Your local EMS system got a rare gift last year: a budget increase. Now, though, council members want to make sure their funds were well spent, and specifically that they helped you reduce response times and improve cost recovery. They want an update from the chief at their next meeting.
Assembling this begins with pulling some data from dispatch. The chief finds an average response time of 6:42 and a 90th-percentile time of 9:10 – not bad.
Transport and patient data come from patient care reports, for which the service uses a different vendor. ePCRs show 8,900 total incidents, with 6,200 transports and 2,700 nontransports. But already numbers are starting to diverge – some CAD incidents never became PCRs, some PCRs don’t cleanly match CAD incident numbers, device readings that helped shape transport decisions aren’t all accurately reflected in ePCRs, and time stamps aren’t always aligned.
Billing data from a third source complicates things further: It shows 5,750 billable transports. That’s a discrepancy, the chief realizes – 6,200 transports but only 5,750 billed – council members might flag. And while he can explain documentation delays, medical necessity denials, data mismatches and excluded payer types, it all may sound to councilors and the public like inefficiency and excuses.
A solution for every stage of operations
Now consider a different timeline – one where dispatch, patient care reports, device data and billing are all handled and enhanced by an integrated and compatible suite of software and acute care medical products developed to work together.
As that can improve accuracy and efficiency for clinicians in the field, it can similarly make life easier across a range of pain points for chiefs and administrators. That’s a key part of the value proposition offered by ZOLL, the major manufacturer of devices and programs for EMS and hospital providers.
“We can support EMS customers in improving performance at every stage of their operations with our complete ZOLL EMS System of Care,” said Kurt Sandstrom, vice president and general manager of ZOLL EMS. “While ZOLL equipment has always led the way in innovation and clinical outcomes, our devices combined with our EMS software now enable our customers focus on all aspects of running their services to provide the best care and realize exceptional operational efficiencies with time-saving workflows and automated technology.”
A more unified data picture – suitable for both internal QA and public accountability – is one benefit of the ZOLL System of Care approach. Others can include optimization of the revenue process; maximization of resources; reduced time on task across systems; reduced needs for staffing, training and support; and improved visibility into all aspects of the call cycle.
‘A higher level of performance with less effort’
Imagine the 911 call that begins a patient’s journey through such a unified system. The dispatcher compiles basic patient and scene data and, with automated guidance and big-picture visibility into the system’s resources, gets the closest appropriate unit quickly en route. Dispatch data flows directly into its crew’s ePCR – they need not reenter it, burning time and risking errors.
In the field the related patient care reporting solution expedites contemporaneous charting with autopopulation, easy dropdowns, one-click documentation and barcode scanning. Times, demographics and other information remain consistent. Twelve-lead and resuscitation data is pulled into the ePCR. As the call ends, ePCR data is quickly on its way to billing, where its completeness and accuracy can support clean claims with fewer avoidable errors – often helping agencies reduce denials and improve time to cash.
If that’s your operation, you’re optimizing your people’s performance and gaining time, efficiency and accuracy at each step.
“The first and most obvious benefit [of a systemic approach] is not having to manually enter data over and over again,” said Chas Fuller, ZOLL’s vice president of technology. “Anytime you do that, there’s a risk of errors or omissions. And then there’s speed and efficiency every step of the way: If dispatch collects certain information at the 911 call – hopefully patient demographics, and maybe also a little about the history, situational factors, things like that – and field clinicians already know that when they get to the scene, that can help them make better decisions faster. And if they’re using ZOLL products, some of that information can already be populated into their ePCR. They can also pull in ECG data from their Zenix defibrillator/monitor and compression information from their AutoPulse NXT Resuscitation System.”
Those devices are key parts of ZOLL’s holistic System of Care approach, while the software elements are ZOLL Dispatch and its companion app, ZOLL Respond; ZOLL emsCharts and its companion app, emsCharts NOW; and ZOLL Billing.
All three platforms are cloud-based with browser-based access (which can support remote operations as a potential solution to personnel shortages). Each was designed around EMS professionals’ standard workflows to simplify and streamline tasks and reduce duplication and wasted effort.
“Our approach is to think about what the workflows are at every stage of operations and design solutions that follow users’ natural approach to their job,” said Sandstrom. “We don’t want it to be one more thing they have to do, but just something that’s logical in the course of their work. That might include an ePCR that lets the agency configure certain fields to be required or flagged: ‘Hey, did we capture this information?’
“Features like that mean the billing team can confidently expect the ePCR to have the data they need to justify billing a certain level of care or to satisfy payer requirements. With the data flowing back and forth, everybody in the agency has a better understanding of how their job affects the bottom line.”
“We’ve taken cues at every stage of operations from the people who work in those jobs, whether it’s behind the scenes or on the front lines, and designed solutions that help them do their job at a higher level of performance with less effort,” added Fuller. “We try to mimic their natural workflows and make it easier and more seamless for them to collaborate as an organization.”
Improved insight, delivered more easily
With such support, the chief in the opening example can draw coherent conclusions from a linked data set in which each 911 call has a single incident ID; dispatch times, patient care and billing information are all attached; and cancellations and nontransports are clearly categorized. He can break down refusals, bundled payer exclusions, hospice and law enforcement assist calls and need not defer questions to track down more information. He can speak confidently and authoritatively to his council and the public and demonstrate their investment was wise.
His service enjoys a range of additional benefits as well. With an integrated system of care, QA staff need not jump between systems – reviews can be linked to PCRs and billing outcomes, and compliance checks can be embedded into documentation. Trends can be tracked by provider, unit or shift, allowing faster identification and remediation of shortfalls. Training and support are simplified, and broad automation gains employee time back for other duties. At every stage of the call, leaders have improved insight, delivered more easily.
“We know how pinched EMS always is financially – even with private insurance, there’s constant pressure to squeeze and squeeze,” said Fuller. “In terms of financial performance, that’s when technology becomes even more important, because it can do things like let a small team for something like billing be more productive and get more done without overtime or outside resources. It can help a lot with accuracy, and for employees who aren’t as seasoned in the industry, it helps them ask the right questions and get the right information the first time, so there’s less churn when they submit a claim.”
Customers are “shuffling less paper, not mailing things and not having to work denied claims,” Sandstrom added. “Having so many of the more arduous prebilling tasks automated allows agencies to use their personnel in a more efficient manner.”
From the boss’ chair, that’s perhaps the most important thing: getting the best reimbursement possible with the least amount of fuss. ZOLL Billing has numerous specific features to help maximize that, but integrating the entire operation – capturing better information and identifying the right level of care at dispatch; comprehensive documentation in the field without delay; compatible hardware; and speedy, airtight billing that flows seamlessly – can help maximize performance at the system level.
For EMS organizations, that means better patient outcomes and a healthier bottom line.
For more information, visit ZOLL.
