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Ambulance NSW rolls out paperless office

The Ambulance Service of NSW is rolling out electronic medical records as part of a system-wide change designed to eliminate paper records from the back of ambulances.

The Challenge: Eliminate paper-based records from being used in ambulances.

The Approach: The NSW Ambulance Service has undertaken a four-year program to roll out electronic medical records into ambulances.

The Outcomes: Reduced error, easier record keeping.

The Lessons Learned: Paramedics are generally keen on the computerisation of what has traditionally been a paper-based service.

The Upside for:

Clinicians: The next phase is to electronically transfer notes to clinicians in hospitals, further reducing the use of paper and the potential for errors.

Patients: The EMR will interface with the forthcoming PCEHR, allowing a better view of the patient’s medical history.

The Organisation: Moving from paper to computer makes for better audit trails, easier record keeping and superior information management.

The Ambulance NSW story

There’s a room at most ambulance stations you won’t hear anything about. It’s chock-full of paper records which the service needs to keep for between three and seven years in case there’s a question about a treatment needing an answer, or if a case goes before a court.

However the days of the record room are numbered. As part of a four year project, the Ambulance Service of NSW is phasing out paper-based records in favour of an electronic medical record which will see ruggedised laptops placed in the back of every ambulance in NSW.

“The way that paramedics have done it in the past is that they collect notes on an A3 document in triplicate,” said Jacqui Burford, electronic medical record program manager at Ambulance Service NSW. “We originally went to NSW Treasury for funding in 2006, when it became apparent that computerisation was the way to go.”

The system used by the Ambulance Service was originally developed by Ambulance Victoria, which subsequently made it available to other jurisdictions. The plan is to have all the ambulance services on the eastern seaboard using the same system.

The paper-based records have served well, but their day has passed, remarks Ms Burford. “The primary reason for collecting this information is to pass it onto the hospital clinicians, so that there’s not just a verbal record, but a physical record.”

With the current iteration of the EMR, the paramedic must still print out the EMR for handover to the clinicians once they get to the hospital. “The next phase of the roll-out is to have the records transferred electronically to hospitals,” Ms Burford said.

The ruggedised laptop used by the paramedic lives in the back of the ambulance. It is 3G-enabled, meaning it can wirelessly receive dispatch information from Ambulance HQ at Rozelle and automatically populate fields with patient data in the EMR. “This saves time for the paramedic,” said Ms Burford. “The paramedic also has access to the MIMS database so that they can look up medications if they are not familiar with them, and look for potential drug interactions.”

Ms Burford said the Ambulance Service is currently in the final phases of training the 4000 paramedics employed by the service. Training entails a six hour session, with additional field support on top of that.

In future, said Ms Burford, along with the ability to transfer data to hospitals, the EMR will also interface with the defibrillator to store images of the ECG. It has also been designed to interface with the forthcoming personally controlled electronic healthcare record, which Ms Burford said will have great benefits for the paramedic in the field.

“Being able to access a person’s history will help us provide them with better care,” she said.


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