Several months ago, Google launched a new service called Google Health. Google Health is intended to provide patients and healthcare providers with a single common resource and information point. It currently allows patients to set up a profile, and share that data with providers and services they authorize. Several major medical centers and other providers are amongst the test providers. Beth Israel Deaconess Medical Center, and the Cleveland Clinic are the first two major medical centers to participate, along with Longs Drugs, Walgreens, Medco, Quest Diagnostics and Minute Clinic from CVS/Caremark are also participating. Google health is a potential treasure trove of information for EMS providers.
     Google Health's goal is to provide patients with portability of, and access to their medical records. The concept is that patients will be able to authorize a provider to access their records, and streamline the access of data within providers. Increasingly, EMS is utilizing internet enabled devices for ePCR use, this opens the door to possible use in the field.  Let's take a look at how a call might go if your agency was a Google Health Participant.
      You are sent to a residential address for a unresponsive female. on arrival, you find a 56 y/o female, whom is unresponsive. The family says that she was at the doctor's office earlier today for back pain and had a prescription filled at her normal pharmacy, took two pills and came over to her daughters house for dinner. You enter the patients name and date of birth into your ePCR tablet, which checks Google's database and the patient is found in the system. Your patient has previously added XYZ Ambulance as an authorized provider, and your ePCR automatically imports the patients demographic, insurance, past medical history, and current medication list, including the script filled earlier today, which was a powerful pain medication. Your physical assessment findings support the possibility of over medication. You start an IV, give some naloxone and the patient wakes up, now compaining of weakness. You arrive at the ED, link your ePCR to the hospital's medical records system and your ePCR is automatically imported to the ED, registering the patient and importing your ePCR data. While an over simplistic view of how a call may go, and a scenario that would be fairly easily handled in the field without the additional data, it shows how the availability of data may help EMS and ED providers. The availability of PMH data, primary MD, meds, and prior test results are all potentially important data for EMS and ED providers.
      The technology to do this is available, and being implemented in a variety of health care services. I think it is important for EMS to keep abreast of these changes, and preferably become a part of these initiatives. As EMS continues to advance the technologies we use, it is important to partner with other healthcare entities to increase integration and data portability. Increasing the ability to electronically transfer data  offers EMS a variety of ways to decrease costs, and improve the velocity of the billing process. As an example, lets say that XYZ Ambulance service has partnered with ABC Health services who operates three of the hospitals that XYZ transports to. XYZ Ambulance transports about 50,000 patients to ABC facilities. When an XYZ unit arrives at an ABC ED, they are able to transmit their ePCR to ABC's data system. ABC's ED is able to automatically register the patient, create a new medical record number, and fill in any blanks in XYZ's information such as insurance information. When a report is given to the  receiving RN, that RN is able to view the prehospital care data that has already been imported into the patients electronic record. The hospital saves time and employee effort in the registration process, reducing costs. The EMS crew and  receiving RN save time and effort by the correct information being recorded in the hospital's electronic record. The EMS crew saves time and decreases reporting time, which should help decrease turnaround time and Time On Task (TOT), saving the EMS system costs. The patient benefits by a more accurate exchange of clinical information. Additionally, the EMS agency saves billing costs by increasing the availability of accurate insurance data, reducing the time of claims.
      EMS agencies may even be able to partner with  receiving hospital to fund the implementation of ePCR systems. The advantages of this type of ePCR system would provide considerable cost savings to the hospitals as well as EMS. Let's say that the hospital is able to save 5 minutes on every registration done utilizing this system, they stand to save over four thousand man hours in registration costs alone. Saving an additonal five minutes by exporting patient care data could save an additional four thousand hours, now of nursing hours. EMS stands to save close to 8 thousand unit hours, freeing up units to respond to calls or posting ocations, reducing response times. This type of cost savings may encourage hospitals to consider assisting funding EMS ePCR intiatives. Should XYZ have the interfacility transport contract for ABC, the savings would only increase. 
     Granted, the above type of system would require changes in hospital policies, and significant work from both hospital and EMS software vendors, but with demand, those  changes are possible.