Computers in EMS

[pd125 0]

Started to look around for a computer to use in the ambulances. Found several vendors and started to get pricing. I know there are some people on this forum who worked with rugged computers in or out of EMS. Your 2 cent will be helpful.

Thanks

Edited February 18, 2009 by pd125

[jack10562 414]

The most popular fully-rugged laptop used by many Police, Fire, Utilities, Etc, is the Panasonic Toughbook.

They're not cheap, but they are certainly durable.

We use them at Con Ed for in-vehicle CAD (emergency dispatching) and all field service paperwork and forms are electronic.

There is a LOT more to it than just hardware, including vehicle mounting and installation, you need to buy a software package that includes the healthcare applications medical professionals will need. You want something that is compatible with the hospitals' data systems for easy access to your patients medical status that was entered by your EMT's.

Will you have wireless (cellular) connectivity, so patient info can be transmitted to the doctors to help them prepare for your patient's arrival?

[FFFORD 27]

x2 on the toughbook...if you got the money for it that's what i'd buy

[smwells 7]

Scope out the whole picture

1. As jack10562 indicated can your hospital support electronic submissions, if so, find out what software and hardware they support.

2. What is your department plans for the data collected, archiving and submission to the state are all factors to consider.

I started to look at ePCR systems for my department a few years back and found the area facilities were not ready to support them, and the expense to get them online for record keeping was steep. I am sure things have improved, but do your homework before making the jump.

The toughbooks are great units, but I have seen others that have good durability without the hefty price tag.

[helicopper 1,050]

Ditto on all of the above.

What are you using the computer for? Will it be mounted or portable? What type of data entry will be required (key pad, electronic stylus, etc.)?

[Goose 188]

If you are going for ePCR you are going to have to build a server to store all your PCRs. This alone is a multi-thousand dollar investment. What ePCR software are you looking to use - remeber much of the software comes as a rough outline and you adjust/build it up to your state/agency needs. Next you have to figure out how you are going to get the info to the server - wi reless or wired? If wireless explore the options of carriers with solid network coverage - what type of wireless modems do they offer? Once you have those things squared away, choose your field computers. Toughbooks are alright (worked in systems that had major issues with hard drive failures on them) General Dynamics also makes a tablet field computer with a touch screen. You have a few options available and your looking at a huge investment. Get in touch with some agencies in westchester that are electronic and get some feedback from them as well. Also, don't forget to talk with your recieving ERs, the state and the region and you will need permission from them. Generally it will be a bumpy transition and there a strenghts and drawbacks to both paper and digital.Best of luck!

[mstrang1 213]

Although I am not familiar in any way with their software, Stamford EMS has laptops for PCRs. This is in addition to the MDT mounted in the ambulance. The mounted units are regular Toughbooks and the portable units are the ones with the screen that spins around, I am too lazy right now to find out what they are called.

[dxn8388 0]

Hey,

I go to school in Rochester, NY and mostly the entire Monroe County ems system uses EMS Charts. It is definitely a different feel than regular PCRs but it does help get everything organized on the internet. Also, it is all online based and on the website you can post training/events on the calendar, online training documents, certification expiration dates and such. It is a pretty useful piece of software. For the laptop, ive seen everything from Toughbooks to Gateway tablets. Whatever works for the price range is good.

[T. John 21]

Take a look at Itronix (now part of General Dynamics). I have used them in the past and found them to be equal to Panasonic (a little cheaper though).

http://www.gd-itronix.com/

[jk969 1]

In NJ , EMSCharts is gaining popularity, especially now that NJ State OEMS is providing the software for free. Many agencies are using toughbooks, however, some are using rugged PDA devices to capture electronic signatures and basic patient information. This data can then be transferred to a desktop computer via USB and the chart can be completed on the computer. The PDA is half the cost of the laptop. Hope this helps... Jeff

http://www.symbol.com/product.php?productID=240

[knronald 2]

Started to look around for a computer to use in the ambulances. Found several vendors and started to get pricing. I know there are some people on this forum who worked with rugged computers in or out of EMS. Your 2 cent will be helpful.

Thanks

You may to consider the Motorola Ruggedized computers that are in mnay of the police cars such as Greenburgh, Harrison, Yorktown and Ossining. They are availbale on NYS contract and are 35% off at this time. Contact your Motorola dealer.

[FDNYDCHI 38]

One thing I was thinking about while reading this topic is, security of the PC as well as the Data on the computer because You have people's medical history right at your finger tips. With the ePCR's and stuff is there encription and stuff built in and also what about computer acess?

Just somthing to think about?

Chris

[Goose 188]

One thing I was thinking about while reading this topic is, security of the PC as well as the Data on the computer because You have people's medical history right at your finger tips. With the ePCR's and stuff is there encription and stuff built in and also what about computer acess?

Just somthing to think about?

Chris

I suppose it depends on your system. Most systems a crew needs to log on and if they log out jobs are only accessible once logging back in - each with their own unique password. As far as sending jobs to a sever, it is encrypted. Like with anything else electronic, the proper safety measures need to be taken - firewalls, data encryption, etc. Definitely something you want an IT professional/company to assist you with.

Zoll Data Systems (division of the company that makes Zoll monitors, defbis, autopulse, etc) is also a popular software package of choice for a number of EMS agencies. Not only do they make ePCR software, but they actually make scheduling and employee tracking (ie: expiration dates of certs, etc.) software. Other companies include ESO, RAM Software, CodeRedEMS...the list goes on and on.

You're probably looking at a year to year and a half lead time until things hit the streets. It's a big conversion that takes a lot of time, money and thought.

Edited February 19, 2009 by Goose

[ny10570 745]

jk969 mentioned what I've been waiting to see. PDA size versions. The full size tablet is such a headache especially when you're talking ALS where everyone is all ready carrying a lot. Does anyone have experience with or seen a PDA type system?

[pcfpr1 11]

If youre looking to get started or just plain looking into the ePCR systems i reccomend contacting the head individuals who got their own programs started with such agencies as...

1. Town of Mamaroneck Ambulance District (mamaroneck ems and larchmont vac)-contact the district supervisor

2. Port Chester EMS (port chester, rye, rye brook)- contact the chief

3. Harrison EMS (harrison, purchase, west harrison)- contact the Cheif...not to mention they very recently started this program so this would be a good choice to contact.

4. Stamford EMS (stamford)- contact supervisor

5. Empress EMS (commercial transport and 911 service)- contact main office for info.

in addition if you do decide to travel this ePCR route...bare in mind your personel will need to practice on them at least for a month or so..it takes some getting used to..(reccomending moc calls and such) get used to the system you will be using... not to mention the proccess for RMA's and cancelled jobs your still filling out about 25% of the ePCR.

hope some of this info helps you along your way..

[ckroll 101]

The most popular fully-rugged laptop used by many Police, Fire, Utilities, Etc, is the Panasonic Toughbook.

They're not cheap, but they are certainly durable.

We use them at Con Ed for in-vehicle CAD (emergency dispatching) and all field service paperwork and forms are electronic.

There is a LOT more to it than just hardware, including vehicle mounting and installation, you need to buy a software package that includes the healthcare applications medical professionals will need. You want something that is compatible with the hospitals' data systems for easy access to your patients medical status that was entered by your EMT's.

Will you have wireless (cellular) connectivity, so patient info can be transmitted to the doctors to help them prepare for your patient's arrival?

I've got to be a dinosaur on this one. What patient information? By the time you get the computer fired up, logged in, figured out why it won't let you in, reboot, well,... you don't even know why your patient called for assistance and you certainly haven't taken a history, gotten vitals or forbid, done a thorough physical exam or performed skills. That, or you are on scene for 30 minutes. Now you get to one of the three different hospitals to which you transport and transfer the information how?

Empire went to toughbooks when they won the Putnam contract back in 2006 [?]. Many of us spent more time trying to get into the system and keeping it running than we did using it. In theory it's great, just hit buttons and everything gets recorded, big brother gets to watch. In practice, it puts one more obstacle between the provider and the patient.

When choosing when and where to use computers and data entry, ask yourself where patient and patient care fits in. If I or my family is ever a patient in an ambulance and I hear the 'health care provider' typing, well they don't make a computer that's going to survive what happens next.

[Goose 188]

I've got to be a dinosaur on this one. What patient information? By the time you get the computer fired up, logged in, figured out why it won't let you in, reboot, well,... you don't even know why your patient called for assistance and you certainly haven't taken a history, gotten vitals or forbid, done a thorough physical exam or performed skills. That, or you are on scene for 30 minutes. Now you get to one of the three different hospitals to which you transport and transfer the information how?

Empire went to toughbooks when they won the Putnam contract back in 2006 [?]. Many of us spent more time trying to get into the system and keeping it running than we did using it. In theory it's great, just hit buttons and everything gets recorded, big brother gets to watch. In practice, it puts one more obstacle between the provider and the patient.

When choosing when and where to use computers and data entry, ask yourself where patient and patient care fits in. If I or my family is ever a patient in an ambulance and I hear the 'health care provider' typing, well they don't make a computer that's going to survive what happens next.

The empire toughbooks were intended for the cad, they never had anything to do with EPCR or patient care. And yeah, they never ever worked as originally intended.

As far as patient care - it doesn't suffer. Paper or electronic you treat and then document your treatment. If the EMT/Medic is more concerned with writing the job up than treating the patient - paper, plaster or digital the patient will suffer.

It's state law in Connecticut that all PCRs are electronic and they seem to be doing pretty well. Besides, like it or not, it will be mandatory within the next 10 years.

[helicopper 1,050]

Has the original poster been back to tell us what application the computers are for? Is it CAD interface, e-PCR, or just solitaire between jobs?

That will guide us all in answering the question and help us focus on his application for them.

[Guest paramedico987]

We've been working on Panasonic Toughbooks, using Zoll Data Systems software for over a year now, at Empress.

Like everything it has its advantages and drawbacks. Overall I'd have to say, that it is better than paper.

One point of caution.... If you're going to have portable internet connectivity as part of your system, make sure to set it up so that any wireless modems/wi-fi cards/air cards/etc are integral to the units. We find that the "Air Cards" sticking out of the computers are very easily broken.

Also, think about support infrastructure for the system. We constantly have to keep on top of battery charging issues.

We also have encountered several areas of difficulty surrounding transfer of data TO the system from EKG monitors. I'd strongly recommend knowing how you'll be doing those sorts of things ahead of time.

[Skooter92 7]

At Stamford EMS (SEMS), we have been up and running with EMSCharts for some time now, after using another electronic charting system prior to switching. EMSCharts has two components, a mobile version that you can complete the chart in and capture signatures before uploading to EMSCharts's servers, or you can collect a basic data set and signatures and then upload to EMSCharts's site and then finish in their Web-based software. You can easily connect to printers in most hospitals to print out a copy of your record, or the ability to create a PDF or other image file of the chart exists that can be then given or transmitted to the receiving institution. It has a very customizable format and has some great features for QA/QI report generating. It will generate reports specific to any state's data set reporting requirements (believe me, I checked on this!!) and also output elements for NEMSIS reporting. Best off, the cost is minimal to use and the only things you need to have are the platforms to generate reports and capture signatures (if you require them), and the ability to get that data to EMSCharts. All in all, the experience is pretty painless and report writing is quick depending on how your system administrator configures your version. If anyone is interested in seeing how SEMS is using EMSCharts, from soup to nuts, let me know and I can arrage something with one of our chiefs.

[Skooter92 7]

P.S. We're using Panasonic Toughbook CF-29s. They're OK, but a little clunky.

[eagle5473 7]

Most services in Western CT from the coast up to te Mass line are using EMS Charts. CT is requireing all services to be on E-Pcrs. The nice thing with EMScharts from a Volunteer side is that you do not need to go to the bay to complete a chart, just log on to any computer and you can write your form. It takes a little getting used to but it is ot that bad we are using CF19's provided by the State of CT, but all of our hospitals have work stations set up for EMS charts, we rarely use the laptop. You can still use a paper form for signatures if you want and upload it to the chart.

Also the cost is very reasonable we have the basic version with no billing runs about $1200 a year I think thats up to 1000 calls or something

[pd125 0]

Has the original poster been back to tell us what application the computers are for? Is it CAD interface, e-PCR, or just solitaire between jobs?

That will guide us all in answering the question and help us focus on his application for them.

Yea I got several good leads on vendors and pick up on two makers that I have not heard of. Thanks to all who gave an opinion on what works and what doesn't. The main reason is for PCR's we started to use EMS charts as a database and love it we want to take it to the next level. The main problem is while everyone can tell you the best laptop they have no idea on a rugged system. I has seen a lot of the vendors offers a "XP downgrade" Vista is that bad?

Thanks again for all the input.

[OoO 24]

Yea I got several good leads on vendors and pick up on two makers that I have not heard of. Thanks to all who gave an opinion on what works and what doesn't. The main reason is for PCR's we started to use EMS charts as a database and love it we want to take it to the next level. The main problem is while everyone can tell you the best laptop they have no idea on a rugged system. I has seen a lot of the vendors offers a "XP downgrade" Vista is that bad?

Thanks again for all the input.

Vista's really not as bad as people make it out to be. Pretty much all of the compatibility issues have been resolved and the interface is more or less the same. It just takes so getting used to and some tweaking to receive less notifications.

[SRS131EMTFF 471]

Yea I got several good leads on vendors and pick up on two makers that I have not heard of. Thanks to all who gave an opinion on what works and what doesn't. The main reason is for PCR's we started to use EMS charts as a database and love it we want to take it to the next level. The main problem is while everyone can tell you the best laptop they have no idea on a rugged system. I has seen a lot of the vendors offers a "XP downgrade" Vista is that bad?

Thanks again for all the input.

I am not going to say that the XP downgrade is a good thing or a bad thing for what you want but I would not by a PC with a windows Vista operating system. Vista has been constantly troubled by problems and has been constantly updated and upgraded so that it functions well. There are many problems with the vista operating system as a whole, if I were to get a PC I would rather it be on XP then Vista, Vista has been a snafu for Microsoft and now they are going to release a windows 7 if I am not mistaken to fix some if not many of the issues that many people are having with Vista.

If the software can support mac then go for that, by far the best computer I have ever owned, easy to use and never any problems ever, it even updates, saves and configures itself....I dont think they make a tough or duty ready Mac however.

Edited March 4, 2009 by bvfdjc316

[Goose 188]

Vista is overkill for an ePCR unit. XP is far more stable and familiar.

And no, do not buy a mac. This isn't a home computer, this is a working computer. There are no rugged options from Apple as they are simply not in the public safety market and really have no interest to enter that market. And, no, i'm not a MS fanboy, i'm writing this on my Macbook.

Edited March 4, 2009 by Goose