File photo of Squad 30. Photo by volunteer photographer Derek Cutler.
by Nicole Mooradian
August 10 marked a milestone for the Los Angeles County Fire Department: beginning that day, all patient care records generated on calls were submitted electronically.
The switch to electronic patient care records (ePCR) wasn’t easy, said Battalion Chief Eleni Pappas, who led the effort.
According to Pappas, the ePCR project began when the Los Angeles County Board of Supervisors approved a $1.8 million grant for the Fire Department from the Department of Health Services. With that grant came a mandate that the Fire Department implement ePCR by summer 2016.
“The grant covered the cost of the tablets, which was the biggest expense,” Pappas said. “We wound up doing very well.”
Prior to implementation, however, Los Angeles County hospitals had to be on board.
“In order for us to send an electronic report, the hospital has to be able to receive it,” Pappas said. “We had to reach out to over 80 hospitals to make sure they were on the XchangER program and get them all squared away with the website.”
That wasn’t all.
“There were so many moving parts to this,” Pappas said. “Before we could even train our people and put a tablet in the hands of our people, we had to make sure the ambulance companies could get our reports as well.”
The roll-out to the field started with Battalions 6, 22, 11 and 17 because those battalions only work with one ambulance provider and don’t have many mutual aid calls. Battalions in the Central and East operational bureaus followed.
“As of August 10 at 8 o’clock in the morning, we (were) completely electronic,” Pappas said. “It was a big change in our workflow.”
From start to finish, the project took about 16 months.
Nevertheless, there were a few hiccups, according to Dr. Clayton Kazan, the Department’s medical director. The Department is working closely with the vendor to make the ePCR more user-friendly and to “button up” issues.
“It’s a hard transition, and in a big department like ours, it’s going to be bumpy,” he said. “It’s only going to get better over time.”
“The County firefighters had a great attitude in expecting the change and struggling through it,” Pappas said. “But the County firefighters rose up to the challenge … They’re making it work, and they’re producing some really good patient care reports out there.”
“Thanks to their hard work, we have been able to start generating reports from the ePCR system that have been incredibly helpful with some projects we’re working on at EMS,” the medical director said.
Whereas it used to take about a month to receive patient care data, “now we can actually view data that’s hours old, and we can compile reports for a couple of months in a matter of minutes,” he added.
Additionally, analysis of the data will help the Department more quickly recognize trends and better focus its training.
“The tablet is capable of a lot of functions, and this ePCR is just one of the functions,” Pappas said.
“We can put tools on the tablets that can help make (firefighters’) patient care easier,” Kazan said, noting that in the future, first responders could video chat with hospitals or attach photos of incidents to the records. “We’re just opening up a whole new realm of possibilities.”
For Pappas, the switch to ePCR represents a step forward.
“This is just the beginning,” she said. “There are young men and women coming on the job today that will never know that we were using paper. I think that’s fantastic … As far as they know, we’ve always been electronic.”