We recently sat down with Dane Meuler, co-founder and SVP of business development at Kno2, to have a conversation about the technology landscape in emergency medical services (EMS). Recent advancements in connectivity have led to streamlined workflows and improved outcomes for patients. Dane addresses challenges associated with the transition of care from EMS into the hospital setting, how COVID has impacted medics’ workflows and how technology is helping medics create better outcomes for patients.
What are some of the challenges medics commonly face when arriving at a hospital with a patient?
One of the most common challenges we see is the time and hassle of getting the report to the team in the emergency department. The medics find themselves trying to get their devices connected to the Wi-Fi and printers in the emergency department, and it doesn’t always go as planned. Frequently, because of those challenges, they end up purchasing their own printers to be kept in the ambulance or even at each individual emergency department. There is a tremendous cost for the maintenance of those printers, as well as the downtime they experience when things don’t connect properly. Their goal is to care for the patient and get the information to the team at the hospital as quickly as possible.
How has COVID-19 affected medics’ workflows when arriving at the emergency department?
During COVID, the issues with connecting to Wi-Fi and printing the report has become a greater source of stress. Agencies want to minimize medics’ time in the emergency department for their safety and well-being. In early 2021, we conducted a survey of our EMS customers to understand what they valued most about their connectivity using Kno2. The top two most common responses were expected: #1 – improved efficiency for the medics and #2 – improved turnaround times at the hospital. Closely behind was #3 – reduced stress level for the medics. We did not fully realize how much stress relief we were providing to the medics. We found that because of the COVID crisis, risk of infection and EMS resource issues have increased the urgency to get out of the ED quickly, and we’re helping resolve this issue.
I think we all assume that if I’m holding a computer and you’re holding the computer we should be able to exchange information. Medics are always befuddled by the fact that they create an electronic report and are still printing paper or faxing the report at the emergency department, instead of automatically sending it to the hospital’s EHR. Medics are also aware that after providing the printed or faxed PCR some of the hospital’s workflows are surprisingly slow. I’ve seen and heard of situations where the PCR doesn’t populate into the patient’s record until two weeks after the patient is transported to the emergency department.
When you speak to EMS agencies and medics, how do they feel about the technology that they’re using? Do they feel like the technology helps them or do they feel like is slows them down or creates barriers to their ability to deliver care?
Interestingly, the transition away from paper-based PCRs to electronic PCRs has been challenging for the medics. They need to be trained on the new technology and it requires more work. It’s not that they’re resistant but it does require more time and effort. In the end, they all appreciate what it means when they can see the results of the data and how the analytics help them perform their job better.
In an ideal world, how do you see technology helping EMS?
Ideally, the systems available to the medics should be connected to the rest of healthcare. This means they have clear visibility to the patient’s previous medical history, including meds, allergies and other complexities about this patient’s health. Not only does this provide them insight as they’re treating a patient who is experiencing a stroke or a heart attack, it also helps them properly complete their documentation accurately and in timely manner. Thankfully, this technology is available today.
For instance, the medic may be treating a patient that holds up a large zip lock bag full of medication bottles. It takes a long time to document each of those medications, which means that the medic may only document a few of those medications. With the connectivity that’s now available to ePCR vendors and the medics, it is possible to bring back the full list of medications from that patient’s provider and have it easily reconciled into the PCR.
This connectivity also allows for feedback about the patient’s diagnosis at the hospital. This allows a comparison of the diagnosis to the initial impressions in the field and interventions performed by the medics. Ultimately, this leads to better quality assurance and improvement initiatives through EMS agency training programs. This is extremely important when evaluating time-critical incidents like stroke, STEMI and trauma. In the past (and currently), this feedback loop is very manual and expensive through interfaces that are not scalable.
The same connectivity can be used to bring back current payer information for the transported patient, allowing EMS to bill properly and more efficiently. Because EMS does not have the convenience of pre-registering the patient or collecting an insurance card while treating and transporting a patient, the ability to access this information can be a game-changer.
If you could change one thing about EMS technology, what would it be?
It’s not so much what I would change about the technology, it’s about educating both EMS and the hospitals about what is currently possible with limited cost. In many ways we are stuck in old paradigms with paper, faxing and HL7 interfaces. Connectivity between EMS and the rest of healthcare has been simplified. It’s fun to experience the “Ah-ha!” light bulb moments when both understand the advancements in interoperability and the seamless nature of connection and exchange of information.
