Renfrew paramedics road-testing portable records system

Paramedics in Renfrew County are turning to technology to help them provide care in isolated communities.

Quebec-based company Prehos supplying digital system used pilot project

Chief Michael Nolan demonstrates how paramedics will now be able to access patients' medical information on an iPad. (CBC)

Paramedics in Renfrew County are turning to technology to help them provide care in isolated communities.

In a new pilot project, the team is using new software offered by Quebec-based company Prehos, which centralizes a patient's medical records and cross-checks those records with others in the patient's name. 

The app is hosted on an iPad, making the records completely portable — a first for paramedics in Ontario's largest county. 

Paramedics in Parry Sound, Ont., are also trying it.

Renfrew paramedic Chief Michael Nolan said currently, paramedics start with a blank slate when they go to visit new patients, and have to rely on paper files for existing ones.

With repeat patients — especially elderly ones — having their medical records on hand will simplify calls, he said. 

"It's creating an efficiency for us, but it's also allowing us to increase our patient safety because we don't have to rely upon the information that we receive from our patients on a visit-by-visit basis," he said. 

With the new technology, paramedics will have a patient's complete health records immediately available, Nolan said, eliminating the need to ask a patient the same questions about their medical history each time. 

System used in community program

Renfrew's community paramedics visit at-risk patients in their homes, many of whom live in rural communities, in an attempt to provide proactive care before a real emergency occurs. 

The strategy has reduced the number of times people need emergency transportation to the hospital by about 23 per cent, according to a Prehos news release.

With the advent of portable, digital record-keeping, much of what paramedics do — from filling out forms to sending information to a family physician — can be done using the software, saving valuable time that can be used to move on to other patients, said Prehos CEO and co-founder Christian​ Chalifour.

"It's a lot of paperwork and it was a waste of time," he said. "[Now] they can see more patients and they focus all their energies on patient care."

The software was specially designed for Renfrew County by the Quebec-based company Prehos. (CBC)

The new software also gives medics the option of adding media files, Nolan said.

"Adding images of a wound, for example, now gets embedded within that emergency medical record," he said. "So when the paramedic goes back to check on that individual, they can see the progress based upon those images."

Developed specially for Renfrew County

Renfrew is the largest county in Ontario, leaving paramedics with a unique set of challenges, Nolan said. 

In the past, paramedics from across the county would have to start their day in one location to collect files and review cases, Nolan said.

But with portable, electronic case files, he said the need for that has largely been eliminated. 

"By now having a centralized electronic repository, we'll now have paramedics starting at bases throughout the county, which will save us hours in the day of drive time," he said. 

While developing the program, Chalifour said Prehos staff would ride along with community paramedics, watching how they do their jobs and tailoring the software to match. 

"If we just stay in our offices and do software, it would never work," he said. 

Questions about security

Centralizing the medical records of hundreds of patients leads to questions about security vulnerabilities, however.

"It's the first question we've always been asked by EMS or paramedics, or governments," Chalifour said. "But it's the first thing we do when we build software in that industry."

Prehos has limited the program for use only on Apple devices because of their security, he said, and all data centres used to store the records are built to comply with federal and provincial security regulations. 

"People want to make sure that their personal data is safe, and if we don't do that, we won't stay in business long," he said. 

Technology team-ups

It isn't the first time that paramedics in Renfrew County have gotten crafty with technology. 

Last summer, paramedics started carrying portable ultrasound machines to evaluate a patient's internal injuries, a procedure that was previously restricted to the emergency room. 

Paramedic Chief Michael Nolan shows a video of an ultrasound taken in the field using this device, which is about the size of a late-90s flip phone. (Matthew Kupfer/CBC)

And paramedics turned to the help of a drone in 2015 when three women were murdered near Wilno, Ont., to assess whether there was movement in the area surrounding the crime scenes. 

That investigation would lead police to Basil Borutski, who was convicted last year of murdering Anastasia Kuzyk, Nathalie Warmerdam and Carol Culleton. 

Nolan said the new record-keeping system will be invaluable, especially when it comes to patients who may not be able to speak for themselves.  

"Many of our patients may not remember yesterday," he said. "They may not remember the medications they're on, or in extreme cases, may be unconscious. We can automatically pull up records on them which can help guide the paramedics in their treatment of that patient."