Collaboration with pre-hospital providers, namely emergency medical services (EMS), is a critical success factor for hospitals and healthcare systems. Yet, enabling EMS collaboration and data integration is an often-overlooked component of healthcare IT strategy. Why does this gap persist?
The arguments for integrating EMS data and making it available through the electronic medical record (EMR) system include improving continuity of care, supporting medical decision making (MDM), and supporting operational and financial performance by:
- Improving patient throughput and reducing barriers to discharge
- Delivering services more efficiently, using existing resources
- Quantifying performance as required for accreditation and value-based care
An estimated 25-30% of total healthcare spend in the U.S. can be traced to inefficient patient throughput, delayed access to treatment, excess length of stay, preventable readmissions and over-utilization, and unaddressed social determinants of health (SDOH).i ii The Centers for Medicare and Medicaid (CMS) prioritization of health equity is converging with the rise of value-based healthcare, prompting hospitals and healthcare systems to look for new ways to drive down inefficiencies.
Improving Bed Utilization, Care Transitions, and Discharge Planning
Patient throughput initiatives prioritize streamlining treatment and discharge, using resources efficiently, and providing services in the most appropriate setting to reduce emergency department (ED) utilization and inpatient admissions. Workflow integration with EMS partners can help hospitals and healthcare systems meet these objectives.
For example, while EMS patients are in transport, the receiving facility can leverage EMS data to triage and pre-register patients, activate necessary resources, such as cardiac catheterization laboratories, and route patients there upon arrival, enabling faster access to life-saving treatment.
Similarly, integrating hospital patient logistics software and EMS scheduling software workflows can accelerate patient transfer to the most appropriate care setting, such as a specialized surgery center or a children’s hospital.
Finally, discharge planners can manage barriers to discharge and help prevent excess inpatient days with integration between the hospital discharge planning software and EMS transport scheduling software. Using existing tools, planners can reduce delays caused by manual workflows and efficiently arrange transport and timely discharge.
Delivering Services Outside of Inpatient Settings
EMS providers can serve many community healthcare needs without utilizing limited inpatient beds and increasing demands on hospital staff. They are already equipped to encounter and provide care to patients where they live, work, and play. Interventions like homeless outreach, support for aging in place, and routing super utilizers to the most appropriate setting all fit logically under EMS responsibilities.
EMS Hospital at Home and mobile integrated health and community paramedicine (MIH/CP) programs have demonstrated that they improve adherence to medication, shorten inpatient stays, reduce readmissions, reduce repeat 911 calls and ED visits, decrease complications, and reduce the cost per inpatient day.iii iv Case management integration with EMS scheduling can automate enrollment of patients into these EMS-delivered programs, as well as the continuous reporting back of patient findings and outcomes.
Partnering with EMS providers to deliver services in the most appropriate settings helps hospitals and healthcare systems meet accreditation and value-based care requirements, such as Joint Commission cardiac and stroke accreditation and AHA “Get with the Guidelines” programs.
Implementing Technology To Enable EMS Integration
Technology to enable integration of EMS data into the EMR must be fully integrated into existing workflows to reduce disruption, streamline labor-intensive tasks, and improve staff efficiency. Smooth implementation depends on identifying a technology partner with deep expertise in relevant clinical workflows and a strong track record for successful EMR integrations.
Hospitals and healthcare system IT teams working to integrate EMS workflows can help ensure project success by:
- Identifying an executive sponsor with authority to drive hospital-wide change
- Dedicating interdisciplinary teams representing the hospital, EMS, specialist providers, and social services
- Establishing shared objectives and metrics between providers and across care settings
Collaboration with EMS is a critical success factor for hospitals and healthcare systems. Investing in workflow integration technology can help wring out inefficiencies and pave the way for meaningful progress against priority performance indicators, like patient throughput, barriers to discharge, and preventable readmissions. Organizations that implement technology like the ZOLL Care Exchange platform can boost operational and financial performance while optimizing resource utilization and enhancing continuity of care for their patients.
i William H. Shrank, MD, MSHS1; Teresa L. Rogstad, MPH1; Natasha Parekh, MD, MS2. “Waste in the US Health Care System Estimated Costs and Potential for Savings.” JAMA website, 2019;322(15):1501-1509. doi:10.1001/jama.2019.13978 www.jamanetwork.com/journals/jama/article-abstract/2752664. Accessed 6 Feb. 2024
ii "IOM Report: Estimated $750B Wasted Annually In Health Care System.” KFF Health News website, www.kffhealthnews.org/morning-breakout/iom-report/. Accessed 6 Feb. 2024
iii "Hospital at Home℠ Care Reduces Costs, Readmissions, and Complications and Enhances Satisfaction for Elderly Patients, Agency for Healthcare Research and Quality.” AHRQ website, www.psnet.ahrq.gov/innovation/hospital-homesm-care-reduces-costs-readmissions-and-complications-and-enhances. Accessed 6 Feb. 2024
iv Olufunke Sokan et al. “Impact of a mobile integrated healthcare and community paramedicine program on improving medication adherence in patients with heart failure and chronic obstructive pulmonary disease after hospital discharge: A pilot study.” NCBI website, www.pubmed.ncbi.nlm.nih.gov/36457714/. Accessed 2/6/24