Cardiovascular Disease and Diabetes Coalition of Indiana | CADI

Systems of Care Workgroup Meeting Minutes

Meeting Date: / 2/11/14
Meeting Time: / 9:00am to 10:30am
Meeting Location: / Indiana Public Health Association,
English Foundation, 615 N Alabama St Ste 426 Indianapolis IN 46204
Conference Line: / Number: (877) 422-1931
Passcode: 4717625879
Recorded By: / Caitlin Neal

1.Agenda:

  1. Welcome and introductions
  2. Approve January meeting minutes
  3. Hospital Discharge Data:
  4. Combined Member Survey/2014 Member Application
  5. Presentation from Robert Atkins, Director, EMT-P, AEMD; Communications, Emergency Medical Transport Services, and Emergency Preparedness - Indiana University Health Bedford Hospital
  6. Presentation from Kelly Trieglaff-Boylan,MSN,RN, NP-C, Senior Clinical Specialist - Genentech
  7. Brainstorm questions for CADI Q1 Meeting Presentation by EMS Commission
  8. Wrap-up and adjourn

2. Attendance:

First / Last / Title / Organization
Bob / Atkins / Director, EMT-P, AEMD / Indiana University Health Bedford Hospital
Liz / Fiato / Education and Training / Indiana Department Homeland Security – EMS Division
Hanna / Kelley / Executive Director / Indiana Dietetic Association
Susan / King / Diabetes Educator, Community Based / Parkview Integrated Community Nursing and Care Navigation
Lanet / Owen / Parish Nurse Coordinator / Memorial Hospital and Health Care Center
Ruth / Rench / Senior Clinical Specialist / Genentech
Scott / Setzepfandt / Senior Regional Manager, State Government Affairs / AnthemGenentech
TJ / Smithey / Manager, Healthcare Solution Specialist / Sanofi
Teasa / Thompson / Program Manager and Assistant Director of Outreach / Purdue University Center for Cancer Research

3. Discussion

  1. Welcome and introductions
  2. Approve January meeting minutes
  3. Those present reviewed the most recent meeting minutes. Scott Setzepfandt motioned to approve, Hannah Kelley seconded. Minutes were approved as distributed.
  4. Hospital Discharge Data:
  5. The group discussed the data and decided to table it until the next meeting.
  6. Combined Member Survey/2014 Member Application
  7. The group reviewed the finalized application that was approved by the Steering Committee.
  8. Lanet Owen motioned to approve the survey as distributed. Hanna Kelley seconded. The group voted and the survey was approved for dissemination.
  9. Presentation from Robert Atkins, Director, EMT-P, AEMD; Communications, Emergency Medical Transport Services, and Emergency Preparedness - Indiana University Health Bedford Hospital and Liz Fiato - EMS Preparedness, Training,and Education Section Chief at the Department of Homeland Security
  10. Slides from Bob’s presentation can be seen at the end of this document. Some highlights of his presentation include:
  11. There are as many ways to do dispatch as there are organizations doing it.
  12. The state tried to get everyone certified a few years ago but there were issues with fees.
  13. IU Health chose Priority Dispatch for training and national certification.
  14. There is a law in place to set standards for EMS however there is no teeth to enforce it.
  15. In 2014, there is an update to switch from three toBLS (Basic Life Support) Levels – First Responders and EMT Basic. EMT Basic-Advance was able to do more but no longer can charge for services. There will be two ALS (Advanced Life Support) levels - Advanced EMT and Paramedics. People in between will have to either drop down or move up with some additional training.
  16. Most EMS systems are fire-based but there are city-owned, county-own, hospital, volunteer, private,etc.
  17. Indiana Code 16-31-2-1 provides for the EMS Commission which includes 13 minutes with four year terms. Bob recommended working with them as well as medical directors for any major projects. All providers have medical directors and they need to be board certified physicians. They worked with them on stroke before; they decide policies including training and competencies for recertification.
  18. Bob included contact information for the Indiana State Fire Marshal James L. Greeson and Chief of Staff of the Department of Homeland Security, Mike Garvey.
  19. Bob also noted that financial resources mainly come from Medicare, which makes funding tight throughout the state.
  20. Some highlights from the presentation by Liz
  21. She gave more background to changingBLS and ALS certification levels, including that out of 3500 certified responders, only 170 were ALS –Intermediate and 1200 were BLS Basic-Advanced. To overcome payer issues, they decided to adopt national standards in 2011 for Basic Advanced. They received a lot of push back due to the timeline for implementation. The law took effect in 2012, giving BLS Basic-Advanced and ALS-Intermediate two years to take a bridge program to get to the next level. In developing a curriculum, they learned that BLS Basic Advanced responders were providing some services that were not included in the national standards, so in August 2013, the commission decided to adopt those extra services. Now they are trying to address curriculum gaps which took time to get established. For those who were waiting to see what happened with the law and curriculum, BLS Basic Advance and ALS Intermediate arenow left with 5 months to upgrade. Because it was set in legislation and now addressed in the 2014 short session, we are waiting to see if extensions are granted.
  22. Bob suggested seeing where CADI can get involved with EMS education as it is a hot topic and area of need for EMS Commission. Right now the General Assembly or the EMS Commission can mandate training before recertification, however there are no rules through the state stating that dispatchers have to do any training. It says they need to be certified but there’s no way to enforce it.
  23. Liz explained more about EMS training. She explained that if we want to make a certain training a core part of any course of continuing education the EMS Commission makes that happen. Certain trainings are in legislation (SIDS, Autism). They explained how the POST (Physician Order on Scope of Treatment) training works; it is in the online learning management system and participants can enter their credentials so they can see anyone’s training record or certification and verify if they’re completed the training. They recommend POST as an example of getting something through the system and mentioned the key role of the Fire Chief’s Association – EMS Section.
  24. IDHS is responsible for training first responders, especially that which their area cannot provide, like simulation training. They have a mobile training center that does simulation training for free and it is not limited to EMS; nurses etc. can also request training. They customize training for each audience. They’re currently working on Tactical Emergency Casualty Care and Law Enforcement Trauma Care(including care under fire, self-aid, buddy aid). They’re also thinking of partnering with Department of Education to train teachers.
  25. All trainings are free! Bob noted that much opportunity to interface with responders’ training comes in the hours they need to stay certified. There is a training calendar that is available at
  26. They have also been working on CPR and AED Trainings. Their goal is to have an AED on every floor of the government center and state house. So far they have trained 300 people and are training trainers, who are then encouraged to go out into the community and do trainings, which they support. This project is independent of AHA but they use their trainings; Ruth recommended partnering with AHA to enhance training. Lanet noted that Toyota was able to sponsor some CPR equipment and that she has been working with Spanish language trainings.
  27. Liz also noted that IDHS is offering grants to EMS providers across the state for training or for training equipment.
  28. The group discussed the medical directors’ conference and which directors may be on board to work with us or have worked with us in the past. TJ recommended reaching out to and potentially adding Directors and Commissioners to the CADI Newsletter.
  29. Liz is currently writing a grant to fund a person to help develop an EMS Strategic plan as well as process the data they have been collecting for nearly a decade. Because we are looking to make data-driven decisions, this is an area of synergy that CADI may be able to get involved with.
  30. Community Paramedicine/ Mobile Integrated Health Care initiative.
  31. This is a community-based care initiative driven by changes in healthcare and reducing hospital readmission rates. It sends PAs, Nurses Paramedics etc. to people’s homes to mitigate the non-emergency problems that might drive someone to the Emergency Room. It targets the gap between home health care and the emergency room.
  32. Presentation from Kelly Trieglaff-Boylan,MSN,RN, NP-C, Senior Clinical Specialist – Genentech
  33. She is working with stroke coordinators in northern Indiana to improve treatment. In May 2013, they started working on a pre-hospital stroke form or checklist. They pulled together the stroke coordinator, EMS coordinators within those centers to discuss the feasibility of a stroke checklist of those things that need to be evaluated in the field. They are looking for feedback on EMS use of the form and usability, they want to know if the form is used as a handoff tool, and if it helps coordinators collect data. They are currently pilot testing with different kinds of EMS Services. Kelly reported informally that issues have come up on how to use the form in the ER department and avoiding duplication.
  34. Liz asked how data forms are being collected. Kelly noted that some EMS include it with the run sheet, others fax the sheet, and some drop it off in the ER. Currently, they are manually inputting data and we might be able to help with that. Liz noted the similarities between this project and the Indiana Perinatal Quality Improvement Committee. They will be presenting their standard with the hopes of getting to rule promulgation. She said if we can find a standardized process for any of these projects that can be extended to the hospital side, where information is uploaded and collected, that would be critical.
  35. Kelly will also be speaking at the Quarterly Meeting on March 12 and should have more data available by then.
  36. Brainstorm questions for CADI Q1 Meeting Presentation by EMS Commission
  37. The group decided to work on the questions via email.
  38. Wrap-up and adjourn

4. Post-Meeting Action Items

Action Items (NEW) / Assigned To / Timeline
Send documents to Caitlin / Liz / Completed
Follow up with Jerry King regarding Community Healthcare Workers’ Association / Caitlin / Completed
Send Membership Survey to all previous members / Caitlin / Completed
Write and send questions to EMS Commission / All / COB, 2-21-14
Action Items (OLD) / Assigned To / Timeline
Connect with 10 organizations / Caitlin, TJ / Ongoing
Contact Dr. Kaufman about Indiana Chapter of American College of Emergency Physicians / Greg
Contact Mike Brady about Indiana State Medical Association , send information on Statewide EMS Association annual meeting to Caitlin / Danielle

5.Decisions Made

  • We will table hospital discharge data discussion to the next meeting
  • Everyone to send questions for EMS Commissioners to Danielle by February 21
  • Caitlin willsend the membership survey to the full membership later this week.
  • We will begin reaching out to those organizations that have meetings scheduled before June .

6.Next Meeting

Next Meeting: Tuesday, April 3, 2014

Appendix: Organizations to Promote CADI

Organization Name / Contact Person / Next Meeting / Status/Previous Contact
Aesculapian Medical Society
/ Andrew Moore M.D. / 2/4(first Tuesday of month)
Indiana Healthcare Executives Network / Barbra Broadbridge, 317-442-9966 / 2/5 regular program, 5/7 networking meeting (more informal)
Indianapolis Medical Society / Beverly 639-3406 / 2/18 Executive Committee
3/18/14 Board/DinnerMeeting
Indiana State Medical Association / Mike Brady, Lobbyist / 3/2 Board of Trustees Meeting (9am) / Danielle to contact Mike Brady
Coalition of Advanced Practice Nurses of Indiana ( / Sue Spivey, President,
Elizabeth Law, Treasurer,

Angi Thompson, Secretary, / 3/7 – 3/8 Annual Spring Conference
Indiana Academy of Physician Assistants / Courtney Duran, local president, 344-2099 / 3/12, 5/15, 7/9 Board meetings
Indiana Pharmacists Alliance / (Carrie Maffeo?) / 4/16 Spring meeting
Indiana Rural Health Association / Tina Elliot / 6/10/14 – 6/11/14 conference
Indiana Academy of Family Physicians / Missy Lewis, Director Membership and External Affairs, / 7/24-7/27 Annual Meeting at Westin Indpls.
Community Healthcare Workers Association / Judy Jacobs / Judi Jacobs and Jerry King meeting on 1/29
Indiana Chapter of American College of Emergency Physicians / Susan Barnhart 846-2977 / Greg to ask Dr. Kaufman if he has information
Indiana Chapter of Dispatch Association
Diabetes Educators ( / James Specker, Federal and State Advocacy Manager, or (312) 601-4873,

Page | 1