Q&A: How Can EMS Agencies Leverage Technology for Growth & Evolution?

In this Q&A, EMS1 talks with Pulsara’s Kris Kaull about the importance of communication, how to improve it with the right technology, and how the role of EMS in the overall healthcare landscape is changing.

With mobile integrated health and the expanded scope of community paramedicine, we’ll be
that out-of-hospital caregiver, not prehospital. The COVID-19 pandemic has already rapidly modified our scope to meet the unprecedented needs. We are not just one step in a linear progression from the time of injury to arrival at the hospital. Instead, we are another access channel for healthcare and ongoing wellness in our communities, and there’s a lot of discussion around technology and how we communicate.

EMTs and paramedics need to be able to communicate dynamically with different people, for different needs, for different patients, each and every call. And the technologies to allow them to do that in a safe and secure, HIPAA- compliant way will need to be dynamic and able to cross different organizations, not just from point A to point B, not just from the back of the ambulance to the emergency department.

How is Pulsara addressing these challenges, including HIPAA compliance? 

The technology is really about connecting the people. Who are the people that need to be connected, and how do we do that on the fly? And, because every call is different, how do we connect the right people at the right time with a simple tap? That’s what Pulsara does. It allows EMS services or hospital facilities, nursing homes, standalone emergency departments, urgent cares, and referring hospitals all to be on the same network with each other and to be able to communicate in real time.

Pulsara is fully HIPAA-compliant. It’s encrypted at both ends, meaning at the sender’s end on their smart device, as well as the receiver’s end and at rest. For example, EMS personnel show up on scene of a car crash, they take photos of the scene and the injuries. Those images are sent with the patient alert to the hospital requesting the trauma team. The hospital then alerts all the caregivers within the hospital that are part of that trauma team on their smart devices. At the end of the day, none of the sensitive data is actually on the phone. None of those photos are in the camera roll. It was all done within a HIPAA- compliant, secure encrypted app.

So you're adding a purpose-built tool for first responders to that familiar smartphone, rather than them needing a new device or mode of communication. 

Yes. Healthcare providers – from physicians to nurses to lab techs to allied health to paramedics – use what they normally use in their real life. Take that same car crash example. If it’s easier to FaceTime or make a phone call or text the hospital with those images, that’s what they do, including physician to physician; even if it’s against policy and not secure.

The key to great design isn’t to change the behavior of what they do naturally. I would argue that if live video, messaging, sending photos, and recording audio are a well-thought-out, good way to communicate day-to-day, then it’s probably a good way to communicate about the patient within that setting. The only difference is that we need to put safeguards around it so that we can be protected and we know where that data is, who’s seen it, and that we are protecting the community and the providers from needless liability.

When an entire region is using the same communication platform, it enables the opportunity for transparent communications without a lot of back and forth. Ineffective communication, especially during transitions of care, is the No. 1 cause for medical errors in healthcare.

What's the difference between sharing data and communicating?

I do think there’s a difference between communication and data. Let’s go back to the future concept that all medical devices in the back of the ambulance are smart devices. And, for the sake of this example, let’s agree that they are all seamlessly interoperable with each other. Ideally, there’s an opportunity for all that data to automatically flow into one clear, chronological picture within the documented patient care report. It’s good for streamlining the paramedic workload, it’s good for quality assurance, it’s good for consistency of patient care, it’s good for billing – it’s good for a number of things. That is data.

And then there’s also communication. You are sharing data, but it’s about sharing the right information at the right time with the right people for the right patient. So, what are the key pieces of data that I need now – in real time – in order to mobilize the right resources and then make the right decisions for my patient? That’s what communication is.

Data and communications are partners in patient care, but we often blur the lines and say that interoperability, smart machines, wearables, health information exchanges, data repositories, or post care documentation are the same as communicating, but they aren’t. When treating and transporting the trauma patient from the car crash, the paramedic may have access to a thousand pieces of data, but at that moment, the emergency department doesn’t need to know all 1,000 data points. They simply need to know key pieces of information so that they have the right people and resources available upon EMS arrival at the hospital.

What's next for EMS?

The EMS industry must be proactive to the ongoing and changing needs of our communities. In preparation, we should be incorporating technologies, processes and leadership skills that allow us to scale and change accordingly.

If you want a glimpse into the future of EMS, just take a look at what you do in your regular life. So, if my mother, who’s in her late 60s, can video chat with my nephew who’s 3, and they don’t need an instruction book, that’s probably a good way to transfer information. We should consider communicating in a similar fashion in the back of the ambulance.

Download the full 2020 EMS Trend Report here.