ESO Launches 2019 ESO EMS Index to Track Nationwide EMS Performance Across Key Metrics

Stroke assessment, 12-lead EKG, and aspirin administration highlight areas for improvement; new metrics include opioid overdose and influenza surveillance

February 21, 2019 – AUSTIN, TexasESO, the leading data and software company serving emergency medical services (EMS), fire departments and hospitals, today announced the findings of its 2019 ESO EMS Index. The Index tracks performance of more than 1,200 EMS agencies nationwide across five metrics contained in our previous EMS Indices: stroke assessment, end-tidal carbon dioxide (ETCO2) monitoring following advanced airway placement, 12-lead electrocardiogram (EKG) use for adults with chest pain and aspirin administration for adults with chest pain.

For 2019, the overdose metric has been refined to give better temporal information regarding trends in opioid overdose and added a new measure focused on influenza (flu) surveillance. Data used for the Index stem from patient encounters that occurred between January 1, 2018 and December 31, 2018.

“This is the second year of our annual Index, and we are seeing how the use of data is having a positive impact for our customers and the communities they serve,” said Dr. Brent Myers, Chief Medical Officer for ESO. “In particular, we see year-over-year improvement of 12-lead EKG utilization and improvement in complete stroke assessment and documentation. While overdoses continue to represent a national public health concern, we are seeing some positive trends related to a decline in overdoses involving opioids specifically.”

Key Findings Include: 

  • In 65 percent of situations, a complete stroke assessment was documented when the EMS provider’s primary impression indicated stroke. This is up from 50 percent as measured in the 2018 ESO EMS Index (or a 15-percentage point improvement). The data show that EMS providers are either performing a complete stroke assessment more frequently or documenting the assessment more regularly after a primary impression of stroke is identified.
  • Overdose encounters outpaced cases where stroke was the primary impression. There were nearly 40 percent more encounters related to overdose in 2018 than stroke-related encounters, aligning with trends reported by the CDC.
  • EMS encounters for overdose more frequently involved men than women. Men accounted for 32 percent more overdose encounters than women.
  • Only four percent of opioid overdoses involved prescription opioids. 94 percent of opioid overdoses involved illicit drugs.
  • EMS providers recognize the value of end-tidal CO2 monitoring after advanced airway placement. In 96 percent of cases, ETCO2 monitoring was initiated and documented after an advanced airway was performed.
  • Aspirin administration is hit or miss. Just more than half (52.3 percent) of reported cases of patients over the age of 35 experiencing chest pain had appropriately documented administration of aspirin.
  • Not surprisingly, flu is very seasonal and hit hardest in January and February. 2018 was a particularly severe year, affecting all age groups, with more than 78,600 EMS encounters for influenza-like illness included in the Index.

“While it’s fantastic to see improvements across many of the metrics, we know there are still some areas that warrant further attention across the entire EMS landscape,” added Myers. “We look forward to continue working closely with our customers and the industry to share data-driven knowledge that helps improve the health and safety of all our communities.”

The full 2019 ESO EMS Index can be downloaded here.

About the Index

The dataset for the 2019 ESO EMS Index consists of real-world, de-identified data compiled and aggregated from more than 1,200 agencies across the United States that use ESO’s products and services. The findings presented in this year’s iteration of the Index are based on 7.58 million anonymized patient encounters that took place between January 1, 2018 and December 31, 2018, representing a full calendar year.

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 14,000 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]