Electronic Patient Care Records (ePCRs)

sf1009

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I was looking for a post on this and could not find anything. I would like to find out who of you out there use ePCRs and your thoughts.
Thanks,
Sue, RN
 

CFRBryan347768

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i do not like them, their more work for me, because we have the paper copy and than have to do it again on the internet. its a pain
 

firecoins

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The notebook computer the program is on keeps crashing.
 
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sf1009

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Does your jurisdiction have any plans to go electronic only?
Would your thoughts be different if you were electronic only?
 
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sf1009

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hmm....does the info get backed up to a central repository prior to crashing? That sounds bit frustrating!
 

JPINFV

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i do not like them, their more work for me, because we have the paper copy and than have to do it again on the internet. its a pain

Oh, God, why do people do this. If you're thinking about going electronic for PCRs, either go electronic or don't go electronic. Combining the two is just asinine. My waterpark job did something similar to this (word document instead of a specialized PCR program) and it always took me twice as long to complete both reports than need be.
 

ffemt8978

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My paid service uses ePCR's. We have to fill out a paper form, leaving a copy at the facility before we depart, then go back to the office and scan in the originals and process them on the computer. It's great from a billing aspect because we do everything for them, but it sucks on our end because we basically have to do the same report twice.

Electronic PCR's are great if every facility involved uses the same system and you can access it. Given the large number of facilities we transport to, including across state lines, we're stuck with having to do paper copies for the facilities.

Paper copies also have the advantage in that they work every time, regardless of whether or not the computer is working that shift.
 

JPINFV

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Aren't there compact printers that would work with the tablet/laptops computers and can be stored and used on the ambulance?
 
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sf1009

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Oh, God, why do people do this. If you're thinking about going electronic for PCRs, either go electronic or don't go electronic. Combining the two is just asinine. My waterpark job did something similar to this (word document instead of a specialized PCR program) and it always took me twice as long to complete both reports than need be.

well...yes...I wonder why have both unless it is a transition period
 
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sf1009

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My paid service uses ePCR's. We have to fill out a paper form, leaving a copy at the facility before we depart, then go back to the office and scan in the originals and process them on the computer. It's great from a billing aspect because we do everything for them, but it sucks on our end because we basically have to do the same report twice.

Electronic PCR's are great if every facility involved uses the same system and you can access it. Given the large number of facilities we transport to, including across state lines, we're stuck with having to do paper copies for the facilities.

Paper copies also have the advantage in that they work every time, regardless of whether or not the computer is working that shift.

I agree about paper working all of the time. If you are scanning the paper into a computer, then the data is not part of an interoperable system with the ED, is that correct? How about a system where your ePCR populates a record at the receiving ED....anyone work in a system like that?
 

Katie

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both have their goods and bads i think. the worst with electronic is when the system goes down and you're stuck at the hospital for an hour rewriting a report a report eight times over. the main point is having a system which is conducive do writing accurate reports. the electronic programs i've seen don't really accomplish that imo, though i admit i've only seen three different programs in use.
 
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sf1009

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ePCR populating ED record?

I agree about paper working all of the time. If you are scanning the paper into a computer, then the data is not part of an interoperable system with the ED, is that correct? How about a system where your ePCR populates a record at the receiving ED....anyone work in a system like that?
 

Ridryder911

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The ePCR main advantage is reimbursement ratio. This is the reason most EMS goes for the system. With about >80% reimbursement payments, ePCR assures each required field is completed before transmission or completed. As well it has the capability of storage and transmission of records to other facilities. TQI is another major advantage ePCR, being able to bring up statistics and placing filters for the needed information.

The disadvantages is multiple and one has to evaluate if the "good will out-way the bad".
Unless one has a good I.T. and can keep the system up, "crashes" are to be expected and downtime will be costly. This downtime is one of the problems, I have seen and know that is costly for services.

The other disadvantages is also the costs. Generally costing $70,000 to $100,000 for just the start up (without any hardware) and place up to another $15,000 to $20,000 per EMS unit. Also needed is peripheral hardware for servers, printers, etc. Training and continuous education is also an added expense.

Now, Medicare delegated payers have found loop holes on payments, where it is was a high reimbursement rate. I have heard that the percentages have dropped from the upper 90's & 80's to mid 70's ...not much better than using the paper system.

Of course ePCR will be required in the future, but unless the system can afford or off set the costs then I suggest using the traditional method.

R/r 911
 

BossyCow

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Oh, God, why do people do this. If you're thinking about going electronic for PCRs, either go electronic or don't go electronic. Combining the two is just asinine. My waterpark job did something similar to this (word document instead of a specialized PCR program) and it always took me twice as long to complete both reports than need be.

Our agency has paper reports, but our billing is done electronically through an offsite contractor that does it for us. We need to translate the paper document into an electronic format in order to get paid. Luckily due to a lower call volume than some agencies, I'm able to keep up with the data entry myself as officer instead of giving every volunteer access to the reporting system. I like the process as it gives me a chance to review each report as I enter it.

So, using a combination of the two in a way that is not asinine, but merely an effective addressing of our needs within the confines of our agency. But, I'm sure you didn't mean asinine in every case.
 

JPINFV

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Bossy, I was going more for the "provider writes PCR and then immediately writes the entire thing on paper" aspect. Plenty of services use paper PCRs with electronic billing, but the difference is that the ones who write the PCRs are not normally the ones who enter the information into the computer for billing. I can see it being very easy to get backlogged when an active unit has to essentially write a report twice. It's also a good way to lower morale since a lot of providers, for some really strange reason, don't connect billing with money for equipment/maintenance/pay.

Of course low call volume services fall into a separate category since their providers have less of a workload and unit utilization is normally not nearly as much of a problem.
 

Doctor B

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We currently utilize a web based prograsm that can be accessed by any computer that has an internet connection. The program is called EMSCharts and once you "buy " into the program they take care of all of the system upgrades and IT issues. They even have a 24 hr. tech support. The report is very thorough and like Rid identified you can apply as many or as few filters as you'd like. The program can also track your skills utilized for QA/ QI and has a format that can be extrapalated for billing purposes. While there is a bit of a learning curve once you get the hang of it the chart can be completed fairly quickly.
 

Jon

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We currently utilize a web based prograsm that can be accessed by any computer that has an internet connection. The program is called EMSCharts and once you "buy " into the program they take care of all of the system upgrades and IT issues. They even have a 24 hr. tech support. The report is very thorough and like Rid identified you can apply as many or as few filters as you'd like. The program can also track your skills utilized for QA/ QI and has a format that can be extrapalated for billing purposes. While there is a bit of a learning curve once you get the hang of it the chart can be completed fairly quickly.
+1.

I'm just getting used to EMSCharts, and I like the program. They also have a system that allows for "standard" mobile ePCR implementation, where a computer in the vehicle collects information, then uploads via the internet to their online system. Then all the user needs to do is log in and finish the chart... most of the info can be entered before the crew clear the hospital or returns to station. We don't currently use the mobile program at my work.

Jon
 

AJemt

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Most of the companies in my area (county) use EMStat - it's on computers back at the stations. Charts are done on the computer then printed and faxed to the hospital or printed and placed in a billing box for collection by the supervisor (depending on what company you are at). the only time its a pain is when the server or system crashes.....which has gotten a lot better (once i did a chart and a couple weeks later got an email from our PI boss who was like you need to do this chart its from way back and over the 24 hr mark and i was like i did so i ended up having to get ahold of the billing office supervisor, get the chart from her - printed copy - and take and re enter all the information bc it got wiped out of hte computer system.....not a happy camper...lol).
 

Ops Paramedic

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Good old pen and paper for me!! There is currently one PVT service using electronic PCR which is completed on Panasonic Toughbooks and then immediatly sent to the office via the mobile internet. I understand the advantages of the system, as mentioned in the posts, but from the crews working with it, not a whole lot of good has been mentioned. Also understanding there will be teething problems. It also cost them a fortune, i am sure.

For me...why re-invent the wheel!!!
 
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sf1009

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We currently utilize a web based prograsm that can be accessed by any computer that has an internet connection. The program is called EMSCharts and once you "buy " into the program they take care of all of the system upgrades and IT issues. They even have a 24 hr. tech support. The report is very thorough and like Rid identified you can apply as many or as few filters as you'd like. The program can also track your skills utilized for QA/ QI and has a format that can be extrapalated for billing purposes. While there is a bit of a learning curve once you get the hang of it the chart can be completed fairly quickly.

So, if this is web based, is it also real time where the receiving ED can access the information...or is it web based in that it goes to a central repository accessible only by your system.
 

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