Is filling in fields making you less effective in the field? when it introduced its own system, called “TapChart,” in 2000. Since then, patient information enter-San Diego Fire-Rescue Department was an early adopter of electronic patient care reports (ePCRs)
ing has matured and evolved. Electronic documentation of patient data, now hailed as a feat EMS, has been
successfully accomplished, and rightfully so, but with the seemingly infinite possibilities for data analysis
and the subsequent ability to make data-driven decisions, there has also been a downside. EMS providers now find themselves asking the question, “Am I a healthcare provider or a data collection technician?”
More than a decade into the TapChart
project, San Diego Fire-Rescue paramedics might now reluctantly admit that they
played a part in creating a problem of
excessive data collection. But as health
records systems inevitably expand, understanding the complexities and evolution
of data systems means their experience
allows them to also be part of a solution.
Computers and electronic medical records
are more widely used today by clinicians
in the prehospital setting than ever before.
According to the National EMS Information
System (NEMSIS), more than 75% of U.S.
states have an electronic storage system that
houses patient data. These systems are at various levels of sophistication, and many states
are in the process of revising data elements,
improving data capture and ensuring compliance with the future NEMSIS dataset.
Both the U.S. federal government and the
National Health Service (NHS) in the U.K.
have recently announced new initiatives to
increase the use of computers as part of routine prehospital patient care data collection.
For example, all 50 U.S. states, Washington D.C. and three territories have signed a
memorandum of agreement documenting
support for the NEMSIS project, a campaign
to create a national EMS database. This will
be done in collaboration with the Centers
for Disease Control (CDC), National Center
for Statistics and Analysis and the National
Highway Transportations Safety Administration (NHTSA), which will store the data.
So we know data is important. Unfortu-
nately, there’s little information on how EMS
provider use of computers to obtain this
data in the prehospital setting affects patient
care and transmission of critical information
(in the form of data) as the patient moves
from EMS to the emergency department
and perhaps to hospital admittance. This
absence of knowledge is particularly con-
cerning given that communication arguably
is one of the most influential, encompassing
and versatile aspects of EMS.
DATA COLLECTION IN EMS
Private insurance and government coverage providers are making documentation
requirements for reimbursement increasingly stringent. A missing data field great
or small may mean the difference between
whether your organization gets paid for
transport. Billions of dollars in lost revenue
for EMS organizations are at stake. The need
for thorough patient documentation has
never been greater. Undeniably, electronic
documentation indeed has been beneficial
in this regard.
Making data-driven decisions based on
numbers rather than anecdotes can result