Tuesday, December 1, 2009

No Patient Found - Defining Response Dispositions

A new incident template has been created within ImageTrend to streamline the documentation of incidents when no patient is found. This template also provides for a signature block for a Witness to EMS Arrival that no care was requested or required. Below the screen shots are some considerations when using the template specifically pertaining to the definition and the intended use of Response Dispositions.




The current common treatment guidelines provide a definition of a patient as:




Response dispositions provide for several options when documenting the disposition of the call.


  • Treated, Transported by EMS – When a patient is treated and transported by the reporting unit.    
  • Treated and Refused Transport  - When treatment is provided to a patient, but transportation is refused.    
  • Patient Refused Care – When a patient is identified based on the criteria above, but the patient refuses care.   
  • Treated, Transferred Care  - When a patient is treated and transportation is provided by other than the reporting unit.  
  • No Patient Found  - When no patient is found based on the criteria above.   
  • Cancelled – When a reporting unit does not arrive on scene.   
  • Dead at Scene  - When a patient is dead at scene, treated or not treated.  



Thursday, August 13, 2009

Completed vs Locked Document - Protecting The Integrity of Your PCR Data

The history of patient care reporting in Lee County made a huge leap with the selection of the ImageTrend solution. With earlier version of patient care reporting whether paper or electronic, once the patient care report was submitted for billing purposes then the patient care report was complete. Certainly an addendum could be done to add any extra information to the report, but not to the degree that information can be added to the ImageTrend solution. With ImageTrend, crews have the ability to view the documents and the information as appears to anyone who might retrieve the data in the future. Making a change on the Service Bridge today directly reflects the information that appears in the official record.


This ability has created a new set of issues for Lee County as well. Patient care reports must be submitted to the billing vendor in order to recover revenue. This occurs through an automated process that runs nightly (@1 a.m. EST) that looks at the validity of the call and the status of the call and determines whether or not it is acceptable to move on to the billing vendor. There are a series of algorithms that this process looks at to determine whether the PCR moves forward for billing, or moves into a status that requires a review of data. If when this automated process runs, the PCR has a score of 100% validity then it will be Locked and Completed.


What do these automated processes mean for you and Lee County? As the author of information, there is an incentive for the calls to be locked and completed.

A)      It means that you did your work and this work was billable.

B)      It means that the document that you prepared to support your work cannot be altered without a recording of what changes were made occurs.

C)      Any changes that are made to the document require a supervisor to unlock the PCR so that changes can be made. Even when unlocked, these changes are recorded.



Locked means the document is locked and no changes can be made to the document without authority.

Completed means that changes can be made to the document and these changes will be recorded in an audit trail.


The screenshots depict the various screens that you will see as relates to this document.


What does this topic require of you? Nothing specifically; however, if you are truly concerned about the quality and integrity of your document before the end of each shift visit Safelee, verify that your document has 100% valid, complete and accurate, then Mark Run as Completed. This will ensure any changes that are made are recorded for your protection. Once a document is marked as completed, the only changes or updates to the document must occur on the Service Bridge. If you fail to upload input into the document before it is marked as completed, then realize it the next shift, this will require you to request a supervisor to unlock the document and input the data into the Service Bridge.






Monday, August 3, 2009

Transfer of Care & Validity Compliance


Frustrated that you ran a call, transferred care and now the software won’t accept 0 miles. This is a result of not selecting an accurate destination type. When transferring patient care, this can be done in one of two places – onscene or not onscene. If patient care is transferred at scene then mileage is not required. If patient care is transferred at other than the scene, then mileage is required.


  • Other EMS Responder (Ground) – Mileage Not Required
  • Other EMS Responder (Air) – Mileage Not Required
  • Other EMS Responder (At Scene Ground) – Mileage > 0 Required
  • Other EMS Responder (At Scene Air) – Mileage > 0 Required

Do No Have Proper Credentials?

Are you getting the error that reads, “Field Bridge is unable to post, current user does not have proper credentials.  Please log-off and log back in, if it continues contact administrator.” This is likely because you changed your password on the Service Bridge (web interface) and that password has not synched down to the Field Bridge (Toughbook/client interface). When this happens, simply Sync the software so that it pulls down your new credentials (password) and you should be find.


Currently, passwords are set to be reset every 60 days. We are working to determining if this window of time is sufficient based on HIPAA and security considerations.


Wednesday, July 29, 2009

Switching Between Templates Using ImageTrend

If you ever started a PCR and then the disposition of the incident changed, you can now switch to the template that is most appropriate for the case.
With ImageTrend 4.2, a "Switch" button sits in the top right corner of the application. By selecting the "Switch" button, the desirable template can be selected.

Monday, July 20, 2009

Auto-Post Records to Server

The ImageTrend Field Bridge software experienced an error that occurred on July 14-15 that affected 131 calls. As of today, 59 of those calls have arrived at the server in their entirety. However, there are still a remaining 72 PCRs that need to be posted to ensure accurate record keeping and billing procedures.

In order to ensure these remaining records arrive at the server, the following four steps should be taken as soon as practical by field providers. In addition, the practice of closing the application and reopening should become more common practice to ensure that the proper user is logged in and so that the auto-posting feature can be taken advantage of.


Thursday, July 9, 2009

ImageTrend Errors Occuring?


When errors occur in ImageTrend, the best way to help determine the root of the problem is to post the error logs. In this past, this was a time consuming effort; however, today the software is streamlined to allow it to occur in three easy steps. Once you have an internet connection, then simply follow three easy steps.

Ø       1. Select Help / Support

Ø       2. Select View Error Log

Ø       3. Select Post Error Log

This will help ImageTrend technicians determine what the issue is and work toward resolution.