Abstract
Paramedics and Emergency Medical Technicians (EMTs) often serve dual roles in their communities as both emergency medical providers and firefighters. Therefore, the demands and needs of these providers are different than those working directly in a hospital emergency room or medical office. Medics are required to treat a patient in less than ideal conditions where seconds can mean the difference between life and death. The goal of this work is to better understand how research informing technology for the emergency room (ER) can be linked to improving the user experience of EMTs and paramedics in the field. Through a review of relevant literature, we capture lessons learned in conveying information quickly, linking necessary information from disparate sources, and giving these providers accurate information to successfully treat and transport patients during prehospital care.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Lluch, M.: Healthcare professionals’ organisational barriers to health information technologies—a literature review. Int. J. Med. Inform. 80(12), 849–862 (2011)
Pozner, C.N., Zane, R., Nelson, S.J., Levine, M.: International EMS systems: The United States: past, present, and future. Resuscitation 60, 239–244 (2004)
Roudsari, B.S., et al.: International comparison of prehospital trauma care systems. Injury 38(9), 993–1000 (2007)
Breyer, T.: An analysis of rules, regulations, and policies to identify opportunities and limitations for fire-based EMS systems to integrate into healthcare using a community paramedic model. Int. Fire Serv. J. Leadersh. Manage. 9, 41–48 (2015)
Peyravi, M.R., Modirian, M.J., Ettehadi, R., Pourmohammadi, K.: Improving medical emergency services system by evaluating patient satisfaction: means for health management. J. Heal. Manag. Informatics 1(1), 15–18 (2014)
Curka, P.A., Pepe, P.E., Zachariah, S., Gray, G.D.: Incidence, source, and nature of complaints received in a large, urban emergency medical services system. Acad. Emerg. Med. 2(6), 508–512 (1995)
Persse, D.E., Jarvis, J.L., Corpening, J., Harris, B.: Customer satisfaction in a large urban fire department emergency medical services system. Acad. Emerg. Med. 6563(03), 106–110 (2003)
Carr, C., et al.: When should ED physicians use an HIE? Predicting presence of patient data in an HIE. South. Med. J. 109(7), 427–433 (2017)
Ratwani, R.M., Fairbanks, R.J., Zachary Hettinger, A., Benda, N.C.: Electronic health record usability: analysis of the user-centered design processes of eleven electronic health record vendors. J. Am. Med. Inform. Assoc. 22(6), 1179–1182 (2015)
Bigham, B.L., et al.: Patient safety in emergency medical services: a systematic review of the literature. Prehosp. Emerg. Care 16(1), 20–35 (2012)
Redhead, C.S.: The Health Information Technology for Economic and Clinical Health (HITECH) Act (2009)
Baird, S., Boak, G.: Leading change: introducing an electronic medical record system to a paramedic service. Leadersh. Health Serv. (Bradf. Engl.) 29, 136–150 (2015)
Eden, R., Burton-Jones, A., Scott, I., Staib, A., Sullivan, C.: Effects of eHealth on hospital practice: synthesis of the current literature. Aust. Heal. Rev. 42(5), 568–578 (2018)
Akhlaq, A., Sheikh, A., Pagliari, C.: Defining health information exchange: scoping review of published definitions. J. Innov. Heal. Inform. 23(4), 684–764 (2016)
Cuk, S., Wimmer, H., Powell, L.M.: Problems associated with patient care reports and transferring data between ambulance and hospitals from the perspective of emergency medical technicians. Issues Inf. Syst. 18(4), 16–26 (2017)
Cuk, S., Wimmer, H., Powell, L.M., Rebman, C.M.: Electronic emergency medical technician reports-testing a perception of a prototype. Issues Inf. Syst. 19(3), 81–91 (2018)
Potter, L.E., Purdie, C., Nielsen, S.: The view from the trenches: satisfaction with eHealth systems by a group of health professionals. In: Proceedings of the 23rd Australasian Conference on Information Systems, ACIS 2012, pp. 1–9 (2012)
Newgard, C.D., Zive, D., Jui, J., Weathers, C.: Electronic versus manual data processing: evaluating the use of electronic health records in out-of-hospital clinical research. Acad. Emerg. Med. 19, 217–227 (2012)
Landman, A.B., Lee, C.H., Sasson, C., Van Gelder, C.M., Curry, L.A.: Prehospital electronic patient care report systems: early experiences from emergency medical services agency leaders. PLoS ONE 7(3), 1–8 (2012)
Eysenbach, G.: What is e-health? J. Med. Internet Res. 3, 2–3 (2001)
Ahern, D.K., Patrick, K., Phalen, J.M., Neiley, J.D.: An introduction to methodological challenges in the evaluation of eHealth research: perspectives from the Health e-Technologies Initiative. Eval. Progr. Plan. 29, 386–389 (2006)
Black, A.D., et al.: The impact of eHealth on the quality and safety of health care: a systematic overview. PLoS Med. 8(1), e1000387 (2011)
Sidorov, J.: It ain’t necessarily so: the electronic heath record and the unlikely prospect of reducing health care costs. Health Aff. 25(4), 1079–1086 (2006)
Geisler, B.P., Schuur, J.D., Pallin, D.J.: Estimates of electronic medical records in U.S. emergency departments. PLoS ONE 5(2), 3–6 (2010)
Abdulwahid, M.A., Booth, A., Turner, J., Mason, S.: Understanding better how emergency doctors work. Analysis of distribution of time and activities of emergency doctors: a systematic review and critical appraisal of time and motion studies. Emerg. Med. J. 35(11), 692–700 (2018)
Furukawa, M.F.: Electronic medical records and the efficiency of hospital emergency departments. Med. Care Res. Rev. 68, 75–95 (2010)
Desroches, B.C.M., et al.: Electronic health records’ limited successes suggest more targeted uses. Health Aff. (Millwood) 29, 639–646 (2009)
Hund, A.M., Nazarczuk, S.N.: The effects of sense of direction and training experience on wayfinding efficiency. J. Environ. Psychol. 29, 151–159 (2009)
Sarangarm, D., Lamb, G., Weiss, S., Ernst, A., Hewitt, L.: Implementation of electronic charting is not associated with significant change in physician productivity in an academic emergency department. JAMIA Open 1(2), 227–232 (2018)
Benda, N.C., Meadors, M.L., Hettinger, A.Z., Ratwani, R.M.: Emergency physician task switching increases with the introduction of a commercial electronic health record. Ann. Emerg. Med. 67(6), 741–746 (2016)
Yamamoto, L.G., Khan, A.: Challenges of electronic medical record implementation in the emergency department. Pediatr. Emerg. Care 22(3), 184–191 (2006)
Hill, R.G., Sears, L.M., Melanson, S.W.: 4000 Clicks: a productivity analysis of electronic medical records in a community hospital ED. Am. J. Emerg. Med. 31(11), 1591–1594 (2013)
Ahmad, M., Kartiwi, M.: A model for measuring well-being of medical practitioners in EHR implementation. In: Proceedings of the 6th International Conference on Information and Communication Technology for the Muslim World, ICT4M 2016, pp. 148–153 (2017)
Choong, Y.-Y., Dawkins, S., Furman, S., Greene, K.K., Prettyman, S.S., Theofanos, M.F.: Voices of first responders – identifying public safety communication problems: findings from user-centered interviews, phase 1, volume 1 (2018)
Dawkins, S., et al.: Public safety communication user needs: voices of first responders. Proc. Hum. Factors Ergon. Soc. 1, 92–96 (2018)
Sittig, D., Singh, H.: A new socio-technical model for studying health information technology in complex adaptive healthcare systems. Qual. Saf. Heal. Care 19(Suppl. 3), 1–14 (2011)
Militello, L.G., Hutton, R.J.B.: Applied cognitive task analysis (ACTA): a practitioner’s toolkit for understanding cognitive task demands. Ergonomics 41, 1618–1641 (1998)
Sittig, D., Classen, D.: Safe Electronic Health Record use requires a comprehensive monitoring and evaluation framework. JAMA, J. Am. Med. Assoc. 303(5), 450–451 (2010)
Tsiknakis, M., Kouroubali, A.: Organizational factors affecting successful adoption of innovative eHealth services: a case study employing the FITT framework. Int. J. Med. Inform. 8, 39–52 (2008)
Tsiknakis, M., Spanakis, M.: Adoption of innovative eHealth services in prehospital emergency management: a case study. In: Proceedings of the 10th IEEE International Conference on Information Technology and Applications in Biomedicine (2010)
Lavariega, Juan C., Avila, A., Gómez-Martínez, Lorena G.: Software architecture for emergency remote pre-hospital assistance systems. In: Adibi, S. (ed.) Mobile Health. SSB, vol. 5, pp. 453–471. Springer, Cham (2015). https://doi.org/10.1007/978-3-319-12817-7_20
Acharya, S., Imani, O.V.: A novel resource management approach for paramedic triage systems, pp. 1–4 (2017)
Lenert, L.A., et al.: Design and evaluation of a wireless electronic health records system for field care in mass casualty settings. J. Am. Med. Inform. Assoc. 18(6), 842–852 (2011)
Anantharaman, V., Lim, S.H.: HEAL (hospital & emergency ambulance link): using IT to enhance emergency pre-hospital care. Stud. Health Technol. Inform. 84, 875 (2001)
Bergrath, S., et al.: Implementation phase of a multicentre prehospital telemedicine system to support paramedics: feasibility and possible limitations. Scand. J. Trauma. Resusc. Emerg. Med. 21(1), 54 (2013)
Van Wynsberghe, A.: A method for integrating ethics into the design of robots. Ind. Robot Int. J. 40(5), 433–440 (2013)
Koufi, V., Malamateniou, F., Vassilacopoulos, G.; Ubiquitous access to cloud emergency medical services. In: Proceedings of the IEEE/EMBS International Conference on Information Technology Application in Biomedicine (ITAB), pp. 19–22 (2010)
Elsaadany, A., Sedky, A., Elkholy, N.: A triggering mechanism for end-to-end IoT eHealth system with connected ambulance vehicles. In: 2017 8th International Conference on Information, Intelligence, Systems & Applications, IISA 2017, vol. 2018, pp. 1–6 (2018)
Metelmann, B., Metelmann, C.: M-Health in Prehospital Emergency Medicine: Experiences from the EU funded Project LiveCity. IGI Global, Pennsylvania (2016)
Turcu, C.E., Turcu, C., Popa, V.: An RFID-based system for emergency health care services. In: International Conference on Advanced Information Networking and Applications Workshops, pp. 624–629 (2009)
Majeed, R.W., Stöhr, M.R., Röhrig, R.: Architecture of a prehospital emergency patient care report system (PEPRS). Stud. Health Technol. Inform. 57(7), 2013 (2013)
Pines, J.M., Abualenain, J., Scott, J., Shesser, R. (eds.) Emergency Care and the Public’s Health (2014)
Benda, N.C., et al.: Human factors design in the clinical environment: development and assessment of an interface workload human factors design in the clinical environment: development and assessment of an interface for visualizing emergency medicine clinician workload. IISE Trans. Occup. Ergon. Hum. Factor. 6(3–4), 225–237 (2018)
Shelton, D., Sinclair, P.: Availability of ambulance patient care reports in the emergency department. BMJ Qual. Improv. Rep. 5(1), u209478.w3889 (2016)
Connelly, D.P., et al.: The impact of electronic health records on care of heart failure patients in the emergency room. J. Am. Med. Inform. Assoc. 19(3), 334–340 (2012)
Lammers, E.J., et al.: Departments does health information exchange reduce redundant imaging? Evidence from emergency departments. Med. Care 52(3), 227–234 (2020)
Balka, E., Tolar, M., Coates, S., Whitehouse, S.: Socio-technical issues and challenges in implementing safe patient handovers: insights from ethnographic case studies. Int. J. Med. Inform. 82(12), e345–e357 (2013)
Cheung, D.S., et al.: Improving handoffs in the emergency department. Ann. Emerg. Med. 55(2), 171–180 (2010)
Hilligoss, B., Zheng, K.: Chart biopsy: an emerging medical practice enabled by electronic health records and its impacts on emergency department-inpatient admission handoffs. J. Am. Med. Inform. Assoc. 20(2), 260–267 (2013)
Collins, S.A., Stein, D.M., Vawdrey, D.K., Stetson, P.D., Bakken, S.: Content overlap in nurse and physician handoff artifacts and the potential role of electronic health records: a systematic review. J. Biomed. Inform. 44(4), 704–712 (2011)
Norman, C., Mello, M., Choi, B.: Identifying frequent users of an urban emergency medical service using descriptive statistics and regression analyses. West. J. Emerg. Med. 17(1), 39–45 (2016)
Hansagi, H., Olsson, M., Hussain, A., Öhlén, G.: Is information sharing between the emergency department and primary care useful to the care of frequent emergency department users? Eur. J. Emerg. Med. 15(1), 34–39 (2008)
Kargl, F., Lawrence, E., Fischer, M.: Security, privacy, and legal issues in pervasive eHealth monitoring systems. In: International Conference on Mobile Business (2008)
Arora, S., Peters, A.L., Burner, E., Lam, C.N., Menchine, M.: Trial to examine text message – based mHealth in emergency department patients with diabetes (TExT-MED): a randomized controlled trial. Ann. Emerg. Med. 63, 15–20 (2013)
Elmasllari, E., Reiners, R.: Learning from non-acceptance: design dimensions for user acceptance of E-triage systems. In: Proceedings of the International ISCRAM Conference, vol. 2017, pp. 798–813 (2017)
Chisolm, D.J., Purnell, T.S., Cohen, D.M., McAlearney, A.S.: Clinician perceptions of an electronic medical record during the first year of implementation in emergency services. Pediatr. Emerg. Care 26(2), 107–110 (2010)
Hockstein, M.A., Pope, S.N., Donnawell, K., Chavez, S.A., Bhat, L.: Emergency medicine residents on electronic medical records: perspectives and advice. Cureus 11(2), e4027 (2019)
Neri, P.M., et al.: Emergency medicine resident physicians’ perceptions of electronic documentation and workflow: a mixed methods study. Appl. Clin. Inform. 6(1), 27–41 (2015)
Coffey, C., et al.: A comparison of paper documentation to electronic documentation for trauma resuscitations at a Level I pediatric trauma center. J. Emerg. Nurs. 41(1), 52–56 (2015)
Hughes, A.M., et al.: Teammate familiarity, teamwork, and risk of workplace injury in emergency medical services teams. J. Emerg. Nurs. 43(4), 339–346 (2017)
Rosenfield, D., Harvey, G., Jessa, K.: Implementing electronic medical records in Canadian emergency departments. Can. J. Emerg. Med. 21(1), 15–17 (2019)
Horsky, J., Gutnik, L., Patel, V.L.: Technology for emergency care: cognitive and workflow considerations. In: AMIA Annual Symposium Proceedings, pp. 344–348 (2006)
Madathil, K.C., Koikkara, R., Gramopadhye, A.K., Fryar, K.: An analysis of the general consenting process in an emergency department at a major hospital : challenges for migrating to an electronic health record (2011)
Denton, C.A., et al.: Emergency physicians’ perceived influence of EHR use on clinical workflow and performance metrics. Appl. Clin. Inform. 9(3), 725–733 (2018)
Dastagir, M.T., et al.: Advanced proficiency EHR training: effect on physicians’ EHR efficiency, EHR satisfaction and job satisfaction. AMIA Annu. Symp. Proc. 2012, 136–143 (2012)
Moore, L.: Measuring quality and effectiveness of prehospital EMS. Prehospital Emerg. Care 3(4), 325–331 (1999)
Bernard, A.W., et al.: Postal survey methodology to assess patient satisfaction in a study. BMC Emerg. Med. 7, 1–5 (2007)
Ebben, R.H.A., Vloet, L.C.M., Verhofstad, M.H.J., Meijer, S., de Groot, J.A.M., van Achterberg, T.: Adherence to guidelines and protocols in the prehospital and emergency care setting: a systematic review. Scand. J. Trauma. Resusc. Emerg. Med. 21(1), 9 (2013)
Ben-Assuli, O.: Electronic health records, adoption, quality of care, legal and privacy issues and their implementation in emergency departments. Health Policy 119(3), 287–297 (2015)
Dela Cruz, J.E., et al.: Typed versus voice recognition for data entry in electronic health records: emergency physician time use and interruptions. West. J. Emerg. Med. 15(4), 541–547 (2014)
Díaz-Palacios, J.R., Romo-Aledo, V.J., Chinaei, A.H.: Biometric access control for e-health records in pre-hospital care. In: ACM International Conference on Proceeding Series, pp. 169–173 (2013)
Maguire, B.J., Browne, M., Neill, B.J.O., Dealy, M.T., Clare, D., Meara, P.O.: International survey of violence against EMS personnel: physical violence report. Prehosp. Disaster Med. 33(5), 526–531 (2020)
Taylor, J.A., Barnes, Ã.B., Davis, A.L., Wright, J., Widman, S., Levasseur, M.: Expecting the unexpected: a mixed methods study of violence to EMS responders in an urban fire department. Am. J. Ind. Med. 163, 150–163 (2016)
House, A., Power, N., Alison, L.: A systematic review of the potential hurdles of interoperability to the emergency services in major incidents: recommendations for solutions and alternatives. Cogn. Technol. Work 16(3), 319–335 (2013)
Capp, R., et al.: Coordination program reduced acute care use and increased primary care visits among frequent emergency care users. Health Aff. 36(10), 1705–1711 (2017)
Acknowledgments
The authors would like to thank the anonymous paramedics and EMTs who participated in this study. Additionally, Katelynn would like to thank Joel Youker, Stephen Cabrera, and Andy Long for comments that helped to improve the manuscript. This paper is dedicated to the memory of Christopher Asseff, Connor Kuschel, and David Dangerfield. Thank you for the lifesaving care you provided to so many. These views are the authors alone and do not represent the official views of the University of Central Florida, the U.S. Government, or any fire department.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer Nature Switzerland AG
About this paper
Cite this paper
Kapalo, K.A., Bonnell, J.A., LaViola, J.J. (2020). Outside the Box: Contextualizing User Experience Challenges in Emergency Medical Technician (EMT) and Paramedic Workflows. In: Stephanidis, C., et al. HCI International 2020 – Late Breaking Papers: Interaction, Knowledge and Social Media. HCII 2020. Lecture Notes in Computer Science(), vol 12427. Springer, Cham. https://doi.org/10.1007/978-3-030-60152-2_11
Download citation
DOI: https://doi.org/10.1007/978-3-030-60152-2_11
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-60151-5
Online ISBN: 978-3-030-60152-2
eBook Packages: Computer ScienceComputer Science (R0)