Electronic Charting and Billing for EMS
Volume 22 Number 5
Many of us who have been in the EMS game for a while have seen the early electronic versions of patient care and billing forms that came out. Most were woefully inadequate and "amateurish" at best and clearly not what the professional EMT/Paramedic was looking for in a comprehensive electronic version to carry us out of the paper age. This, coupled with the lack of supporting and necessary hardware to backup these "programs", has made the ability to transfer to an all electronic paperless system virtually impossible. Some of that is changing with some products that are coming out or have been utilized with some success.
Hardware had always been the biggest of the problems. Most of the early laptops (and PDAs, those hand held "personal digital assistants", like a PALM? or something like it.) were so fragile that even dropping one or simply jostling one would wreak havoc. Often it meant an expensive trip to the repair shop and possible loss of all data. That is totally unacceptable in an environment that demands that the equipment to be durable enough to withstand day to day operations.? It's just that simple. Now I'm not saying that we should be able to throw it down two flights of stairs, or run it over with the largest piece of apparatus and still expect it to function like it came out of the box (would be nice and yes, I can dream too!), but it has to hold up under the normal demands that the job is going to place on it. Otherwise it's just an expensive piece of junk that constantly needs repair.
Now when it comes to hardware there are quite a few choices that are out there and my readers always know that I never tout any particular products in this column nor do I have any affiliation with any manufacturer. I only highlight them here for your information and always encourage you to do your own research and pick what is best for your needs. I'm also eliminating the PDAs from this discussion as they are not usually utilized for patient charting. They are more for data retrieval, information management, and sometimes communications. We can take up the PDAs another time if you are interested.? There are oodles of EMS applications for those as well.
One of the latest of the hot laptop/notebook style computers to hit the shelves is the Panasonic Toughbook?. Several of the laptop/notebook styles available have all that Panasonic claims to have in rigor to support the operations of the fire service. What I like about this unit, especially the Toughbook 19, is its 10.5 inch notebook style (swivel top) and that it weighs in at only five pounds while protected by a durable as all get out with it's mag-alloy case. Its pressure sensitive touch screen suitable for finger or pen is perfect for digital writing. Many of the software programs allow notes in digital 'longhand' which I love. I can actually write notes on the screen to save for later. The swivel top makes it work just like a notebook so I do not have to open a "laptop" to do my charting, I'm holding no more than I used to with my clipboard and the paper. These Toughbooks? are also UL-1604 certified for use in explosive environments and that's important for the industrial providers who work in these potential areas. All are either Windows XP? or Vista? loaded so there should be no issues with the operating systems. All are also wireless ready, but I have thoughts on how that may be utilized. More on that issue another time. As far as the pricing, well the quote I got from the manufacturer which didn't involve bulk purchases is under $4000.00 (something close to $3899.00). I'm sure the distributors can and will do better in the end.
As far as real durability, well I asked that specific question.? "If I throw it down two flights of stairs, or run it over with my largest piece of apparatus will it still work?" Jenni from their PR firm hesitated on the phone, but clearly stated she thought they might "survive" considering what the testimonials have said from other customers; surviving 1000? heat, drenched in water, really banged around, etc. Regardless, it was NOT recommended and of course due care should always be given to all equipment in your charge, but it still made me wonder and it made me want to get a nice big Sutphen? and run one over to see...just for giggles of course!? The Toughbook? laptop is at www.panasonic.com/business/toughbook/fire.asp.
Software on the other hand is a totally separate issue and one that has consistently failed to fill the void where it was needed most. Either it was too complicated, could not be individually tailored to the user's needs, was not user friendly at all (come on, this is NOT rocket science and I/we are NOT rocket scientists) and despite my having some computer savvy, some of these software programs required a degree from MIT just to understand (ok, maybe not MIT). No, I'm not a computer weenie (this is NOT a derogatory term by the way, just ask any of the real computer weenies, like our own Lou Molino Jr.!) by any stretch of the imagination, but come on! The programs had to be something we could use with a limited amount of training and in-servicing to get them up and running. It has to be totally user friendly for even those with limited computer skills.?
Next issue will be all about the software as there are a couple of different programs that seem to stand out above the rest. In the mean time, if any of you are currently utilizing any of the charting/billing software programs, drop me a line as I would love to hear your success or failure comments and issues regarding the programs.????????????????
William R. Kerney, MA, EMTP-A, is a professor of emergency medicine at the College of Southern Nevada.