Electronic PCRs

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dhaage

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Our local service has planed to budget for Electronic Charting starting in 2012. I am starting to do some research on what is available. We have three primary units and a couple rigs for special events such as football games and races. We do around 2000 runs each year total. I am looking for software that would fit us but not be overkill. At this time we do batch billing for ALS or BLS service and would like to switch to itemized billing. Our plan is to buy our own computers, internet connection would most likely be a secured connection at the bases instead of cellular. We have considered Intermedix in the past, but the minium percentage they take is double our current billing company, which has served us very well and do not wish to change from. I am going to be doing research on my own and talking to companies, but if anyone had any suggestions it would be very much appreciated.
 
Our service is converting from paper to ePCRs with iPads. It's a big service, however, and we have our IT guys writing custom software. Everyone is getting personal issue iPads, ours to use how we want.
 
We've been using AmbuPro EMS for 10 years in my service, and it's made a major difference. It's easy to use and the front office folks can get bills out within a couple of hours of the call itself. When you're looking at ePCR you need to look at a few things:

1) Initial startup costs. How much will it cost for the software AND the hardware, plus any additional fees such as training, OT to train folks, etc.

1a) Hardware. iPads are great little devices (I have one, and you can take it away from me when you pry it from my cold, dead hands) but they aren't meant for the type of abuse seem in field use. I'm a Mac guy through-and-through, but when it comes to field use you need to look at real ruggedized hardware. One of the neighboring departments left their Panasonic ToughBook on the back bumper of their ambulance and drove 15 minutes to the hospital in a blizzard; when they got there they were able to open the ToughBook (amazingly it had stayed on the bumper) and continue working with no problems.

2) Ongoing fees. Most software has yearly support fees; make sure those are clearly stated and understood before you buy the "cheapest" and discover you're spending more on yearly support fees than on startup.

3) Architecture. How does this work? Are your runs stored locally and synchronized through a master server, or do you have to connect to the internet every time you want to access your web-based system? If you decide to change vendors later on, will you own your data or will it be sitting on someone else's server?

3a) Internet connectivity. If you have to connect to the internet every time you want to write a report you're going to have some major issues. You'll either have to write your runs out every time and type them in (a waste of time in my opinion) or depend on a cellular wireless card. The wireless cards are fine for consumers / folks who can afford to have the occasional loss of connectivity but not for emergency providers. Think of every time you haven't been able to get a cellular signal - you also won't have an internet connection. What then? Paper and pen? Why bother buying that system in the first place? Also, we are still expected to respond during hurricanes, blizzards, etc. - all times when cellular towers are known to fail.

4) Features. What are you trying to do with this? Are you looking for a way to "prettify" your runs, or do you want to be able to do faster / better QA, billing, etc. Are you required to submit info to the state? If so, does a particular system allow you to export directly or will you have to type everything into a separate state-run database? Again, why perform the same task twice?

5) Support / reputation. Talk to folks in the surrounding areas - what do they use? How do they like it? What kind of customer service history does the vendor have? Can you reach someone fairly quickly or do you have to chase after them for weeks at a time?

6) Integration. Will your ePCR product work with the hardware and software you already have? If you bill, can you export directly from your ePCR product or do you have to do that in a separate product (again, why duplicate effort?). Can you import data from your AEDs (You mentioned you were a BLS service - any plans to go ALS? If so, keep in mind that the big 3 monitor manufacturers all have some capability to send data to external sources.). How about CAD? Can the ePCR product you're looking at automatically import CAD from the system you already have (if appropriate) or are they going to try to make you change to a different CAD package?
 
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Thank you very much for your suggestions on what we need to answer before we get into this. I will definitely keep this in mind as I contact companies and when speaking with our board.
 
Having done my ride time with a squad that has electronic PCRs, they seemed more work than necessary. The EMT wrote down all of the information on a notepad. That's exactly what he read to AMR (the squad doesn't transport) and when they got back to the building, they filled out the PCR online.

I just think that unless you have something the size of a smartphone. I think like if you had like a phone one of those slide out keyboard things for a ePCR, that would be best. However, I do think a tablet like an iPad wouldn't be bad either. The tough books are a hastle to carry around in my opinion.
 
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i have experience in both ePCR (name of the software) and ESO Suites, and i must say i love them both, ESO is easier to use for me but ePCR goes in more detail about the incident
 
Going through this process now.

It's been narrowed down to Zoll's ePCR (not the whole suite, yet), Intermedix and the new iPCR (for the ipad). Looks like the decision is going to boil down to which one has better integration with our billing company.

Any opinions on these three platforms? The only one I've put through alot of use is Zoll's.
 
Ambupro

We are aboue to start using Ambupro - Ill let you know how it goes ..
 
I have been using an ePCR via toughbooks and absolutely love them. We have the ability to preview pt run history, hospital lab work, and previous ecg's. Our hospital turn around time is much quicker as well. The ability to time stamp everything, especially on arrests, is a big help.
 
We are using Zoll's ePCR, its completely integrated with our entire dispatch system, scheduling for crews and all the billing. Our trucks are all equipped with mobile hotspots that are part of the intranet. While it does have its issues, it is pretty simple and makes filling out charts a lot faster. I have used Intermedix before and found it to be pretty easy, but very expensive for what it does.
 
We've been using Zoll ePCR for about a year, EMS Charts prior to that. When we used EMS Charts, we didn't have laptops. We would just get all the info we could, and write the chart back in quarters.

Since moving to ePCR, we're 100% paperless for 911 calls. Consent signature is done on the Toughbook screen, LP15 data is uploaded to the Toughbook via bluetooth.

Personally I like it a lot better. There's still people at every project that wish they could go back to paper charts though...
 
Devilz311 said:
We've been using Zoll ePCR for about a year, EMS Charts prior to that. When we used EMS Charts, we didn't have laptops. We would just get all the info we could, and write the chart back in quarters.

Since moving to ePCR, we're 100% paperless for 911 calls. Consent signature is done on the Toughbook screen, LP15 data is uploaded to the Toughbook via bluetooth.

Personally I like it a lot better. There's still people at every project that wish they could go back to paper charts though...
Click to expand...
.. I hope you still carry paper PCRs and refusals... isn't it difficult to get multiple patient refusals at an MVC on the tablet?
 
We use HealthEMS by Sansio. It's alright, mostly all drop down menus but we can free text in them. All the times/dates are pre-entered by our dispatch program so that is pretty nice. It generates a narrative with all the objective and treatment info for your and you just go through and edit what you don't need and add the subjective part yourself. I like the ePCRs for the fact that my handwriting sucks and I can type much faster than I can write.

and the spell check :ph34r:

We do need new toughbooks though.
 
Our county uses RescueMedic PCR. It is OK, but it does have some glitches. Overall, it is much better than paper.

http://www.emergidata.com/
 
emt.dan said:
.. I hope you still carry paper PCRs and refusals... isn't it difficult to get multiple patient refusals at an MVC on the tablet?
Click to expand...

AmbuPro has a button that you can click to duplicate all the pertinent information - address, dispatch info, etc. So you'd start an incident, put the patient and dispatch info in, get a signature, click the button, get the next patient's info, get a signature, click the button, etc. I've done a 5-person MVA with 4 refusals and a transport where we got the 4 refusals in less time than it took to get the 5th person boarded and collared.
 
We just tried ePCR by RTApplications. It works well on iPhone and it looks like their new version will be compatible with iPads.
 
I've used both Zoll and intermedix.

Zoll has a very easy to use interface, it's responsive, and you can go into detail. I only used it for a few months but the only real bugs we had with it were syncing up to the main server to send reports.

I was part of the training crew for my station when my old county started using intermedix. I'm not a huge fan of the interface, it's a little more complicated then Zoll. However it's very detailed, and it has a few cool features like info look up using SSN or DL #. Their customer service is pretty good. They have someone available 24hrs via phone to help you out. That came in handy at 3 am when it would freeze up.
 
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