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How body-worn cameras improve EMS documentation

A study on EMS documentation accuracy using body-worn cameras discussed at EMS World Expo

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Jeffrey Ho, MD, the chief medical director for Hennepin EMS, who also works as a deputy sheriff, described a simulation study conducted to assess the accuracy of patient care documentation.

Photo by Greg Friese

NEW ORLEANS — Body-worn cameras, though widely used in law enforcement, are infrequently used in EMS. Jeffrey Ho, MD, the chief medical director for Hennepin EMS, who also works as a deputy sheriff, described a simulation study conducted to assess the accuracy of patient care documentation at the EMS World Expo.

EMS documentation usually occurs from memory, a process that can introduce error. Body-worn camera videos can improve event recall during the ePCR process.

Ho has been advocating for body-worn cameras in EMS for six years. Hennepin EMS recently conducted a simulated patient encounter study (read the abstract for Effect of Body-Worn Cameras on EMS Documentation Accuracy: A Pilot Study) to evaluate the effect on documentation accuracy when a body-worn camera was used. Ho, who is the medical director for TASER International, Inc., received TASER Flex body-worn cameras at no cost for the study.

The simulation had multiple complexities and stressful stimuli, such as several firearms, drug paraphernalia, a distraught family member, an ambulance transport, a bystander recording the paramedic and delivering a report to an emergency department nurse. After completing the scenario, the paramedic documented the incident from memory on an ePCR. Next, the paramedics were allowed to view their own body-worn camera video without any limitations on playback. After video review of the simulation, 71 documentation changes were made by the 10 paramedics who participated in the study.

Memorable quotes on memory and documentation
Here are memorable quotes from Ho’s presentation on improving EMS documentation with body-worn cameras.

“I believe body-worn cameras would really be phenomenal in health care when you think about the things we see, need to document and the teaching opportunity.”

“Memory is an adaptive process and subject to errors.”

“This study was completed four years ago, but was not published because no one was interested. Now there is finally some interest.”

Key takeaways on use of body-worn cameras in EMS
Here are the key takeaways from Ho’s presentation on body-worn cameras to improve EMS documentation.

Memory and recall of events
Emotional and physical stress make forming memories more difficult. Stressors, such as fatigue and exertion, are common in EMS incidents. Documentation by memory perception is highly inaccurate.

After reviewing the video, the paramedics in the study, who had an average of seven years of field experience, made minor (7 changes), moderate (51) and major (13) documentation changes. Older, more experienced paramedics made less documentation changes after video review.

Uses of video in EMS
Ho described many uses of video in EMS including documentation of the mechanism of injury, identifying concerning or dangerous items on the scene, capturing the patient’s behavior and statements, point-of-view recording of the methods used to secure, assess and treat the patient.

Video recording may reduce risk of liability from poor or inadequate documentation. All actions performed on scene are captured and can be reviewed later.

Body cameras change behavior
From law enforcement research, we know that body-worn cameras change officer behavior and suspect behavior. EMS leaders can expect body-worn cameras to make a similar impact on the behavior of patients and EMS providers.

Learn more about use of video in EMS:

Greg Friese, MS, NRP, is the Lexipol Editorial Director, leading the efforts of the editorial team on Police1, FireRescue1, Corrections1 and EMS1. Greg served as the EMS1 editor-in-chief for five years. He has a bachelor’s degree from the University of Wisconsin-Madison and a master’s degree from the University of Idaho. He is an educator, author, national registry paramedic since 2005, and a long-distance runner. Greg was a 2010 recipient of the EMS 10 Award for innovation. He is also a three-time Jesse H. Neal award winner, the most prestigious award in specialized journalism, and the 2018 and 2020 Eddie Award winner for best Column/Blog. Connect with Greg on LinkedIn.