It鈥檚 long past shift change, and you鈥檙e exhausted and should be headed home. It鈥檚 been a monstrous day 鈥� the calls never stopped, with no downtime in between. You faced the full assortment of complex patients, difficult bystanders and uncomfortable scenes.
You survived it all and delivered strong care, but the paperwork鈥檚 not done and must be completed before you can sign off and return to your personal life. And that鈥檚 a challenge: You have numerous important details from multiple calls to recollect and add to complete your patient care reports, based on fragments of scribbled notes and other bits of information in assorted places. The right values and data elements must be identified, matched up and filled in, hopefully with no mistakes.
For many providers, that鈥檚 how charting has historically been completed: PCRs that ideally would have been finished with the patient鈥檚 care had to wait hours for piecemeal completion later or at the end of shift. Even as ePCRs replaced paper and medical devices advanced and data was more easily obtained, recorded and transferred, the harsh dictates of time and call volume could prevent the timely completion of all fields.
Technology can鈥檛 buy you more time. It can, however, simplify and streamline your tasks so they consume less.
is a robust mobile app that is fully integrated with the cloud-based electronic patient care reporting (ePCR) software . Since 2023 it has simplified and facilitated the charting of care in the field and helped EMTs and paramedics complete their PCRs more quickly, thoroughly and accurately.
A newly enhanced feature of the app allows charts to be fully completed, locked and uploaded from the field 鈥� providers need not wait for a return to station or access they don鈥檛 have from the rig.
鈥淶OLL emsCharts NOW has always provided the ability to start the chart and start capturing data from the mobile device,鈥� said Philip Wang, senior product marketing manager at ZOLL. 鈥淣ow users will be able to capture all that information, as well as complete all the fields required to close the chart, so they won鈥檛 need to go onto a desktop or laptop to complete it. All the validations can be done directly from the app, and they can submit it to their next step in QA/QI, then on to the state.鈥�
There鈥檚 still no guarantee calls won鈥檛 stack faster than you can humanly complete them 鈥� just the welcome knowledge that completing them can be quicker than ever thanks to the mobile app鈥檚 new capabilities.
ePCRs continue to evolve
If you鈥檙e a long-timer in EMS, you may remember the days before ePCRs. Multicopy paper reports were begun en route to hospitals and completed by hand. One copy went with the patient, a second stayed with the EMS agency, and a third may have been sent to billing or the state. To avoid problems, writing had to be clear, legible and complete. Hand-written narrative sections, however, could often end up hurried and missing key details. Times, vital signs and interventions were recorded manually, with times noted from watches, radios and onboard clocks. There was no mechanism for flagging errors and omissions.
ePCRs improved many aspects of this. They standardized data elements, facilitated NEMSIS reporting, improved billing turnaround, enhanced quality assurance and improvement, and reduced problems with legibility and storage. Still, they often required completion after the fact 鈥� after patient transfer at the hospital or at end of shift.
In both cases, because not all details could always be captured in real time, information was frequently reconstructed from memory. Predictably, this could lead to omissions, inaccuracies and compliance problems. What鈥檚 more, in many systems, charts could not be finalized and locked until the report was synced with the server or a human review was completed. Depending on workload and connectivity, this could take hours or even days.
Mobile devices and apps made things easier still. introduced the ability to start charts and document patient data directly from the scene. Its time- and labor-saving features include quick鈥慳ction buttons, voice-to-text, one鈥慶lick documentation for common problems and medications, barcode scanning of drivers鈥� licenses to import demographics, and timers to log interventions. The mobile app saves data locally when there鈥檚 no connectivity and works seamlessly with other solutions, like and .
Spend less time charting
That鈥檚 a whole lot of potential time savings that can add up to a process that鈥檚 substantially faster and easier 鈥� and that was the experience of Monroe Ambulance of Rochester, N.Y. The service became an early user of for two primary reasons.
鈥淲e had just installed iPads and iPhones in all our vehicles, and I wanted to optimize their use and really leverage the mobile capabilities,鈥� recalled Rachel Weaver, the service鈥檚 deputy chief of clinical operations. 鈥淲e also sometimes struggled with our providers taking excess time to complete their charts. I wanted them to be able to do it faster and felt using a mobile application would help them do that.鈥�
New and younger providers took to the platform immediately, and even skeptical old-schoolers have been gradually won over, Weaver says. And Monroe got the benefits it was seeking.
鈥淭he people who use it primarily seem to spend less time charting,鈥� she said. 鈥淭hey have a higher rate of signature capture. On the web-based platform those could sometimes get deleted accidentally, but on the emsCharts NOW platform it saves them. And then the ability to continue working on your charts during downtime or loss of Wi-Fi is a big benefit.鈥�
The quick-action buttons have been a particular time-saver. This function lets administrators connect select actions or comments to keyboard shortcuts that simplify entry and make certain wording is right.
鈥淲e can ensure things are written in the way that鈥檚 best for documentation and billing and patient care,鈥� Weaver said. 鈥淭hey can always edit little things in that quick action, but it at least provides the framework.鈥�
The newest version of can now be used on Windows and Mac laptop and desktop computers, as well as on Android and iOS mobile devices. Other upgrades include enhanced dispatch and trip information handling, refined timeline and vital signs features, and other tweaks to usability.
鈥淵ou can scan documents now too, so that鈥檚 an added benefit,鈥� Weaver added.
Another feature Monroe takes advantage of 鈥� the ability to import ECG data from ZOLL defibrillator/monitors into the app 鈥� underscores the benefit of having a comprehensive, interoperable patient care product suite to support a spectrum of agency needs. can also import CAD data.
Once the ePCR is submitted, Monroe鈥檚 data flows on to their software, eliminating the need for reentry, and built-in validation checks help reduce the risk of claim denial or rejection. 鈥淗aving everything integrated makes it much easier to follow through and collect payment,鈥� said Weaver. 鈥淚t鈥檚 more streamlined.鈥�
App supports quality care
Monroe Ambulance is a busy service, averaging around 80 transports a day. Beyond BLS and ALS care, it provides critical care transport and standby services. That brings the agency into contact with a lot of patients, and maintaining its positive reputation in its community is important to the team.
The idea of using an app to steer its charting was a novel one to many of its providers, but has helped Monroe deliver high-quality care, chronicle it comprehensively, maximize compensation for it, and contribute to the community members it treats having positive outcomes.
鈥淵ou may have a good process, but don鈥檛 be afraid to try something new 鈥� that鈥檚 what I tell my students and our orientation classes,鈥� said Weaver. 鈥淚鈥檝e been doing this for 25 years. I started on paper and have changed [methods] multiple times to try to always improve. The way you鈥檙e doing things now might not always be the best way.鈥�
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