Literature Review: Prehospital Electronic Patient Care Report Systems

Literature Review: Prehospital Electronic Patient Care Report Systems

By Elijah James Bell, BS Aug 17, 2012

The adoption of healthcare information technology (HIT) is a central priority in the United States. The federal government is providing incentive funds for hospitals and ambulatory practices to invest in and meaningfully use HIT. While EMS agencies are not included in these federal incentive payments, many EMS agencies have begun to transition to electronic patient care reports (e-PCR). A recent study published in PLOS One interviewed 23 EMS leaders about their experiences with e-PCR.1 The results highlight key challenges faced by the EMS agencies adopting e-PCR and also provide lessons for EMS agencies seeking to move to e-PCR.

EMS leaders expressed several motivating factors for adoption of e-PCR systems, including the potential to support quality assurance, improved legibility and billing, fewer lost charts, and compliance with state mandates. The study also revealed the following unique challenges to e-PCR adoption faced by EMS agencies:

  • Concerns for increased ambulance run times: there was widespread fear that the potential extra time needed to complete electronic forms as compared to paper forms would cause an increase in ambulance run times.
  • Challenging integration of e-PCR with hospital information systems: technical barriers, organizational issues, and security/privacy concerns result in difficulty electronically integrating e-PCR systems with existing ED or hospital information systems.
  • Difficulty responding to unfunded state mandates: despite state mandates, many states do not provide the necessary resources and funding to adopt e-PCR systems.

EMS leaders in this study also identified strategies for overcoming common challenges including:

  • Identification of alternative, creative funding sources: state/federal grants, billings companies, and e-PCR system vendors can decrease the initial cost barrier for adoption of an e-PCR system.
  • Leverage existing regional health information organizations: existing regional health information organizations can facilitate health information exchange between EMS agencies and participating hospitals/physician offices through a single electronic interface.
  • Investment in internal information technological capacity: dedicated e-PCR information technology staff can prove advantageous to EMS agencies by producing quality assurance reports, customizing software, and supporting users of the e-PCR system.

These findings may be useful for EMS agency leaders seeking to adopt or enhance existing e-PCR systems. In order for e-PCR systems to reach all EMS agencies and for the full potential of e-PCR to improve care to be realized, additional financial and technical support may be needed.

As a caution, this was a hypothesis-generating study only and needs to be followed-up with a larger quantitative study. While the sample of interviewed participants was diverse, the study findings may not be generalizable to all EMS agencies. Further, participants in this study were EMS agencies leaders and may not have had operational experience using e-PCR systems.

Reference
1. Landman AB, et al. Prehospital electronic patient care report systems: early experiences from emergency medical services agency leaders. PLoS One 2012;7(3), e32692.

Elijah James Bell, BS, graduated from Florida State University in 2008 with a BS in economics. He is currently a senior medical student at Harvard Medical School, set to graduate in May 2013 and plans to become an emergency physician. Elijah can be reached at Elijah_Bell@hms.harvard.edu.

Lee County, Fla. EMS will soon have its own substation in North Fort Myers. Chiefs for the North Fort Myers Fire District and Lee County EMS said it was time for a change because of overcrowding. 

EMS professionals are all taught to look for a MedicAlert bracelet or a necklace. This simple step has become much more complex in the information age, and we may not realize for what and where to look.
The drill involving over 200 people put multiple first responder agencies to the test.
The training was based on lessons learned from the Columbine shooting and taught school employees safety and security measures.
One third of the state's record-high 376 overdose deaths that occurred last year were caused by prescribed painkillers.
The training will be focused on prescribing buprenorphine, the drug used to assist patients in quitting their opiate addiction and relieve withdrawal symptoms.
One of the paramedics was treated after getting hit with shards of glass after the bullet went through the windshield, but the ambulance is not believed to have been intentionally targeted.
The drones are used to improve scene management by assessing areas that are difficult or dangerous for personnel to reach.
Dozens of firefighters and police officers join the annual week-long Brotherhood Ride to honor 20 first responders who have died in the line of duty in Florida.
The event will be held on August 20, with all proceeds going to Narberth Ambulance, an agency that provides emergency services to 145,000 residents.
Speakers presented on topics such as disaster relief, emerging pathogens, the opioid crisis and cyber security.
The state's Department of Health has established an agreement for UNC and NCBP to collaborate on providing public health data to NEMSIS to better prepare EMS for national emergencies.
State troopers rendered aid before turning them over to responding EMS units and New Castle County Paramedics.
Three people were fatally shot and at least 21 others were wounded in separate attacks from Saturday morning to early Sunday.