Case Study: Why Paper Is Poison


Case Study: Why Paper Is Poison

By Scott Streicher Sep 14, 2012

No one likes paperwork—that’s a fact. It’s an inconvenience and perhaps some small drain on productivity. For any EMS provider or first responder, however, it’s actually life-threatening.

Here’s an example of what I mean: A call comes in to a suburban station for a middle-aged, slightly overweight male who is experiencing shortness of breath and pains in his chest after taking a hike along a country road. Local emergency services arrive on scene and ask the patient how he is feeling. Immediately the reporting process begins.

For many agencies, this is still a manual process where one of the respondents takes clipboard in hand and scribbles down notes as quickly as they can, trying to keep one eye on the individual in need and one on the bureaucratic red tape they are developing. If they make the patient their only focus, the paperwork stops, only to have to be whipped out later, likely with less accuracy. The focus becomes split and potentially damages the quality of care.

Thankfully, the paper trail has an end date in sight for many emergency services. The advent of onboard software platforms embedded in ruggedized mobile devices will not only reduce reporting times, but turn a largely administrative process into an additional resource for EMTs and firefighters to improve the quality of care in the field.

The problems with paper patient reports and manual data entry are far-ranging. Paper reports require a lot of effort to maintain. Data entry is not always consistent, and reports do not always contain the data needed for analysis to improve services and manage the risks associated with patient care.

Fire and EMS systems can recognize numerous benefits by migrating to electronic patient care reporting systems (ePCRs). ePCRs allow for documentation to go on continuously during the call, producing more comprehensive and accurate reports by the time you return to service, with no paperwork to do back at the station. Though largely used in the major cities, these platforms are becoming a cost-effective option for more and more fire and EMS operations. The benefits of ePCRs include:

• A dramatic reduction in the processes and systems required to support a paper system, which can translate into significant dollars;

• Enhanced field productivity with quicker return to service and less effort to complete reports;

• Improved protocol compliance with implementation of electronic closed-call rules;

• Maximizing billing potential and more efficient compliance with insurance requirements;

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• The ability to identify key trends and better effect positive patient outcomes through training and protocol changes.

This is not a futuristic projection but a technological reality that exists today. Many agencies have already implemented such systems. To achieve these benefits, field personnel must be convinced their ePCR is more user-friendly than paper, and the optimum mobile platforms should have these types of features and functions in place:

• Secure data capture;

• HIPAA compliance;

• Auto-calculating of scores (GCS, RTS, Apgar, etc.);

• Intuitive work flow and an easy-to-use interface designed for speed;

• Guidance tools to help document elements such as OPQRST, PASTE, CPR, trauma, etc.;

• Capture and storage of electronic signatures;

• Patient records that can be faxed, e-mailed or printed;

• Attachments such as photos or voice;

• CAD integration;

• ECG monitor integration;

• Content and required checklists provided for closing reports;

• Customizable treatment list to meet agency needs;

• Wi-fi or broadband capabilities;

• Agency-definable data collection fields;

• NEMSIS reporting features;

• Billing capabilities or interfacing to a third-party biller.

There are a lot of factors to consider when deciding which system is best for your organization. In short, your electronic patient care reporting system should be usable in real time, as fast or faster than paper, do more than collect data, and be reliable, flexible, intuitive and easy to use.

Scott Streicher, PMP, FF-II, NREMT-I, is a volunteer lieutenant with Virginia's Stonewall Jackson Volunteer Fire Department and director of operations for OPEN, Inc., maker of the SafetyPAD suite of technology products for fire and emergency medical services. Reach him at

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