ESO EMS Index: Mid-Year Update Evaluates Nationwide Performance Across Key Metrics for First Half of 2019

Data show improvement across multiple metrics; opioid overdoses remain a public health concern

August 6, 2019 – AUSTIN, TexasESO, the leading data and software company serving emergency medical services (EMS), fire departments and hospitals, today announced the mid-year release and update of its 2019 ESO EMS Index. The Index tracks performance of EMS nationwide across key metrics: stroke assessment and documentation, end-tidal carbon dioxide (ETCO2) monitoring, 12-lead electrocardiogram (EKG) use, aspirin administration for chest pain, overdose events (and specifically opioid-related overdoses) and influenza-like illness. Data used for the mid-year update of the Index are from January 1, 2019 through June 30, 2019.

“We continue to see steady improvement across core metrics,” said Dr. Brent Myers, Chief Medical Officer for ESO. “For each version of the Index we’ve published, we see better performance around stroke assessment and documentation in particular. Other key measures, such as ETCO2 monitoring and 12-lead EKG use, are holding steady or improving slightly. And while the overall percentage of overdoses shows a slight decline, we are still seeing opioid overdoses climb.”

Key Findings Include: 

  • In 69 percent of situations, a complete stroke assessment was documented for a primary impression of stroke. The data show improvement when it comes to documenting a stroke assessment after a primary impression of stroke is identified.
  • EMS providers continue to recognize the value of ETCO2 monitoring after advanced airway placement. In 96 percent of cases, ETCO2 monitoring was documented after advanced airway insertion.
  • Overdose encounters are falling, but opioid overdoses are rising. In 2018, overdose encounters accounted for 1.65 percent of all the encounters in the Index data set. Halfway through 2019, that number has fallen to 1.59 percent of all encounters. However, opioid overdoses do not appear to be on the decline.
  • Documentation of aspirin administration continues to be hit or miss. Just more than half (53 percent) of the reported cases of patients over the age of 35 who were experiencing non-traumatic chest pain had appropriately documented administration of aspirin.

Download the full Mid-Year Index.

About the Index: Mid-Year Update

The dataset for the ESO EMS Index is real-world data, compiled and aggregated from a subset of ESO’s overall customer base and represents more than 1,200 agencies across the United States that have volunteered their data for this purpose. These data are based on 3.8 million patient encounters between January 1, 2019 and June 30, 2019

About ESO

ESO is dedicated to improving community health and safety through the power of data. Since its founding in 2004, the company continues to pioneer innovative, user-friendly software to meet the changing needs of today’s EMS agencies, fire departments, and hospitals. ESO currently serves more than 10,000 customers throughout North America with a broad software portfolio, including the industry-leading ESO Electronic Health Record (EHR), the next generation ePCR; ESO Health Data Exchange (HDE), the first-of-its-kind healthcare interoperability platform; ESO Fire and ESO FIREHOUSE Software for fire departments; and ambulance revenue recovery/billing software. ESO is headquartered in Austin, Texas. For more information, visit

Media Contact:
Andy Prince
[email protected]