Healthcare has seen significant transformations over time. The impact of these changes will continue to reach all aspects of healthcare, from injury prevention, to research, to EMS. The ability to respond to such changes will require leaders and managers to not only use best practices regarding their management style, it will also require managers to be aware of their cadence -- or rate at which they respond.

Consider the impact of technology in today's delivery of healthcare. While some healthcare systems have embraced this opportunity, other organizations may have encountered challenges. The following example provides an example of how technology can impact a system and helps to demonstrate the leader's cadence.

EMS system "X" has been a paper-based system since its inception more than 2 decades ago. In the past year leaders from the EMS system and surrounding healthcare system have been meeting to plan for the introduction of a paperless EMS documentation system. In the last 6 months updates have been provided to the staff in the EMS system and hospital. The "technology committee" has secured funding and is preparing to review the product offerings that are available through several vendors.

While the opportunity to introduce technology into the EMS system has been embraced by the leadership, several employees have expressed concern about the change. Questions and statements such as "Why go paperless," "I started in EMS for patient care, not to become a data entry person," "How will this information be used," and "Great, now everything we do will be tied to a computer" have been mentioned.

In an effort to provide the staff with information regarding the EMS system's pursuit of technology, the operations manager and administrator will conduct information sessions for each shift. The theme of the meetings will be centered on the title: Technology in EMS -- why our system? The following are examples of the topics that the leadership team covered during the meetings.

Improved patient care
Patient care can be enhanced or improved through the use of technology. This has been demonstrated through reductions in pharmaceutical errors as well as the use of programs that can guide treatment. Technology can allow for access to information that was once limited to textbooks and medical libraries. Unsure of a medication? Consult with your PDA's drug reference guide. Technology is considered by some to be part of innovation. Organizations that seek to be on the cutting edge of healthcare practices might benefit from the adoption of technology.

Reducing costs
While there may be costs up-front with the investment in technology, the long-term benefits will often outweigh them. In the EMS system "X," the chart review process is an extensive manual process. Each crew summarizes their shift's call volume by writing each call on a log. For certain calls, quality assurance audits are conducted. This includes reading each chart then summarizing outcomes on a separate quality assurance form. The technology that is being considered for the EMS system will allow for the above processes to be conducted by the push of a button versus the labor-intensive process described above. It has also been noted that completing the current paper system is very time consuming. Streamlining the process with automation will result in future cost savings.

Sharing knowledge
The leadership team and quality coordinator see the potential for the technology to support the staff's education. By having the ability to provide timely feedback to the crews, process improvement and quality programs may be reinforced. This type of information will also allow the EMS crews to have access to real-time information versus reports that are several months old. Information leads to knowledge. Knowledge can contribute to employee satisfaction. Employee satisfaction leads to lower turnover, and reduced turnover leads to an experienced workforce.

Clinical complexity
Depending on the details of the program that the EMS agency selects, it may be possible that the program provides real-time guidelines. This in turn may support providers as they manage complex cases. The leadership team recognizes the potential benefits that such a program could support, especially in the critical care services.

Minimize administrative tasks
Having access to technology that auto-generates reports and provides real-time data is critical in healthcare. Administrative tasks, such as duplicating patient care records, manually locating documents, and manually creating reports can be reduced through technology. In addition, having a system that does not rely upon human recall (e.g. now what were the vital signs...?) reduces the likelihood that an error may occur.

Education
Healthcare providers and patients benefit from knowledge and education. The ability to distribute mass educational materials creates a definite win-win situation. It is no longer necessary to always have a student in a class for hours; e-learning and distance learning have revolutionized education. Providers may have minimal time to attend an educational program. Having the option to provide the program at the end-user's schedule convenience is appealing. Technology has broadened the opportunities for educational opportunities. Supporting CME and other forms of education can be accomplished in the push of a button.

Clinical research
The EMS leadership team in system "X" realizes that in order to advance or improve on current practices, they need an accurate initial assessment. While the paper system can be used to determine this, there are technology systems that will assist in this process. Measurements, data points, and trend will be more readily available through technology versus a manual paper-based system. System "X" also anticipates conducting several studies in the next 16 months. Having an electronic system that will allow for custom reporting and data capture is appealing.

Healthcare and EMS systems are impacted by technology. Technological advances will influence the future delivery of healthcare services. Healthcare leaders and managers must remain abreast of these developments. Healthcare systems that are able to exploit technology may experience positive outcomes, including positive patient impacts.

Paul Murphy has been involved in the emergency medical services and healthcare for more than a decade. He has held a variety of clinical, administrative, and consultant roles. He has functioned as an EMT, Paramedic, Flight Paramedic, and Critical Care Paramedic. He has worked in a variety of settings, ranging from rural volunteer to paid urban EMS systems. Paul is active in healthcare management and has held management roles at start-up companies as well as a Level II Trauma Center. He is a published author and has spoken at healthcare conferences. Paul has Master's degrees in Computer Resources/Information Management and Healthcare Administration.