Gabe Gan, MPH, NRP
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gabegan.bsky.social
Gabe Gan, MPH, NRP
@gabegan.bsky.social
Innovating to keep people healthy and safe. QI practitioner at DC Fire and EMS, paramedic, & gadget enthusiast. Views=mine
12/ Longitudinal EMS documentation isn’t just about reducing the burden on providers—it’s about delivering better care to patients. Let's build systems that match how EMS truly operates and integrate seamlessly with the rest of healthcare. 🌍🚑 #EMS #HealthIT #PrehospitalCare #medsky
November 23, 2024 at 9:17 PM
11/ The future of EMS documentation could be one record per patient, with:
Shared demographic and clinical data
Separate sections for each provider’s contribution
Attribution for individual roles (just like physicians, nurses, PT/OT notes in a hospital)
November 23, 2024 at 9:17 PM
10/ Longitudinal documentation could streamline this process:
• A single record with multiple encounters makes matching seamless.
• MIH teams could see all prior EMS contacts in one place.
• At the point of care, EMS could query past EKGs to identify acute vs. chronic changes in real time.
November 23, 2024 at 9:17 PM
9/ Why is this an issue?
• Minor data errors (e.g., wrong DOB or a misspelled name) can make it difficult to match records.
• Addresses frequently change, further complicating record retrieval.
• EMS providers waste time searching through or disregard past records altogether.
November 23, 2024 at 9:17 PM
8/ Longitudinal EMS documentation has huge potential for Mobile Integrated Health (MIH) efforts and improving care continuity. High-volume utilizers often generate many EMS records. When each is a separate, incident-based document, it creates challenges for matching and continuity.
November 23, 2024 at 9:17 PM
7/ Here’s why this approach would be a game-changer for EMS systems:
🕒 Providers focus only on their contribution.
✅ Shared data prevents conflicting documentation.
📊 Easier to analyze for QI, research, and system improvements.
🤝 Aligns EMS with hospital and healthcare standards.
November 23, 2024 at 9:17 PM
6/ Shared information like demographics, allergies, medications, and vital signs could be entered once and accessed by all contributors. Each provider would focus on documenting their part of the care, significantly reducing the documentation burden.
November 23, 2024 at 9:17 PM
5/ Imagine if EMS documentation worked more like hospital EHRs. A single record could house multiple contributors, with sections for each provider or team:
• First response note (engine/truck company)
• Transport note (ambulance crew)
• Supervisor note (if applicable)
November 23, 2024 at 9:17 PM
4/ Each PCR is a standalone document. Demographics, medications, allergies, and even vitals are often duplicated across all PCRs, leading to inefficiencies and opportunities for discrepancies. This system is time-consuming and prone to conflicting documentation. 🤯
November 23, 2024 at 9:17 PM
3/ In a tiered EMS system, it’s not uncommon for a single patient incident to result in multiple PCRs. For example, a cardiac arrest might involve:
• A first-arriving fire engine writing one PCR 🧑‍🚒
• The transporting ambulance writing another 🚑
• A supervisor writing yet another note 📋
November 23, 2024 at 9:17 PM
2/ In EMS, documentation is typically incident-based. Each patient encounter generates a separate PCR, which serves as an incident report rather than a longitudinal record. This contrasts sharply with hospital EHRs, where patient records compile all encounters into one cohesive chart.
November 23, 2024 at 9:17 PM