracy  Q? Was the monitor/defibrillator checked? 56 Cardiac Monitor-Defibrillator- Electrocardiogram (ECG) Clock Photo: Medtronic Quail MT 2013 57 19

4/12/2013 Cardiac Monitor-Defibrillator- Electrocardiogram (ECG) Clock Photos: Medtronic 58 Quail MT 2013 Pyxis Photo:carefusion.com Photo: fotolia.com 59 Photo:webmm.ahrq.gov Photo:carefusion.com Pyxis Reports Reports Overview Inventory Reports Detailed account of the status of inventory throughout the Station. Generated for the selected Station. Activity Reports Provide detailed transaction history for the Station. Generated by item name, item ID, user name, user ID, patient name, patient ID, transaction type, and date range. Document transactional information. System Reports Monitor and track system-wide data at the Stations. List information for users. Allow you to view the data in your database. 60 20

4/12/2013 Pyxis Activity Report 61 Pyxis Reports SUSPICIOUS ACTIVITY Specific Nurse Activity 62 ELECTRONIC MEDICAL (HEALTH) RECORDS (EMR/EHR) Photo:cutcaster.com  File: Audit Trail  Program: A Detailed Log  Runs in Background  Used: To ensure records are not changed, or if changed what was the change  Discoverable Quail MT 2013 63 21

4/12/2013 EMR AUDIT FILE  Metadata:  Replicates Each Step/Change  Preserves the Original Content  Printable Version  Monitors Quail MT 2013 64 AUDIT RECORD ~ SAMPLE 1 Quail MT 2012 65 Quail MT 2013 AUDIT RECORD ~ SAMPLE 2 Quail MT 2012 66 Quail MT 2013 22

4/12/2013 MISC.  Local Media  Incident Location  Conduct Interviews  Take Photographs  Cameras 67 CONCLUSION  Technology continues improve  Know Current Technology  Use to your advantage.  Be aware of the obstacles 68 CONTACT INFORMATION tom.quail@state.ma.us 617-624-5743 69 23

Webinar Evaluation Form Title: Powerful Discovery Tools through Technology Instructor: Tom Quail 1. How would you rate the instructor? ___Excellent ___Good ___Average___ Poor 2. Comments about this webinar: 3. What are your suggestions for future topics? Please return this form by email to contactus@medleague.com or by fax to 908-806-4511 or by mail to Patricia Iyer Associates, 260 Route 202-31, Suite 200, Flemington, NJ 08822.