6 questions EMS leaders must answer about buying an ePCR system

If you’re considering ePCR for the first time or replacing a legacy system, start with these six key questions


Electronic patient care reports, once nice-to-have alternatives to hard-copy documentation, are now as common in EMS as 12-lead EKGs, CPAP and capnography. Not only is ePCR required by many states, but implementation deadlines are approaching.

If your agency hasn’t adopted ePCR, here’s a brief beginner's guide to the six most important questions.

1. What is ePCR?
It’s documentation software that runs primarily on desktop computers, laptops, smartphones and tablets. Like other database management systems, ePCR specializes in storing and retrieving information. These management systems are routinely used in business to track details such as sales, payments, inventory and even employees.

Input screens validate entries as they guide users through required data fields. Output is what makes a database management system worthwhile, although; well-designed systems allow users to view data in many ways.

A consumer-product system could show, for example, which customers bought how much of each item and when they made a purchase. Likewise, ePCR apps can summarize stored facts about patients, caregivers and treatment according to user-defined reporting criteria.

2. What ePCR isn’t
An ePCR is not a mind reader. You have to load raw data into ePCR to get back useful information.

A common misunderstanding about database management systems is that they somehow figure out what users want. It might help to think of these systems as an assistant who’s very reliable but needs to be told exactly what to do.

ePCR ensures data validity, but not accuracy. For example, the system might warn you 80/120 is an invalid blood pressure, but it wouldn’t know whether 120/80 was the patient’s actual BP.

3. Why switch to ePCR?
Because your state says so would be one answer, but not the best one. Managers in any industry should want to monitor and improve the quality of whatever they’re selling or providing. Customer care is what service-oriented businesses like EMS agencies sell.

If you were running a 911 operation, what would you want to know about patient care? At the top of the list might be interventions and outcomes. That is, how are your EMS providers influencing the health of their patients?

Close behind is the recency of experiences, which are the types of cases handled by each caregiver in a specific time period. You might also want the option to request ad hoc summaries of dates, cases, patients, providers and destinations.

Sharing information is important, too — not just with other in-house database applications, like billing, but with state and federal databases, so agencies can analyze performance compared to each other. ePCR makes that possible by standardizing the data tracked.

4. What you need for ePCR
Top-down support is necessary for any large-scale software implementation. You can enhance cooperation among prospective users by involving them in the specification and design process. It’s also important to maintain a feedback loop, whereby employees are updated on the dispositions of their purchase and implementation suggestions.

Users get more comfortable with new software by practicing with it before it goes live. Don’t abandon old procedures — even if it means duplicating work — until the ePCR is running smoothly.

5. What’s hot in ePCR?
Paramedic Kim Hamilton, ePCR director for American Medical Response, says there’s growing interest in information exchange with hospitals.

"Getting field data into hospital charts, then retrieving outcomes and billing details, is a challenge for everybody," she says. "We’re all trying to figure out ways to do it as securely as possible."

On the hardware side, iPads and other tablets are becoming popular alternatives to laptop computers.

"We're having a lot of success with (tablets)," Hamilton says. "They're fast and light and our users love them. You can stick them in your pack and take them with you.

"The crews try to be gentle with them, but we do have an increase in breakage because tablets aren't as rugged as laptops."

Hamilton adds that voice recognition is improving, but still a work in progress.

"It's a matter of training the system to recognize speakers in an environment that's not always as quiet as we'd like," she says. "We’re looking at different options, like crews talking into headsets while they're treating patients."

6. How to put it all together
Take time to find an ePCR vendor with the best product and support for your organization. Know the extent to which packages you're considering can be customized for your environment, and what those changes would cost.

Hamilton suggests trying sample versions of software on whatever hardware you're planning to use prehospitally. "Vendors should be willing to help with that," she says. "What works on a desk in an office isn't necessarily best for the field."

By establishing a partnership with a conscientious dealer and buy-in from educated users, you'll greatly increase your chances of succeeding with ePCR.

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