The Missouri Foundation for Health and the Missouri Department of Health and Senior Services Time Critical Diagnosis (TCD) Task Force held its fifth and final meeting on March 18 in Jefferson City at the Governor’s office building in Jefferson City.

 

In attendance were approximately 55 doctors, EMS professionals, nurses, advocacy groups, hospital administrators, first responders and medical organizations to make final recommendations for a draft document that will define what the Time Critical Diagnosis System should look like in the state of Missouri.

Previous meetings had participants divided into small groups to diagram the current system’s inputs, actions and outputs for ST-Segment Elevation Myocardial Infarction (STEMI) and Stroke.  The object was to identify other elements for an ideal system from the two perspectives.

Once the draft document is created it will go back to the Task Force participants for review and revision and then on to DHSS Director, Jane Drummond.  The final document will define how the system should be implemented and is expected by early June.

“We have been incredibly fortunate to have such dedicated professionals involved with the task force,” says Dr. Bill Jermyn, EMS Medical Director with DHSS.  “The amount of time they have given during and outside of our meetings has been gracious and key to the successes we’ve had to date and expect to have in the near future.”

The Time Critical Diagnosis Plan is unique in that it is the only one of its kind in the nation.  While a number of other states have time critical systems for STEMI or Stroke or trauma individually, Missouri is the only state currently creating one strategic plan for all three.

The plan is the brain child of Dr. Bill Jermyn, who is also director of the Time Critical Diagnosis Task Force.
Three years ago while attending a Stroke conference, Dr. Jermyn listened as Dr. Scott Duff, stroke interventionalist at Cox Health System inSpringfield, presented concepts for a Stroke system and a data collection system for designated Stroke centers.  

“It just hit me like a ton of bricks,” says Dr. Jermyn.  “We didn’t just need a system for Stroke.  We needed a system that could oversee the process for Stroke, STEMI and Trauma together.  This way we could share the data collection system and share other resources.”

Dr. Jermyn refers specifically to resources such as the MOStorm Trauma Registry System, a product of Image Trend, which is currently used by more than half of Missouri’s ambulance services for electronic medical records.  The data system automatically links an individual patient’s out-of-hospital records and hospital data.

Legislation submitted for the creation of a stroke and STEMI system, led by DHSS and supported by MEMSA, MAA, ACEP, AHA, the Missouri Hospital Association and SAC, recently passed in the Missouri House of Representatives 143 - 0.  The bill will now move to the Senate.  The bill would create stroke and STEMI centers similar to existing trauma centers and would give DHSS the authority to promulgate rules to expand the current trauma system to include heart and stroke systems.  As the bill currently reads, it “changes the laws regarding hospital designation to include a heart attack center and a stroke center if it meets the criteria of the Department of Health and Senior Service.”