Tenn. Agency Improves Annual Billing by $2M

Tenn. Agency Improves Annual Billing by $2M

Article Jul 14, 2010

Sumner County EMS is the 9-1-1 service for all of Sumner County, one of the largest counties in Tennessee, serving more than 150,000 residents. With 13 ALS ambulances and six BLS units in service, Sumner County EMS employs 125 people and maintains an "A" rated service mark, the highest rating Tennessee awards for public services.

With a rapidly growing service area, Sumner County's technology team began moving the organization from paper to electronic forms in order to improve process efficiencies and productivity. In an effort to replace its initial solution--a non-PC software application built specifically for small handheld devices--Sumner County turned to an integrated software solution for both EMS and public safety. With offerings for both in-house billing management and mobile field service, Sumner County's technology team needed a new hardware solution that would enable them to fully leverage all of the benefits of the selected software.

A Complete Mobile Solution

Michael Cook, Sumner County's IT manager, was in charge of selecting the device that would provide full support for its software, survive the daily stresses of the EMS environment and meet all necessary national compliances. With experience as both an EMS technician and a technology manager, Cook knew he needed a robust computing device with a rugged and portable design that could withstand the rigors of harsh environments.

Cook had tried several other solutions but none seemed to fit the bill until he looked into the rugged Motion F5 Tablet PC. The solid design tailored to highly mobile users that often compute in harsh environments impressed him from the very beginning.

"We looked at a lot of different rugged computing devices that just didn't meet our needs. Either they had too many moving parts, which are guaranteed to break in this environment, or they were too small to enable full utilization of the new software solution. When I saw the fully sealed design of the F5 with the virtual keyboard and integrated handle I knew this was the right device for our environment," says Cook.

Cook was also intrigued by the integrated features of the F5. After doing his research, he realized that for the same price as the other rugged PCs, he could get a fully rugged device with useful integrated features such as a Barcode scanner, RFID reader, fingerprint scanner and digital camera.

Cook worked with John Hill of Allegiance Tablet PC Experts, a Motion reseller partner and expert in tablet PC solutions. In business for over six years, Allegiance focuses solely on helping customers like Sumner County EMS develop, purchase and implement tablet PC technologies designed to improve productivity and profitability. Cook arranged a demo of the F5 and, shortly after, was convinced that it was the right tool for the job.

Technology in Action

After making the decision, Sumner County EMS purchased 25 F5s for its fleet of ambulances and has found that the devices are even more capable than he first imagined.

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Together with the new software the F5s are being used daily by providers in the field to:


  • Facilitate a streamlined data collection process to quickly produce accurate and complete electronic patient care reports
  • Provide valuable patient history to onsite emergency care givers (allergies, medications, existing conditions, etc.)
  • Generate patient data and gather information to immediately begin the billing process
  • Forward patient information to receiving hospitals to ensure patients receive treatment as quickly as possible.


The rugged tablet PCs offer a host of technologies that help personnel. When an emergency call comes in and the vehicle is dispatched, the driver can access GPS directly on the tablet to help guide them to the scene. Additionally, with ambulances equipped with full wireless capabilities, the tablets function as complete mobile offices, and with Doppler radar and traffic updates available on all tablet PCs, drivers are aware of conditions that could interrupt emergency response times.

Upon arrival the technicians begin the process of administering care and, with the F5s on hand, they are able to begin taking patient data and creating a profile as soon as they reach the patient. If the patient has been previously assisted by Sumner County personnel are able to quickly retrieve the patient's profile, which includes allergies, medications and other important medical history that might affect their treatment options.

The billing process also begins upon arrival and unlike the old system updating the records is now a much more efficient process. With the old paper system personnel would have to record all data on a paper form that would be sent to the billing department, which manually transcribed the information into their system. Often billing was delayed because it could take from one to several days to arrive. This process not only took a large amount of time, but was composed of too many steps, each a possibility for data errors and double-entry.

"Our old process was full of stages where something could get lost or recorded incorrectly. At a scene our technicians are on the move, which makes writing perfectly legible text an impossible task. This then becomes a problem at billing where names and numbers were often entered into the system based on interpretation, creating false entries due to guessing and, in the long run, costing us time and money," Cook says.

Now the process is made much simpler with the F5's rich feature set. The technician is able to pull up a new or existing patient file and begin the data collection and billing processes all at once. Using the onscreen keyboard, every action taken by the technicians is logged and once the patient is stabilized and ready to be transported the patient simply signs the form digitally with the stylus on the tablet.

While in transit to the receiving hospital information can be sent to allow the hospital to prepare for that particular patient's needs. One solution that really helps to ensure patients receive immediate care is a specialized cardiac monitor connected to the F5 through a Bluetooth connection. The cardiac monitor automatically sends patient heart data to the tablet which is then distributed to the receiving hospital.

Vital signs and medications administered while in transit are recorded on the tablet, which is also relayed to the receiving hospital. Making this information available prior to arrival significantly reduces the time needed to determine treatment by the receiving hospital.

Once the patient arrives at the hospital the receiving RN signs the form digitally and the form is updated and sent to billing in real time. The entire process is now integrated tightly with the efforts of the EMTs allowing more efficient and accurate billing and improved patient care.

Motion Makes a Vital Difference

With the new software and tablet PC solution, Cook says that Sumner County EMS has improved billing by $2 million annually and achieved a nearly 40% improvement in billing cycle times.

"We are now billing back 96% with our new process, which is incredible," Cook says.

Additionally, the electronic process that was once heavily based on paper is enabling a much improved patient care process. As its software solution further evolves to support the tablet, they will soon be able to leverage the camera for onsite documentation in areas such as traffic accidents.

The F5 itself has proven to be extremely well fitted to the rugged fast-paced setting. With roughly 40 people using the F5s during a 24-hour shift Cook knew the devices would need to perform under pressure. The F5 with its integrated handle and durable sealed chassis is rugged enough to withstand the occasional drop, plus Cook's decision to go with the SSD hard drive has made his tablets fully optimized for the environment.

"We had one fall out the back of a truck while driving and it still worked," Cook says. "We're a lot rougher on these things than most, and now with the availability of Gorilla glass for added durability we're looking forward to adding even more tablets in the near future."

The sealed chassis also presents a valuable advantage when it comes to HIPAA compliance and the security of patient data while in the field.

"The lack of external ports has made these things virtually impossible to grab data off of while away from the docking solution," says Cook. The F5 also incorporates biometrics, RFID and barcode scanning for added security of data. "When the tablets are in the trucks, we can remain confident that our patient data is secure."

The tablets now also function as desktop replacements in the office. Moving from a desktop to the tablet was simple due to the ease of inputting information with the stylus, the integrated handle for easy transport and the screen that is big enough to see full software applications on.

While on the road the F5 is perfectly capable of going a full shift combined with 12V chargers and vehicle mounts and while off the mount the F5 can last up to 4 hours depending on setup in a single charge.


Since implementing Motion F5 tablets throughout its fleet of emergency response vehicles Sumner County EMS has experienced substantial improvements in both its billing process and the ability to provide the highest level of care to its patients.

Additionally, Sumner County has found the device to be versatile enough to provide them to their EMTs on bicycles during recent marathon races and other outdoor events where maneuverability is key. The rugged lightweight design of the F5 has enabled Sumner County EMS to bring their now standard level of care to even the most unconventional of settings.

In this way, Sumner County EMS is constantly looking to improve its processes and streamline its services. With the adoption of Motion F5s, Sumner County has set an example for other emergency services to follow and leads the march toward providing the best patient care service available.

For more information on Sumner County EMS, visit http://sumner-ems.org/. For more information on Allegiance Tablet PC Experts, visit http://www.alltp.com/.

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