Hospitals Infrequently Receive EMS Patient Care Reports in the Era of Electronic Medical Records: A Preliminary Report

Abstract

Listen

Translate article

Objectives Emergency Medical Services (EMS) patient care reports (PCRs) are an important component for the transfer of patient care from EMS systems to hospitals and a foundational element of EMS quality improvement (QI). The PCR may serve as the only objective source of information for EMS patient presentation. Surprisingly little data, either objective or anecdotal, exists regarding the reliability of this process. Our objective is to describe the frequency of missing PCRs and the time of their receipt following EMS transport to hospital emergency departments (EDs). Methods We performed a retrospective study of EMS PCR provision for patients transported to a large single eight hospital health system in Southeast Michigan from 1/1/2022 to 7/1/2023. We included agencies who transported >100 patients annually to system hospitals. All PCRs are transmitted by fax or to email server and manually uploaded into the system’s EPIC® EMR (Electronic Medical Record). We stratified agencies by whether they were primarily 9-1-1 responders or interfacility transport. The PCR receipt by hospital and time of upload were obtained from EPIC Toad Data Point® queries. Our primary outcome was frequency of PCRs received (in aggregate and by agency) and uploaded to EPIC®. Our secondary outcome was the interval from EMS arrival to EMR upload. We report descriptive statistics including receipt of PCR (mean, median) by hospital and agency. Results There were 155,423 patients transported by 63 EMS agencies. Overall, receipt of PCRs varied substantially by hospital mean (SD) 50.6% (23.5), median (IQR) 44.0% (33.9, 70.2). A minority 26.3% (26.2) of these were uploaded within 120 min of hospital arrival. PCRs receipt also varied substantially by agency, with overall median (IQR) of 56.8% (17.2, 83.1). Conclusions Many PCRs are missing after EMS transport, with marked variation in submission rates and time to upload by agency and hospital. Many PCRs were infrequently available for use in a timely manner. Further assessment is needed to quantify the degree to which the lack of transfer of documentation of EMS patient care exists across emergency care systems.