JMIR Publications

ABSTRACT

Background:

With the aging society, the number of emergency transportation has been growing. Although it is important that a patient be immediately transported to an appropriate hospital for proper management, accurate diagnosis in the prehospital setting is challenging. However, at present, patient information is mainly communicated by telephone, which has a potential risk of communication errors such as mishearing. Sharing correct and detailed prehospital information with emergency departments (EDs) should facilitate optimal patient care and resource utilization. Therefore, the implementation of an application that provides on-site, real-time information to emergency physicians could be useful for early preparation, intervention, and effective use of medical and human resources.

Objective:

We aimed to examine whether the implementation of a mobile application for emergency medical service (EMS) reduced phone-communication time, which was the time for EMS to negotiate with ED staffs for transport requests.

Methods:

We performed an interrupted time-series analysis (ITSA) on the data from a tertiary care hospital in Japan from July 2021 to October 2021 (8 weeks pre-implementation period and 8 weeks post-implementation period). We included all patients transported by EMS. Using the mobile application, EMS can send information on patient demographics, vital signs, medications, and photos of the scene to the ED. The outcome measure was the phone communication time.

Results:

During the study period, 1966 emergency transportations were made (1033 patients during pre-implementation period, and 933 patients during implemented period). The ITSA revealed a significant decrease in mean phone-communication time between pre- and post-implementation periods (from 216 to 171 seconds; −45 seconds; 95% CI, −71 to −18 seconds). From the pre- to post-implementation period, the mean transportation time from EMS request to ED arrival decreased by 0.29 minutes (from 36.1 minutes to 35.9 minutes; 95% CI, −2.20 to 1.60 minutes), without change in time-trends. We also introduced cases where the application allowed EMS to share accurate and detailed prehospital information with the emergency department, resulting in timely intervention and reducing the burden on the ED.

Conclusions:

The implementation of a mobile application for EMS was associated with reduced phone-communication time by −45 seconds (22%) without extending overall transportation time despite the implementation of new methods in the real clinical setting. In addition, real-time patient information sharing, such as the transfer of monitor images and photos of the accident site, could facilitate optimal patient care and resource utilization. Clinical Trial: none