Effective ePCR Program Use

In Memory of the “Bubble Sheet”

There’s no doubt that the introduction of the ePCR (Electronic Patient Care Report) software to the EMS industry has taken us to a new level of efficiency.

The ePCR is a great “Tool of the Trade.”

R.I.P. the “Bubble Sheet” of old which was often a 3-part NCR/Carbon form, filled out painstakingly with long-hand documentation, written by those of us whose handwriting is illegible and atrocious.

We’ve definitely come a long way in the last forty years or so into what constitutes today’s modern Emergency Medical Services documentation.

But like any tool, if you’re trying to use a hammer to tighten a screw or a screw driver to drive a nail, it’s not going to work very well. Use of the ePCR programs can make the same mess if not used appropriately.

Written Narratives

We often are questioned by street providers, during documentation training sessions, about where we feel the best place is to locate the narrative.

Basically there are two locations within most ePCR packages to type and record the trip narrative.

Open Space

Most ePCR programs provide a fairly wide and robust area to type narratives.

You’ll probably fine this area labeled with one of these labels within your ePCR program. These are called “Summary of Events”, “History of Present Illness” and we’ve also seen the area called just “Narrative.”

In most cases the ePCR programmers have left ample space areas of several hundred character-counts to give you, the provider, ample space to type out an effective narrative.

So let those words, sentences and paragraphs flow!

Flow Charts

Chronology of events is crucial to “painting the picture” in words about your incident when documenting your just-completed run.

Be sure to use this space wisely to augment your documentation.

The “flow chart” areas on ePCR programs are labeled a number of different ways, depending on the software package you are using. We see them with headers called “Procedures and Treatments”, “Activity/Flow Chart” or yet another software application calls this area “Treatments and Assessments.”

These areas appear to be spreadsheet-like when completed. The section typically allow you to record a time (using a drop-down menu format), list the treatment/intervention/procedure and then apply a comment such as an outcome, response or even comments about barriers to providing that specific segment of care.

Proper use of the “flow chart” section can augment your narratives greatly. As you all know, per our communications and training sessions, we are seeing an increase in instruction from the Center for Medicare and Medicaid Services (CMS) the Medicare Administrative Contractors (MAC’S), State Medicaid Offices and even Commercial Insurance payers urging the placement of values and objective criteria to be infused into our documentation. These areas on the ePCR programs are the best place to meet those numeric/value-driven objectives.

Outside-the-Box Implementation

Implementing these programs takes some planning and vision, but when used with in ways that fall Outside the Box the efficiently of your organization can be kicked-up exponentially.

An increasing number of our clients are now using mobile devices in the field to capture all the scenario-related data. Patients are signing authorization forms on iPads and rugged tablet devices, ridding the need for paper in many organizations.

When paper is still in play, those documents can easily be scanned upon return to the station (even in the field with portal scan devices) and appended directly to the PCR within the ePCR application for export to various locations (billing office for one example). Archiving is achieved, HIPAA protection is virtually accomplished and indexing and search capabilities can be built in for future retrieval and review aiding everything from QA/QI to supply inventory control and, of course, billing.

Providers are employing voice-to-text options on smart phones, creating a text file narrative and e-mailing or transferring the voice-generated words into the narrative without striking a single key on a keyboard. All this can be accomplished “on the fly” in the field for better use of precious staff time.

And, don’t forget the interface and capture abilities to import EKG monitor data from monitoring device directly into the ePCR interface for Electronic Health Record (EHR) sharing and forward reporting and review.

Kind of makes Johnny and Roy’s bulky radio flip phone seem like the dinosaur it really is in only four decades removed!

Technology Tools

Enhanced Management Services has long encouraged the use of digital technology and ePCR report generation tools in the field.


Because we believe that the future of effective ambulance billing revolves around digital technology.

That’s why we’ve developed cutting-edge applications such as our  client portal with On-Demand Reports and FTP Document Sharing tools built right into the application. It’s why we were one of the first all-EMS billing contractors to offer an online patient interaction solution.

Current clients are easily sharing PCR information using scripted import/export capabilities and all data sharing of PCR’s is backed up using our simple Trip Tracker e-mail confirmation system.

And there’s more technology in the works to “enhance” the client experience. Stay tuned!

If your department is not using us for your billing needs, it’s time to check us out.

It’s time you started riding the digital info wave to greater billing efficiencies!! 

Leave a Reply

Your email address will not be published. Required fields are marked *