EMS administrators should change the way
their agency collects data.
At a regulatory level, insist the data collection process be made efficient. Increasingly
stringent insurance and medical reimbursement requirements for documentation
make it cumbersome for paramedics to create patient records. Keep in mind providers shouldn’t be burdened with collecting
demographic or other data that isn’t critical
for the emergency call.
Look at hardware as a
There will be a better
platform next year.
We’re conditioned to look at capital investment as getting the most use of our precious
funds through a long lifespan of hardware.
However, the opposite is actually best
when it comes to technology. Once an item
comes down from the shelf, it’s virtually
obsolete. Look at the devices you purchase
for electronic documentation as a more disposable item, something meant to be used
for a time and replaced.
Keep it simple.
It’s tempting to want to add all the bells and
whistles, questions and reference guides,
and apps we can to our electronic device,
but we must resist the urge. If your current
vendor can’t or won’t make the changes
you need to simplify your software, then
find someone who will. Market hunger is an
Build standardized data
bridges to our health-care devices and to the
hospital systems we
work with every day.
It’s time to insist on standardization and uni-
versal standards of healthcare data exchange.
Currently, each medical device manufac-
turer has its own system, most of which
are incompatible with others. Users need
to insist on bridging the disparity of data
silos from healthcare devices with a com-
mon, universal standard. There’s a need for
better integration and sharing data sources
within and across healthcare entities, such
as between EMS, EDs and area hospital sys-
tems as a whole.
Be supportive of
your EMS crews with
the adoption of
Some people are going to naturally adopt
new technologies more easily than others,
and you will always have a contingent that
resists. Provide appropriate, hands-on training about electronic charting to improve
their performance and quell concerns.
Watching a PowerPoint presentation
about the 47 simple steps to complete a
patient report on a new device isn’t going to
help someone who just learned to program
his microwave. Work closely with those
providers who are hesitant, and assign people among the ranks on duty who can troubleshoot when necessary.
If you have the means, give your field providers adequate time to chart. If you don’t
have the time, make it. Some systems are
so busy that paramedics must respond to
call after call from the hospital without time
to document their calls properly. A paramedic at the end of their shift trying to document a cardiac arrest call that happened
eight hours and five calls ago is going to be
challenged, regardless of the features on the
device they’re using.
Solicit and accept
This is probably an “easier said than done”
item, but try asking trusted co-workers how
you can improve ease of use of electronic
devices. Or ask them to note specific times
when you could have done better in this
regard. And periodically self-reflect about
how you did well or could have done better.
Evaluating electronic patient care information systems isn’t much different than
clinical quality improvement steps your
agency has instituted. How about evaluating your crews’ performance with integrating electronic devices and the effects of those
devices on the crews’ ability to effectively
communicate with a patient the way you
test them on how to put a patient in C-spine
and cardiac pace?
You probably got into EMS because you
wanted to help people, not fill out boxes and
collect data. But the integration of technology in EMS, as in life, is the inevitable way of
the future. By keeping pace with your ePCR
technology the same way you keep yourself
up to date on the newest monitor or intubation gadget, you can be great both in the field
and in filling out the field.
John Pringle is a firefighter paramedic and the electronic
documentation coordinator for San Diego Fire-Rescue
Department. He is also a California CEMSIS EMS systems
Division Data committee member, a 2008 Computer-World Honor program laureate and an EMS 10: Innovators
in EMS award winner.
Loralee Olejnik coordinates community outreach
and education for Rural/Metro of San Diego, San Diego’s
9-1-1 ambulance provider.
1. Brice JH, Friend KD, Delbridge TR. Accuracy of
EMS-recorded patient demographic data.
Prehosp Emerg Care. 2008; 12( 2):187–191.
2. Regenstein M, Sickler D. (2006). Race, ethnicity,
and language of patients: Hospital practices
regarding collection of information to address
disparities in health care. In National Public Health
and Hospital Institute. Retrieved from www.naph.
Check out www.jems.com/
for more about the San Diego