ERA – Electronic Records in Ambulances

Increasingly, ambulance services have a role to play in keeping people out of hospital. Instead of transporting people to the emergency department, they might provide them with care in their own home, or refer them to a community-based provider such as a falls service. For this to happen safely and effectively, paramedics need to be able to make the right decision for patients, for which they need the right information; they need to be able easily and accurately to pass on the patient’s details; and they need to make a record of their contact with their patient.

 
Technology can have a role in helping paramedics with all of these, and so help to keep people out of hospital. Electronic records are not just useful in their own right, but can be linked to other technology which helps paramedics to make the correct decision and put people in touch with services to help them. Some ambulance services are recording patient information electronically, but some are not. It is known that switching to new technology is not always straightforward and it can make a change to people’s jobs – sometimes in ways which aren’t expected.

 
This research aims to find out how ambulance services can make the best use of information technology to support people with good quality care out of hospital, it will look at what happens day to day, when paramedics use technology in practice; at how the ambulance service as an organisation starts to use new technology and adapts to the changing landscape of care; and at what happens in between, as paramedics respond to this changing environment, learn new skills and change their role and practice. Researchers will talk to all the ambulance services in the UK to find out what they are doing in terms of introducing electronic records and other IT to support care delivery and decision making followed by a detailed study of four ambulance services – one service which has used electronic records for a few years, one which does not use them, and two which are part way through bringing them into use. In each area there is a research paramedic who finds out about how decisions are made about using electronic records and technology, whether and how they are used, what people feel about them, and what difference they have made (or could make) to how paramedics and the service work. Data about current levels and patterns of usage of electronic records will be analysed.

 
Discussions will be had with paramedics, managers, and people running other relevant health services, researchers will read reports and documents and spend time on ambulances looking at how records and other technology are used and will compare what has gone on across the four sites. Detailed analysis for care of people with three particular conditions (falls, diabetic hypoglycaemia, mental health crisis) which have potential for increased non-conveyance, to see what difference electronic records in ambulances are making – or could make – to people with those conditions. Finally all UK ambulance service will be brought together to talk about what has been found and discuss what they think will be the best way to make use of technology to help paramedics keep people out of hospital.

 

Participating ambulance services: WAST-Welsh Ambulance Service, SWAST- South West Ambulance Service, EMAS- East Midlands Ambulance Service, SAS- Scottish Ambulance Service