Investing in an electronic patient care reporting (ePCR) system is no small undertaking. The result definitely has its advantages ─ an efficient method of documentation that provides insight into local and national EMS trends. The process of identifying the right vendor to meet your agency’s needs, at the right price, takes research and time.
In November 2014, the National Association of State EMS Officials (NASEMSO) developed a guide for agencies that outlines questions to consider when purchasing ePCR. It covers important topics such as assessing the needs of your agency or department, compliance with state requirements, hardware, updates and technical support.
One of NASEMSO’s recommendations is to contact other EMS providers and find out what their experience has been with ePCR. Jim Bratcher, EMS chief of Peoria (Ariz.) Fire Department, shared lessons learned about the development of their program that has been in place for five years. Peoria completes approximately 14,000 records per year. When implementing ePCR in a department or agency with a high call volume, there are critical factors to consider.
What Bratcher emphasized is the support that is required within the agency to maintain ePCR.
“In order to get full utilization of the product in a large department, you need to have someone dedicated to the system,” Bratcher explained.
One of the benefits of having ePCR is the amount of qualitative and quantitative data that can be extrapolated from the reports, such as the number of calls for a specific patient’s chest pain complaint, the medications given, or response times. The information that is available to EMS providers who use electronic charting is phenomenal. However, the data is only useful if you have someone who can interpret it, which can take time if you are running reports on thousands of records.
Another reason to have dedicated staff for ePCR is ongoing maintenance and training. Bratcher urged EMS providers to “understand the time and effort it takes to maintain the software.”
When budgeting for a department’s ePCR program, the total cost must include maintenance and technical assistance, such as upgrades and the availability of a vendor support line. In a large department or agency, someone also needs to be available to serve as a subject matter expert inside the agency.
The vendor may provide the first round of training, but there will be new employees who need to be trained. Even after extensive field-testing, a new software program will have bugs. A single point of contact for personnel to notify with issues and questions and subsequently, receive answers and updates from, simplifies the flow of information. Even after five years, Peoria continues to monitor and adjust their system on a regular basis.
Bratcher also discussed the importance of thoroughly field-testing the product. Talking to a vendor’s current customers about the performance of a product or seeing a demonstration is a start, but it’s not the same as installing the software on a tablet or laptop and having personnel enter information while they are in the field.
Staff can provide feedback on what works and what does not, whether it is the training they receive, the flow of information, or the reports available. Determine what changes the vendor can make to design a program that is right for your agency. Trade-offs may have to be made, but finding a balance between cost, performance, compliance with state requirements and compliance with the National EMS Information System (NEMSIS) is the ultimate goal. NEMSIS is a national collection of standardized EMS data used to establish standards of care, identify areas for improvement, and prioritize educational needs.
Field-testing is a good opportunity to introduce into the system a point of contact, or liaison, for department personnel. Establishing an internal network to support ePCR early in the implementation process gives the vendor, administration and field personnel confidence that they are well supported to establish an effective ePCR program.
Consider what your agency needs:
- What is your agency’s call volume?
- Who will be responsible for interpreting the data and reports?
- How many department personnel will be using the program?
- Who is the point of contact in your agency for those people? With the vendor?
- How much time are you planning to allocate to ePCR each week? Each day?
- What field-testing should be done?
