Electronic Patient Care Records (ePCRs)

[NomexMedic]

Good old pen and paper for me!! There is currently one PVT service using electronic PCR which is completed on Panasonic Toughbooks and then immediatly sent to the office via the mobile internet. I understand the advantages of the system, as mentioned in the posts, but from the crews working with it, not a whole lot of good has been mentioned. Also understanding there will be teething problems. It also cost them a fortune, i am sure.

For me...why re-invent the wheel!!!

Because the wheel is becoming obsolete and we need to update it to keep on the edge. We use HealthEMS and as a new medic, I love it. Granted it has its issues. But when I run on an unconcious pt. with no family around and I can get a name from a wallet or bracelet, I can enter it into the ePCR and BAM...I've got the pt's. address, dob, allergies, past medical hx. and anything else I need to know about them. I'm no longer left in the dark wondering what might be causing my patient's problem.

Our ePCR's are linked with dispatch and all of the receiving hospitals so that my times, address, unit number and repetitive information is automatically added to my PCR. I can also upload my 12-lead EKG's, V/S, and other information straight from my LP-12 to my ePCR with the click of a few buttons. It saves me a lot of steps and gets me in service faster.

Not only that, but all the ED's can access the PCR's and if need be, I can transmit it to Minnesota (where HealthEMS is located) and they will fax the PCR anywhere I need them too. I have to say it's been a positive impact on what we do.

The only con I've seen so far is the range of the wireless network and dealing with constantly having to reset our box. I believe this has to do more with the strength of the signal coming from my truck and the crappy ISP we have.

As far as having to do both ePCR and paper, I don't really agree with that unless its a transition phase and it's for the same reasons as everyone else has already stated.

 

[wolfwyndd]

[snip]But when I run on an unconcious pt. with no family around and I can get a name from a wallet or bracelet, I can enter it into the ePCR and BAM...I've got the pt's. address, dob, allergies, past medical hx. and anything else I need to know about them. I'm no longer left in the dark wondering what might be causing my patient's problem.

That is an advantage of the electronic records. The problem with that is it takes quite a long time to build up that database with all the patient information. We just started using our system one year ago this month and we still aren't anywhere close to building up that sort of information in our database yet and our EMS Charts is a 'stand alone' database. IE, it's only for our jurisdiction so if someone comes in from some place else they are a 'new patient.' It would be nice if we could share information with other agencies or hospitals but I imagine there's some HIPPA issue there.

Our ePCR's are linked with dispatch and all of the receiving hospitals so that my times, address, unit number and repetitive information is automatically added to my PCR. I can also upload my 12-lead EKG's, V/S, and other information straight from my LP-12 to my ePCR with the click of a few buttons. It saves me a lot of steps and gets me in service faster.

Once again, I'd LOVE to be able to share our information with the hospital electronically and vice versa, but it's not capable of doing it. Unless that's some add on piece that we just didn't buy. If we could share information electronically with the hospitals and vice versa, I may not have as much of an issue with it as I do now.

 

[IrishMedic]

there is a programme you can add to the units that use ePCR's and it allows you to email it to the receiving hospital kinda like emails on your cell phone etc or bluetooth as you arrive at the ED...as long as it is secure and sent to a secure email address i dont think it infringes on HIPPA since its the same as calling in a patient on a cell phone.....cell phone can be caught on a scanner etc....i agree with the whole idea though of having a printer on board etc..in ireland are PCR are all tick the boxes, very lil narrative if any to be honest..there is a ePCR version of this being launched but i cant many services having the funding the adopt it as the cost of normal ambulance equipment is so high i can imagine how much the notebooks service packages etc wud cost for ePCR database...

 

[mycrofft]

From the other end of the barrel (payment case management)

I was a case manager for indigent services for 2 yrs before I saw the light and returned to the jails (line work).

If there was anything we hated it was handwritten pt info. The only thing worse was badly handwritten info (such as mine, or most MD's). One of our providers used a system they called "EMR" with CITRIX. Very nice, allowed for integrated access to labs, digital xrays, appointment history, patient's given addresses and contacts, clinical notes, allergies, even operation reports. N O idea if it is applicable for your mobile/field recordskeeping, but anything to smooth data flow to/from payors is good as long as it doesn't breach HIPPA.

Adopting a computer system like this is extremely risky professionally: going to be expensive, will be done over people's dead bodies (pun unintended, meaning "staff people's"), require babying to get it going and is susceptible to hardware glitches...then it is obsolete in five years or less. It's no wonder dual systems get started then perpetuated. If I were working with one, though, I'd keep my own records in case I were called upon to recreate them (just I have in cases where I might be subpoenaed, as I have been...no-no, no dead bodies involved).

 

[emtwacker710]

my agency is actually working on transitioning to that system, we should have it in a few months after all the members go through the training..if I remember to, I'll post here how it turns out..

ok..we got it and I have to say...I LOVE THEM...lol i honestly have to say they are an excellent way of completing a pt. care record, they are so through and they account for everything done for the pt. I hope my squad stays with this version...any questions about how they work feel free to message me..

 

[PeteBlair]

We're looking

I work with a total volunteer BLS unit in Florida and to participate in NEMSIS and EMSTARS (Florida's data collection system), we are planning to go electronic.

Over the next four weeks we (a 40 member steering committee) are looking at one software package at a time.

During weeks 5, 6 and perhaps 7, weeks will be going from one to another of the four to narrow down the choices.

We will be looking at either doing paper and then inputting to electronic, doing electronic from the get-go, or scrapping the whole shootin' match and staying with paper and pen.

The average age of squad members is on the far side of 70 so it will be interesting to see what evolves. I'm coordinating the entire steering committee effort and if you see smoke rising over the area about 18 miles southeast of the Tampa area, it could be that the steering committee simply imploded. (or is that exploded? - Maybe just a simple spin, crash, burn, die and go to ....)

If anyone would like to hear the results of our study, send me a private message and I'll let you know what happened. Final results may not be in until late August or early September.

Cheers!

 

[EMTMedic2077]

Already using ePCR's

I currently use an ePCR system for my volunteer ambulance service. I think it works great. We use toughbooks out in the field and have mobile printers in our ambulances for printing out refusals on scene. Also, when we get to our receiving hospital(s) we have wireless printing capibility to print to the ER. This speeds up the registration process (usually before we walk through the door with the patient), which gets us back into service quicker. Also, when we return to quarters the data from the ePCR on the toughbook syncronizes to the master database in the station (so no additional typing). From there it is QA/QI'd and send off electronically to our third party billing company. It is VERY easy to use out in the field. Took me about three of four runs entered to be able to breeze through it. A full ALS cardiac code takes about 8 minutes to write.

 

[MikeRi24]

well, out of the 2 paid services in the area, one uses them one does not. I work for the one that does not. A good friend of mine works for the other place and says it took him a while to get used to them, but they are great. My company will be moving to them shortly, I beleive we are trying to work something out where we can set up a pring station in ever facoility we go to so we can dock the toughbook, push a button and out comes your paper PCR to hand to the ED staff. at the same time, it is transmitted to our offices for billing. I think we are just having some problems getting a "secure" wireless method going to transmit the information (pt privacy thing). I'm actually looking forward to the switch, more so because we can mount the toughbooks up front, and when we get a call, all the information will come up on screan and an integrated GPS mapping and navigation systemm will help get us there.