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National EMS documentation report reveals gaps in training, time and tech

Nearly 60% of leaders cited documentation as a critical concern impacting billing, compliance and patient care, according to a report by the PWW Advisory Group and AIMHI

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PWW Advisory Group

MECHANICSBURG, Pa. — The PWW Advisory Group (PWWAG) and the Academy of International Mobile Healthcare Integration (AIMHI) announced the release of the first-ever National EMS Documentation Survey Report.

Based on comprehensive data collected nationwide from thousands of EMS clinicians, executives, revenue cycle professionals and medical directors, the report offers a data-driven national overview of perceptions, practices, challenges and opportunities related to EMS patient care documentation.

EMS leaders identify documentation as a top concern, recognizing its impact on revenue, compliance and quality improvement. The survey also highlights significant gaps in how providers, billers and leadership perceive documentation quality, training needs and time demands.

Nearly 60% of EMS leaders cited documentation as one of the most significant challenges affecting their operations, and 45% of medical directors noted that clinical narratives frequently lack sufficient detail.

The survey explored real-world documentation experiences, identifying barriers to high-quality records, training and technology gaps, and growing expectations surrounding compliance, reimbursement and oversight. Respondents shared perspectives on documentation burdens, ePCR systems, narrative quality and how documentation requirements align, or don’t, with field realities.

The findings offer data-driven insights to inform improvements in accuracy, billing efficiency, provider well-being and ultimately, patient care. Today, EMS documentation is more than just a clinical or administrative task; it is a strategic asset critical to financial stability, legal protection and clinical excellence.

Download the report here.

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Bill Carey is the associate editor for FireRescue1.com and EMS1.com. A former Maryland volunteer firefighter, sergeant, and lieutenant, Bill has written for several fire service publications and platforms. His work on firefighter behavioral health garnered a 2014 Neal Award nomination. His ongoing research and writings about line-of-duty death data is frequently cited in articles, presentations, and trainings. Have a news tip? He can be reached at news@lexipol.com.