Do Hospitals Get EMS Patient Care Reports?

Background : EMS patient care reports (PCRs) are an important component of the EMS system and a foundational element of quality improvement. In many cases, PCRs provide hand-offs between providers, and may be the only context for patient presentation. Little data exists regarding the frequency and timeliness of PCR provision to Emergency Departments (ED). Objective : To describe the frequency of missing PCRs following EMS transport and timing of receipt by EDs within a regional healthcare system. Methods : We performed a retrospective study of EMS PCRs for patients transported to a single health system from 1/1/21 – 7/1/22. We stratified agencies by 911 response or interfacility transport. PCR receipt and time of EPIC upload were obtained from EPIC Crystal Report® query. Primary outcome was frequency of PCR receipt by EDs (in aggregate and by agency). Secondary outcome was interval from EMS ED arrival to EMR upload (greater or less than 120 minutes of arrival). We provide descriptive statistics reporting proportion of receipt of PCR (mean, range) by hospital and agency Results : There were 106,496 patients transported by 62 agencies, 87.3% were 911 responders. Overall, receipt of PCRs varied substantially by hospital – 54.2% (13.5% - 80.1%). 30.7% (2.4% - 63.4%) were uploaded within 120 minutes of ED arrival. PCR submission rate varied substantially by agency, 45.8% (2.5% - 96.8%). Interfacility EMS services were far less likely to submit a PCR after ED transport (35.9% vs. 56.9%). Conclusions : PCR’s are frequently missing after EMS transport within this large hospital system, and infrequently available for timely review. Interfacility transport agencies are less likely to submit compared to 911 responders. Although hospital manual upload of PCRs may impact time of their receipt, this does not explain the overall rate of missing PCRs. Further work is needed to identify obstacles to PCR delivery and assure their availability.