# PORTAL: Patient Outcome Reporting Tool for emergency medicAL services

> **NIH NIH R34** · VANDERBILT UNIVERSITY MEDICAL CENTER · 2021 · $346,000

## Abstract

ABSTRACT
Nearly 28 million prehospital emergency medical services (EMS) ambulances runs occur annually for patients
with cardiovascular emergencies. The American Heart Association recognizes the value of EMS in the Chain
of Survival yet the inclusion of EMS necessitates logistically challenging communication amongst multiple
organizations. Often, prehospital providers are unaware of their own practice patterns and patient outcomes
wasting valuable opportunities to learn from experience while inadvertently reinforcing suboptimal care.
Providing feedback on clinical practice and patient outcomes is a simple and effective intervention that has
been challenging to scale. We will use human factors engineering principles (user-centered design) to develop,
refine, and implement a scalable feedback system we call “PORTAL.” PORTAL uses automated audit and
feedback, non-financial incentives, and local champions to examine the impact on provider behavior through
the performance of guideline compliant care in the setting of cardiovascular emergencies.
This application describes a mixed-methods proposal that addresses major NHLBI priorities to improve patient
health through the development and refinement of the PORTAL feedback system for EMS providers delivering
acute cardiovascular emergency care to patients with chest pain. The Specific Aims are: 1) Examine the
determinants of guideline compliance amongst EMS providers and stakeholders; 2) Refine the visual interface
for automated EMS feedback through user-centered design; and 3) Examine the feasibility and refine the
implementation of the PORTAL intervention to support a subsequent trial testing the effectiveness of the
feedback intervention.
The team is uniquely qualified to accomplish these Aims, with expertise in care transitions, healthcare
operations research, biomedical informatics, human factors engineering, implementation science, pragmatic
trial design, qualitative methods, and acute care medicine. The institutional environment at Vanderbilt
University Medical Center is outstanding, including the Center for Clinical Quality and Implementation
Research (CCQIR), nationally ranked graduate programs in the relevant fields of study; and the national CTSA
coordinating center.
This application will develop an automated feedback system for prehospital providers treating patients with
suspected cardiovascular emergencies. Taking a user-centered approach by placing the EMS provider at the
center of the design process will substantially advance the ability to enhance provider activities through the
delivery of scalable feedback using provider and stakeholder input. Advancing the delivery of prehospital
provider feedback creates a mechanism to improve the quality and safety of prehospital care through the
enhanced uptake of guideline compliant care. We propose this work in preparation for a cluster randomized
trial evaluating the impact on provider behavior and patient outcomes.

## Key facts

- **NIH application ID:** 10301974
- **Project number:** 1R34HL155400-01A1
- **Recipient organization:** VANDERBILT UNIVERSITY MEDICAL CENTER
- **Principal Investigator:** Michael J. Ward
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $346,000
- **Award type:** 1
- **Project period:** 2021-09-01 → 2024-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10301974

## Citation

> US National Institutes of Health, RePORTER application 10301974, PORTAL: Patient Outcome Reporting Tool for emergency medicAL services (1R34HL155400-01A1). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10301974. Licensed CC0.

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