Digital patient journal streamlines care

An ambulance arrives at the scene of an accident on a busy city street. Paramedics leap into action, rushing to assist an injured pedestrian. They assess important vital signs — heart rate, blood pressure, oxygen saturation levels. They place the patient on a stretcher, load the vehicle and sound the siren while racing to the hospital.

In emergencies like these, time is of the essence — and errors can be costly.

But until recently, ambulance crews in Denmark faced a significant challenge. Paramedics had to rely on pen and paper to record patients’ vital signs. And they had to communicate with the hospital by telephone about the patient’s condition and imminent arrival.

That has changed with the implementation of Pre-hospital Patient Journal (PPJ), a digital tool used to record and communicate patient conditions from that very first meeting with healthcare professionals.

The project, which was designed, integrated and delivered by DXC, has been adopted throughout the country and is improving patient outcomes.

Saving time and lives

Formerly, when treating patients at the scene and en route to the hospital, Danish paramedics would document vital signs and patient conditions in a handwritten journal. These notes — recorded during a very hectic time — were passed on to hospital staff but were often unreadable and unusable.

With the new digital PPJ, the ambulance team can communicate directly and immediately with doctors and nurses at the hospital. Paramedics key in vital information about the patient while en route, and data from the ECG monitor transfers directly to the PPJ via Bluetooth. All of this data can be accessed in real time by hospital staff. The mobile healthcare team can also access medical records from the field, which can prevent major errors, such as giving a medication that might cause an allergic reaction.

“The [PPJ] solution has solved a number of different daily challenges,” says Jan Lindberg, AMK control center director in the region of North Jutland. “One of them is the registration of information about the patient from the moment you arrive at the patient until the patient is at the hospital. In some situations, there is both an acute ambulance doctor and an ambulance [crew] involved in the treatment of the patient, and with the new prehospital solution, both the ambulance doctor and the paramedics are able to write in the same journal. And subsequently, at the hospital, you can follow the treatment of the patient.”

The solution has been a tremendous help for the healthcare professionals using the system. “We can see when [an emergency crew] has completed a task and delivered a patient to us at the hospital. Then we can go into our system and see what happened at the scene, what were the values, what happened before the patient arrived and so on,” says Dorthe Kragelund, emergency department nurse.

Another plus is that the PPJ lets healthcare professionals evaluate and transmit a patient’s condition ahead of his or her arrival. This allows the hospital to prioritize care. For instance, Kragelund says, a status recommendation of “red,” “yellow” or “green” is made, depending on the severity of illness or injury. A “red” or more seriously ill patient will arrive at the hospital as a “priority one,” she says.

“The [PPJ] screen helps me coordinate my patients so I know [whom] to take in or out of the departments,” she says. “I can also chat live via the screen with the ambulances at the scene, so I can tell them ‘Drive to Room 1.’ I can continuously evaluate what is incoming and what to prioritize now and later. It makes the workflow easier throughout the whole system.”

An example of agile healthcare

The project required a smart, sophisticated approach, and DXC successfully delivered.

“It is clearly a complex technical issue to integrate more than 500 ambulances, medical cars [distress cars with doctors] and emergency helicopters in the whole of Denmark with the emergency centers that receive the patients,” says Torben Høy, program manager at DXC.

In addition, the solution had to address the unique needs of five distinct regions in the country.

“To accommodate these differences and ensure success with implementing a common system, DXC has facilitated a process where the regions are involved to meet diverse needs in the new common solution,” Høy says. “Now it is the same solution in every ambulance, no matter where you encounter it in Denmark.”

The PPJ, which has been described as “intuitive” and “user friendly,” is the first system that unifies the country’s approach to what Denmark calls “prehospital” care. And the results have been lauded.

“The best thing about the system is the raising of the patient’s safety,” says Mads Kjær Nielsen, paramedic at Region North Jutland. “It is easier to create an overview of the state of the patient. It eases the medical treatment. It eases the conditions in the transition of vital information to the receiving departments, and overall, the registering of the complete patient progress is much easier and more streamlined now than it was before.”

In addition to designing and delivering the solution, DXC led the cooperative efforts of five companies involved in the work, and it now supports the customer operations center as a managed service, 24x7. With the success of this project, the client expects to call on DXC for future improvements. “We already have ideas for new functions to implement in it, and I am totally confident that DXC will be part of the advanced expansion for the coming years,” Lindberg says.*

*This success story was originally written by CSC, which has become DXC Technology as of April 2017.