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ESO’s Health Data Exchange puts more information in the hands of first responders

The bidirectional exchange of data between EMS and hospitals allows for better-informed decisions in emergencies

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Company Name: ESO
Your name and title: ESO

1. Where did your company name originate from?


2. What was the inspiration behind starting your company?

ESO launched out of a coffee shop in 2004 and ever since then ESO has been pioneering creative, innovative and user-friendly software to meet the changing needs of today’s EMS agencies, fire departments and hospitals.

When first launching ESO, our founder, Chris Dille, recognized that something wasn’t right within the emergency response system. We’ll explore the emergency response system to better understand this. Here’s how typical medical emergencies work:

  1. Someone calls 911.
  2. An ambulance is dispatched to the scene.
  3. A patient is transported to a treatment facility or hospital.
  4. The patient’s disposition determines (death, traumatic injury, minor injury, mental health issue, etc.) post-hospital care.

All sounds familiar, right? But most people don’t know that EMS agencies (first responders, paramedics, emergency medical technicians, etc.) typically don’t receive patient outcome data back from the hospital once they’ve delivered a patient. Imagine taking a test and not knowing the result. Frustrating, right? Did you pass? Did you fail? What did you get wrong? How do you improve? What do you improve? EMS typically don’t know if the patient lived, if the patient died, if they diagnosed the patient the right way in the field, if they missed something important during the diagnosis because there’s no feedback loop – unless a paramedic just happens to be at a hospital and asks how so-and-so patient did. There is no systematic, data-driven way for EMS agencies to understand how a patient fared – until now.

When Chris Dillie first launched ESO, he wanted to change this dilemma. He knew the industry would only improve and grow if feedback was given and quality improvement measures were taken. Our mission at ESO is to improve community health and safety through the power of data. It’s driven us since 2004, leading to multiple acquisitions and technology developments along the way. The result is a technology platform that tracks a patient journey from 911 call to post-hospital care, including bidirectional feedback between an EMS agency and a hospital. For example, EMS leverages our technology to send data and information to a hospital letting them know a suspected heart attack victim is en route to ensure the right medical personnel are activated when the patient arrives, saving precious minutes; the hospital shares data back with EMS letting them know the patient outcome, thus driving quality improvements for subsequent calls.

This saves lives. We are currently the only company in the world that has a technology platform that provides this level of insight across an entire patient journey as it relates to time-sensitive emergencies.

3. What is your signature product and how does it work?

The core product that allows the bidirectional exchange to happen is called ESO Health Data Exchange (ESO HDE). It’s not an exaggeration to say that it’s truly transforming patient care when it comes to medical emergencies. And, per the point above, considering 240 million 911 calls annually – that’s a LOT of positive transformation that can be the difference between life, death, and significant impairment.

ESO’s Electronic Health Records paired with ESO Health Data Exchange both assist in providing data, insights and outcome information to continue moving forward our ESO research initiatives. An ESO Electronic Health Record (EHR) makes it easy to produce quality EMS clinical documentation. EHR is a point of reference tool that helps providers make better patient-care decisions in real time. The system gives back more data than what was initially put in, meaning researchers can take this information and decipher industry trends, or how healthcare is working versus missing the boat. EHR also arms EMS chiefs, quality officers and administrators with the insights you need to monitor performance, optimize operations and improve protocols. With built-in Analytics, ESO turns data into actionable information. Much of this information goes into a data collaborative. The ESO Data Collaborative consists only of entities that have voluntarily agreed to allow use of their de-identified records for research and benchmarking purposes.

4. Why do you believe your products are essential to your vertical (Police, Fire, EMS, Corrections, Government) community?

Our customers are seeing an immediate impact on people’s lives currently, whether it’s from tracking opioid usage in a city to identifying homeless individuals for better care and treatment. Getting patients suffering from a stroke to the right facility with the right equipment can be the difference in a full recovery or some level of impairment due to the stroke. Getting patients suffering from gunshot wounds, heart attacks, vehicle crashes, etc., the right treatment at the right time with the right training and insights can be the difference between life and death. These data and insights deliver better quality of care for ALL of us. Over the next five years, we will continue to make improvements across our entire technology platform to deliver more predictive insights to first responders and front-line workers – in the U.S. and beyond.

5. What has been the biggest challenge your company has faced?

We’ve all heard the phrase, “If you build it, they will come.” But will they? Humans are hardwired to resist change. Change represents a threat. The chemistry in our brains pushes us to “fear, fight, or flight” when confronted with change. So…what’s the biggest challenge we had to overcome? A belief in what we were building and why we were building it. To use another maxim, many established industries joke about “100 years of tradition unimpeded by progress.” While it’s a funny comment, there are threads of truth woven into the joke. How do you convince established industries to use a technology platform they don’t realize they need? It would have been easy to abandon the development of ESO HDE early in its lifecycle, not due to development setbacks, but adoption challenges. But we didn’t abandon the technology – we persisted and realized we would need to find creative ways to showcase the technology, unique ways to engage hospitals that didn’t fully understand the value of the technology, and dedicated ways to show hospitals how to get the most out of the platform. At times, it was a slog – one hospital at a time had to be convinced to take a chance on nascent technology that none of them had requested. This is an approach that doesn’t drive growth or scale … until you start proving the value of the technology. Which we’ve done, in spades.

6. What makes your company unique?

At ESO, we consider ourselves not just a software company, but also a data company. We are uniquely positioned to leverage data and insights from our products to create real change in the first responder community. In 2019, a very tragic situation happened – Elijah McClain died in Colorado after a police encounter. One of the identified culprits in his death was a drug called ketamine, administered by EMS at the scene of his arrest. In the aftermath of his death, there was (and still is) a national debate about the use of ketamine by EMS to calm agitated patients. There were efforts by politicians to ban the use of ketamine by EMS agencies – in both Colorado and at a federal level. But no data or research existed to help make informed decisions about the use of ketamine – other than a handful of small, localized studies that were statistically insignificant. We (ESO) were able to produce a peer-reviewed research paper on the administration of ketamine in the pre-hospital setting (in other words, by EMS) with more than 11,000 deidentified patient records (the largest study of its kind) AND connect that pre-hospital administration of ketamine to hospital outcomes to determine the role ketamine played in the death of a patient. Nothing like this report could exist without our technology (ESO HDE) to connect 911 calls to hospital outcomes. We determined that ketamine was a contributing factor in less than .07% of deaths where ketamine was administered. For what it’s worth, we aren’t for or against the use of ketamine by EMS – we simply wanted the data to drive decisions. With this research, legislation in Colorado was amended and federal legislation was curtailed entirely.

7. What do your customers like best about you and your products?

We fundamentally believe in taking great care of our customers. We believe it’s necessary to continually strive for excellence and push the boundaries in order to be pioneers and create innovative, user-friendly software to meet the changing needs of today’s EMS agencies, fire departments and hospital systems. Customers celebrate the transformation of how they collect, share, report and analyze critical information to improve community health and safety.

Through our seamless platform, customers can stay response-ready. Our products help them drive operational efficiency with integrations, improve visibility and readiness, and improve department accountability, from our Health Data Exchange (HDE), bridging the data gap between EMS and the hospital, to our Electronic Health Record Software (EHR), allowing paramedics to make better patient-care decisions in real time.

Our holistic ecosystem makes communication with departments and teams effortless through bidirectional data sharing and by allowing customers to stay connected from anywhere. For example, West County EMS and Fire Protection District leaders wanted to use data to monitor performance, develop key performance indicators, improve patient outcomes, and demonstrate value within their community. Their adoption of ESO Electronic Health Record (EHR) and ESO Health Data Exchange (HDE) allowed their chief, Jeff Sadtler, to immediately gain insight into the team’s performance and make data-driven decisions to improve patient care. “I don’t think there’s any doubt we’ve improved patient care,” says Chief Sadtler. Our amazing products have helped customers be better providers and provide better patient care reporting.

8. What is the most rewarding part of serving the first responder/local government community?

As a software and research company, ESO has the ability to influence the way EMS agencies, fire departments and hospital systems operate. Our ESO research team and those who partake in the ESO Data Collaborative work around the clock to garner industry insights and trends – making a difference in public safety.

One example is a newly released peer-reviewed research manuscript that looked at sodium bicarb administration amongst cardiac arrest patients. For years, sodium bicarb use has remained a controversy. This medication was used frequently until the mid-1980s. In 1986, The American Heart Association (AHA) first raised concerns about the effectiveness of bicarb when treating patients with cardiac arrest.

The recent study used the ESO Data Collaborative to analyze electronic health records from thousands of EMS agencies. Based on the hospital outcome data using ESO’s electronic health records, researchers found that there may be cases when bicarb use is appropriate and is associated with better outcomes – specifically for patients presenting with non-shockable rhythms and longer resuscitation times. This realization is huge, especially considering cardiac arrests are often not survivable.

That’s the research side of things – the software is even more powerful. Having the ability to notify hospital systems prior to patient arrivals, and ensure hospitals are equipped when a patient gets there can make a difference in a life and death situation.

9. What’s next for your company? Any upcoming new projects or initiatives?

ESO’s engineers and strategic planners have eagerly worked to create processes for the launch of ESO’s patient registry software. It’s set to be introduced into the market in late 2023. The vision is to create a platform that will communicate in-hospital, pre-hospital, and post-acute care environments. Today’s data is often trapped inside silos, which creates a gap in understanding the holistic patient story. To close the gap, ESO Patient Registry aggregates, stitches together, and highlights data from a variety of sources to create real-time decision support and integrated loop closure. The future of navigating patient data across the entire continuum of care includes combining data from EMS, referring facilities, specialty systems – and even outgoing data from transitional care facilities such as rehab facilities – to generate a deeper understanding and improve the way we deliver care for patients.