How Hospitals Can Cultivate EMS Loyalty
When hospitals foster loyalty among EMS agencies, the result is not only greater transport volume and increased revenue, but it’s also greater efficiency and improved quality of care – in both the prehospital and hospital settings. Joshua Ishmael, EMS Coordinator for St. Elizabeth Healthcare, recently shared how his healthcare system set about achieving those results and more using ESO Health Data Exchange (HDE).
St. Elizabeth is a six-hospital system in Northern Kentucky, receiving approximately 40,000 EMS patients a year from 40 distinct EMS agencies in its region. The system was using what Ishmael referred to as “antiquated process” to collect data from those agencies, who use three different ePCR products. “We were faxing, e-mailing, and scanning [into Epic],” all in 2017, Ishmael said. Physicians and nurses lacked the prehospital data they needed for patients, and quality improvement was hampered by limited feedback to EMS about patient outcomes. The hospital’s Medical Records department was perhaps the hardest-hit of all by antiquated processes, literally using magnifying glasses to look at paper printouts and working long hours to import EMS records into the hospital EMR. “You can imagine what their desks looked like,” he said.
The Solution … and the Results
St. Elizabeth’s implemented HDE on a grand scale, with the health system providing the capital so hospitals and EMS agencies alike could get the benefits of two-way data sharing. The project received strong support from the start, says Ishmael. “VPs and ER directors pretty quickly got a sense for how important EMS is, because that’s revenue for the hospital,” he added.
Right off the bat, hospitals saw a benefit in dramatically faster import of EMS data into their Epic system, making information available when and where it was needed, Ishmael said.
As for the region’s EMS agencies, interest in receiving patient outcome information from the hospitals was even more enthusiastic than anticipated. “I didn’t know what kind of interest EMS would have … but shortly they were knocking my door down,” Ishmael said. In a forthcoming second phase, he said, EMS will also be provided with labs and imaging.
As for QI and educational benefits, receiving hospital outcomes plays a vital role in validating (or correcting) the clinical decisions made by EMS personnel by comparing to the hospital’s diagnosis for a given patient. When EMTs and paramedics form the right clinical impressions, the result is increased confidence and what Ishmael described as personal validation: “I was headed down the right path based on this patient’s presentation.”
Having hospital outcomes also helps EMS agencies focus QI initiatives where they’re needed most. “If you can compare [EMS and hospital] diagnoses and figure out … that your crews are only getting stroke diagnoses right 30 percent of the time, you know where to focus your training efforts for the next year or the next quarter,” Ishmael said.
Another benefit has been billing and reimbursement for EMS, Ishmael said. “As part of the outcomes [that EMS receives], page 2 is the face sheet – the most accurate demographics you can get your hands on. And now that process is automated as well.”
As for fostering loyalty, “Folks truly appreciate the efforts that are being made from the hospital perspective,” Ishmael said. “We’ve been able to do this project among many others that catered to the hospital’s #1 referral source, and that’s EMS.”
And remember that beleaguered Medical Records department? Not only did HDE’s ability to automatically import prehospital data into Epic save countless staff hours and eyestrain, but it got rid of “tons and tons of paper,” Ishmael said. “You want to talk about return on investment? For our 6-ED system, toner and paper alone [returned] $20,000 in savings.”
In the larger picture, implementation has been such a success because, as Ishmael said, “Data drives everything – EMS data does matter, and it can help guide hospital decisions about trending, like EMS volumes; they can be able to watch trends. And EMS feels it. Out in the street they can feel a tangible difference …. and they’re empowered.”
“At the end of the day, the biggest winner in my eyes is the patient,” he added. “I live in that community, my family lives in the community, and this is a best practice in my opinion.”
Key Benefits Observed
- Satisfying Board of EMS requirements
- Patient outcomes process is automated
- Education/training component is priceless
- Billing/reimbursement improvement potential
- Satisfying Joint Commission requirements
- Physicians able to see important ePCR data
- Faster ePCR to EPIC (compared to 12-36 hour turnaround time)
- Savings in printing, copying and manual labor in Medical Records dept.
- Long-term benefit from collaboration
- Continuum of care is improved