Emergency Link: How BIDMC and Boston EMS Connect to Improve Patient Care


By Christie Roy


When someone in the city of Boston is brought by ambulance to Beth Israel Deaconess Medical Center, clinicians in BIDMC’s Emergency Department are briefed by the EMS personnel on the patient’s injury or illness. But what if, after the paramedics leave, there are further questions about the patient’s condition, or the treatment that EMS administered?

At BIDMC, the answers to those questions are now at the ED’s fingertips, thanks to an integration of the monitoring systems used by BIDMC and Boston EMS. When ED staff open the patient’s record in their “dashboard,” the electronic tool used to track patients in the BIDMC emergency room, they are also able to access the report prepared by EMS with just a click.

“When an EMS crew brings a patient to our emergency room, they create a patient care record, or PCR, which they provide to the team caring for the patient,” explains Dr. Larry Nathanson, Director of Emergency Medicine Informatics at BIDMC, who developed the ED dashboard. “When the PCR is done on paper, it can get lost easily. So when Boston EMS started creating their PCRs electronically, we worked with them and the software they use to have those PCRs imported into our dashboard as soon as they are completed.”

This integration allows for more reliable communication and patient hand-off between EMS and the emergency room staff — EMS is assured that their report is transmitted to BIDMC immediately, and clinicians can use the records, which show up as a link within the ED dashboard, to avoid any confusions about the patient’s background and treatment.

BIDMC is the first hospital in the city of Boston to successfully incorporate their system with Boston EMS. The security of patient records in the ED dashboard is kept intact with this integration — ED clinicians can only see the EMS records of patients who have been transported to BIDMC.

“We’ve been using our ED dashboard for more than 10 years now,” Nathanson says. “It makes it easy for clinicians to view labs, radiology studies, notes and vital signs with just a few clicks. Having the EMS record be part of it now saves time and lets us better understand what’s going on with a patient’s care.”

“Being able to integrate our dashboard with Boston EMS is really valuable to our staff as well as our patients,” adds Dr. David Schoenfeld, Associate Director of Emergency Medical Services at BIDMC. “EMS reports are also used by our admitting team and other consulting services throughout the medical center, so it’s another useful way for us to get information that we may need, especially when the patient, for whatever reason, cannot provide it to us.”

The overarching goal, according to Nathanson, is to eliminate paper records in the ED altogether.

“We’re continually working to use computer technology to improve all aspects of care,” says Nathanson, “and this is just one more step towards that goal.”

Schoenfeld agrees. “Working with EMS to improve our patient care and safety is really important to us, and no one else in Boston can say that they are quite as integrated as we are,” he notes. “There’s a level of sophistication here that is not available anywhere else in this city.”

Your Health @ BIDMC e-newsletter, September/October 2014