The Journal of mHealth Vol 3 Issue 5 (Oct/Nov) | Page 8

Navigating the Pre-hospital to Emergency Room Transition with...
Continued from page 5

care in the field, get to the hospital, and
stop care. Hospital staff has no idea what
is going on with the patient and is playing catch up to get resources in place and
teams mobilized. Typical waiting times
upon arrival to the ER average five minutes to get the patient entered into the
EHR. When CPR is being performed
and you need Epinephrine,
five minutes is an extremely
long time to wait.

consumer electronics makes adoption as
easy a downloading an app, was the precursor to EMS Relay.

and 43 seconds, and stress of registering the patient upon arrival has been
decreased.

EMS Relay was formed to dive deep into
this transition in care. The app allows
emergency medical staff to capture
images and video from the field for the
hospital to instantaneously see all activ-

This change in workflow has provided
staff with a low stress and efficient environment to register patients. The five
minute rushed registration has now
been turned into a simple 25-second
patient entry.

EMS Relay increases the
quality of data being used,
resulting in the patient
receiving the most accurate
care possible

Enter John Doe. If the hospital chooses to register the
patient as a generic “filler”
ID, a staff member has to go
back, and move all procedures
and charges to the new record.
Based on a study done by Just
Associates, the cost to merge
records is an average of $96 per
incident.1 This error doesn’t
take into account the patient safety issue
with medications and allergies.

“Overlays” need to happen when a
patient has two records needing to be
merged, which costs the facility time
and money in clerical costs to merge the
records. Denied claims can happen as a
result of incomplete or conflicting information. 92% of denied claims are due to
incorrect or incomplete information.2
“Duplicate medical records” are another
big problem effecting from 10-22% of
patient databases. A real life example
is that a patient goes to the ER by the
name of Jim, as that’s what his friends
call him. The next day, the same patient
goes to the hospital as James, because he
is with family. James now has a record of
being seen yesterday that is completely
overlooked. James gets the same X-rays,
labs, and treatments as the day before,
but because he was identified as different
person, the staff duplicated efforts. This
redundancy in procedures is an average
of $1,100 per incident.3

Solution: EMS Relay

6

Having a deep understanding of this
problem and the impact it has on EMS,
ER staff, and of course the patient is
important to evaluate. A team of paramedics evaluated the exact workflow of
getting a patient received into the Emergency Room, and the simple solution of
sending more data was found. This
outcome, coupled with the fact that

October/November 2016

ity. Because the app is HIPAA compliant, anything from EKGs, to injuries, to
motor vehicle accident mechanism, to
stroke symptoms, and even registration
information can be seen minutes before
the patient arrives. Current methods
of contacting the hospital by phone or
radio, then having to describe what is
seen is outdated, subjective, and provides
little useable information. EMS Relay
increases the quality of data being used,
resulting in the patient receiving the
most accurate care possible.

Emergency Medical Services
have also noticed a change in
metrics. Crews that preregister
their patients have a turn time
of four to six minutes sooner
since all formalities are taken
care of before arriving. When
looking at the financial impact
with one of our EMS partners,
they estimated with ten trucks
running ten calls a day, we
would save them $470 per day
in being more efficient, not including the
additional calls that can now be run due
to the improved turn times.
Finally, consider what this new process
does for patient experience when they are
rushed into the ER where they are preregistered and care begins immediately.
Furthermore, they can be greeted with a
“Hello Mr. Davis, welcome to our facility.” Most importantly, the patient not
needing to complete forms now receives
care five minutes faster!

Feedback: The Pilot Project

References

Over the course of a 9-month pilot, over
600 patients had their demographic
information sent straight from the scene,
to the ER for preregistration. On average,
this information was received 11 minutes prior to patient arrival, compared
to a delay of 5 minutes with the traditional method. With this shift in registration during the lifespan of a patient
encounter, patients were registered over
15 minutes sooner in the overall event.
The actual time it took patient access
associates to get a patient registered and
banded, was 5 minutes and 8 seconds,
the whole time the patient was unable to
receive medications and treatment. Most
of this time was spent waiting for EMS
to hand off information, or walking to
and from the room. EMS Relay accepts
information on an iPad in the ER. Staff
had a 25 second task time when receiving information via the EMS Relay app.
Time on task was reduced by