Paperless PCR's - pros..cons?
- Thread starter crashh
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Hunter
Forum Asst. Chief
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Well right now we have to make a copy of our paper pcr so it would save the paper.from the original
Achilles
Forum Moron
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A good con, paperless uses more paper than a paper PCR
I use a extratuff tablet to write my PCRs. Completely paperless system. My pcr program is all checkable items and drop down menus. It is pretty fast once you learn where things are. Rarely do I have to type a narrative, because all of the information is included somewhere within the report already. Management does not want us writing narratives unless there is some very specific information that needs to be included.
We send the PCR through the CAD system I think, and our EKGs are electronically attached to the PCR (so the hospital can have access to all of the monitor information when the PT is attached to it.)
It is nice because you can easily time stamp treatments during a code, and you don't have to worry about spelling (unless you are really bad at spelling and the computer has no idea what you are trying to say).
All of the dispatch information typically automatically uploads onto the tablet right after we get the call. Some times it doesn't and it just takes a few extra minutes to write it in.
Great system over all!!
We send the PCR through the CAD system I think, and our EKGs are electronically attached to the PCR (so the hospital can have access to all of the monitor information when the PT is attached to it.)
It is nice because you can easily time stamp treatments during a code, and you don't have to worry about spelling (unless you are really bad at spelling and the computer has no idea what you are trying to say).
All of the dispatch information typically automatically uploads onto the tablet right after we get the call. Some times it doesn't and it just takes a few extra minutes to write it in.
Great system over all!!
TheGodfather
Forum Lieutenant
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ePCRs are a very easy and fast system given 3 requirements:
1) you have a system that is user friendly.
2) you have a computer that works (my touch panel is broken and my organization doesn't feel the need to fix it)
3) you have QA people that are not QA nazi's and/or don't QA frivolous things (example: medical terminology that is [sadly] over their head --- I.E. "rhythm is supraventricular in origin" --> QA kickback: "This patient was not in SVT!" --> *facepalm*)
end rant. lol
1) you have a system that is user friendly.
2) you have a computer that works (my touch panel is broken and my organization doesn't feel the need to fix it)
3) you have QA people that are not QA nazi's and/or don't QA frivolous things (example: medical terminology that is [sadly] over their head --- I.E. "rhythm is supraventricular in origin" --> QA kickback: "This patient was not in SVT!" --> *facepalm*)
end rant. lol
DesertMedic66
Forum Troll
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Pro: penmanship isn't an issue. Spell check. Drop down bars to get more information.
Con: technology can fail. Batteries die. More expensive. Takes longer to finish a PCR than on paper.
Con: technology can fail. Batteries die. More expensive. Takes longer to finish a PCR than on paper.
VCEMT
Forum Captain
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Field Bridge is horrible, it erases vitals and narratives frequently. The only thing it replaces, is me penning billing info. It only makes operations paperles, someone somewhere still has to print 20 pages of garbage. I miss the old epcr system, we only had to print two pieces of paper.
DrankTheKoolaid
Forum Deputy Chief
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Wow I have had the exact opposite with Field Bridge. We just finished customizing and went live this morning with it. I have written my last 3 weeks charts using it without any problems whatsoever to test before launch. QA functioning Ill be testing today
PotatoMedic
Has no idea what I'm doing.
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That is my qualm with epcr's.
"OK thanks nurse, can I just get your signature for my PCR? Sorry, it'll just take a sec for it to come out of standby mode... sorry just a few more seconds while I type in my passwords and the program boots up... OK you can't rest your hand on the touchscreen while you're signing, you have to hold the stylus like this..."<_<
You guys must have a :censored: system if it is that much of a PITA to use.
PotatoMedic
Has no idea what I'm doing.
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Yeah... then half my pt's wright on my screen. I have resorted to using a pen without any ink in it so that no longer happens.
epipusher
Forum Asst. Chief
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Love them.
DrParasite
The fire extinguisher is not just for show
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I love love love ePCRs. seriously, I think they are AWESOME.
pro: no more dealing with poor handwriting problems, getting signatures in the rain, signatures on the carbon copy paper, writing in between the small lines, easier to change spelling errors, easier to add information in the middle of the chart, much much easier to QA, insurance payments increase 30%, chart validation for mandatory fields prior to submission to help ensure chart completeness, storage and retrieval of charts for QA or legal purposes is MUCH easier, automatic field population from CAD or patient database. and the hospital can log in and see your chart, no need for them to read the 3rd carbon copy that is barely readable unless you pressed really really hard (which made page 1 harder to read).
con: there is a learning curve, and people who have been doing the job for 20 years don't like change. Yes, they do take longer, especially when you start using them, but the more proficient you get, the quicker you can finish them. computers break, batteries die, parts need to be replaced when they get broken (but a good system has a charging system, and a surplus of spare toughbooks, and frequently broken parts). oh, and the nurses need to be educated on how to access the pcrs, and will often say they don't have access when in reality they don't remember or haven't been given permission from their management to log onto the system.
We use EMSCharts as our ePCR provider, and panasonic toughbooks in all the trucks. the only thing that I wish we had would be wireless in either all the trucks or in the toughbooks (we have since made every vehicle a wifi hotspot, within 25 feet or so).
Before you decide on a program and computer type, let your people try it out. have them try to document a megacode, a major trauma/burn, a chest pain, fall victim, see how easy they find it. tell the THIS WILL BE HAPPENING, because otherwise they will say they don't want it, but they can choose which system and computer they like the best. ask what they want, and what would make their job easier (wifi in the computer or truck will allow to automatic CAD dump of address, run number, times, etc).
oh, and Rennex, you should be all logged in and at the proper screen when you are speaking to the nurse asking for a signature, since you needed to be logged in when you wrote the majority of your chart using it.
pro: no more dealing with poor handwriting problems, getting signatures in the rain, signatures on the carbon copy paper, writing in between the small lines, easier to change spelling errors, easier to add information in the middle of the chart, much much easier to QA, insurance payments increase 30%, chart validation for mandatory fields prior to submission to help ensure chart completeness, storage and retrieval of charts for QA or legal purposes is MUCH easier, automatic field population from CAD or patient database. and the hospital can log in and see your chart, no need for them to read the 3rd carbon copy that is barely readable unless you pressed really really hard (which made page 1 harder to read).
con: there is a learning curve, and people who have been doing the job for 20 years don't like change. Yes, they do take longer, especially when you start using them, but the more proficient you get, the quicker you can finish them. computers break, batteries die, parts need to be replaced when they get broken (but a good system has a charging system, and a surplus of spare toughbooks, and frequently broken parts). oh, and the nurses need to be educated on how to access the pcrs, and will often say they don't have access when in reality they don't remember or haven't been given permission from their management to log onto the system.
We use EMSCharts as our ePCR provider, and panasonic toughbooks in all the trucks. the only thing that I wish we had would be wireless in either all the trucks or in the toughbooks (we have since made every vehicle a wifi hotspot, within 25 feet or so).
Before you decide on a program and computer type, let your people try it out. have them try to document a megacode, a major trauma/burn, a chest pain, fall victim, see how easy they find it. tell the THIS WILL BE HAPPENING, because otherwise they will say they don't want it, but they can choose which system and computer they like the best. ask what they want, and what would make their job easier (wifi in the computer or truck will allow to automatic CAD dump of address, run number, times, etc).
oh, and Rennex, you should be all logged in and at the proper screen when you are speaking to the nurse asking for a signature, since you needed to be logged in when you wrote the majority of your chart using it.
Bullets
Forum Knucklehead
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I also use EMSCharts, using the same toughbooks and set up. I love EPCR for all the reasons above
I dont think it takes longer then a paper chart, i can have both done by the time i reach the hospital, or in the 5 minutes after
TheGodfather
Forum Lieutenant
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have either of you used the new mobile version (mobile3 i believe)? we are still using what appears to be the 1.0 version.. i absolutely hate it..
also, do you know if it is free to upgrade to the latest desktop software? i was assuming the terms of licensing would allow this, but i've been told by the higher-ups that in order for us to upgrade, we would have to buy emscharts mobile all over again for each unit...
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For the IFT realm it's great for frequent customers, no more having to fill in the same demographic and medical history six times a week. Or at least that's what we've been told about the new computers.
DrParasite
The fire extinguisher is not just for show
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desktop software? haven't used that since 2006 when I was in Linden, and we were connecting using a Citrix client to ems charts. Since then it's all web based, so any internet explorer browser can go use it.
The last version I used was 2.0 or 2.5. it was pretty good. even 1.0 was decent, once you got it customized the way you wanted.
Assuming you have internet access, you can. however, in my experience, many IFT companies are too cheap to put wireless in your trucks.
btw, it takes maybe 5 more minutes to do an ePCR than a paper chart. most of that 5 minutes involves uploading the chart to the server, doing a quicker grammer and spelling check, chart validation, and having you and your parter sign the chart. definitely worth it in my opinion.