DATE: October 9, 2001
TO: Board of Supervisors
SUBJECT: UPGRADES TO THE EMERGENCY SERVICES DATA SHARING NETWORK

SUMMARY:
We now live under more than the threat of future attacks of terrorism on our Nation. New thinking and priorities are already in place. The County of San Diego serves as guardians of public health and safety and citizens look to public officials to fulfill that duty. Hospital personnel now must focus on identifying symptoms associated with
chemical warfare or in the event of a bio-terrorist attack. This action is just one step in preparing ourselves in the event of an attack.

Each day in San Diego County more than 600 people access our 911 emergency medical services system. These are victims of heart attacks, stroke, car crashes and other sudden and unexpected events. They rely
on emergency medical experts of San Diego County to assess, treat and take them to a nearby hospital for treatment. Unfortunately, too often our emergency rooms are overcrowded and ambulances must take victims to
more distant facilities. The system for monitoring hospital availability is known as the Quality Assurance network. When it works, this mission critical system provides essential communication links between hospitals and emergency responders. Patients get to the right hospital in time to be treated and cared for. However, technology can become outdated in just a few years. This is the case with the current system and getting parts when the system fails, is increasingly more difficult and life threatening.

Today's request is to upgrade, enhance and improve the QA-Net for emergency medical services systems serving all of San Diego County. With it, we can ensure a reliable real-time operating system to assess
system readiness, assure system integrity and monitor system performance.

RECOMMENDATION
CHAIRMAN BILL HORN AND SUPERVISOR DIANNE JACOB:
1. Direct the Chief Administrative Officer to upgrade the emergency services data link between emergency responders, hospitals, and other essential services.
2. Direct the Chief Administrative Officer to work with the Science and Technology industry to develop the most modern, fail safe, and up-to-date real-time data system available at a reasonable cost.
3. Direct the Chief Administrative Officer to refer $3 million to support the Emergency Medical Services information system (QA-Net) to include hospitals, pre-hospital providers and other emergency service
agencies to the October 16th one time tobacco settlement dollars discussion.

FISCAL IMPACT:
$3 million to be designated from Tobacco Settlement funds.

BACKGROUND:
The Quality Assurance Network (QA-Net) was created through the Health and Human Services Agency, which saw a need to share information quickly and efficiently, instead of a phone-in and labor intensive reporting
system. QA-Net is a live interactive system on a private net linking real-time emergency medical responders with base hospitals for medical direction and destination receiving facilities.

This system sets a standard and is unique to San Diego County - we know of no other County in the state that has the capacity to share this type of information. QA-Net takes on new importance, as it would be one of
the first lines of information sharing in the event of a bio-terrorist attack. Unlike Readi-Net used by some hospital systems, QA-Net gives more than hospital bed counts. It instantly communicates vital information with pre-hospital providers.

This live 24 hour on-line system has been in service for approximately eight years. During that time the county's area hospitals and ambulance providers have been linked into the system via a wide area network. Vital information to service providers in a real time environment means lives are saved. The current system is outdated and subject to failure. The database is in Paradox 4.5 DOS rather than a WINDOWS platform and
replacement equipment is increasingly hard to locate. Over the last year, the system has had significant delays in equipment acquisition, system responsiveness, and technology upgrades. Locating spares for the communication hardware is shaky, at best, as the equipment is no longer available on the open market.

I, along with Supervisor Jacob respectfully submit our request to the Board to consider designation of tobacco settlement funds to reengineer the QA-Net system. Additionally, I request that staff work with EMS (Emergency Management Services) community partners and the science and technology industry in San Diego county to redesign the system to better meet the needs of all our emergency patients each day and in times of disasters.

Respectfully submitted,

BILL HORN
Chairman
Supervisor Fifth District

DIANNE JACOB
Supervisor Second District