With a population increase of nearly 2% from 2021 to 2022, Florida was America鈥檚 fastest-growing state. In its largest geographical county, Monroe, numbers rose by 13% between 2010 and 2020. Sprawling across the Florida Keys, Everglades and area south of Miami, the county 鈥� which covers more than 3,700 square miles 鈥� also draws lots of tourists: In 2022 it estimated an annual total of nearly 25 million visitor days.
That all amounts to a lot of medical needs, both emergency and other. E-Care Ambulance is a new service, based in Key Largo, launched to help meet that fast-growing demand. It offers BLS, ALS and critical care transport services with a staff of around 30 that includes EMTs, paramedics and CCT medics.
As it becomes established and known, E-Care anticipates playing a growing role in medical transportation in South Florida. But starting small meant it needed some affordable, streamlined solutions to help get its operations off the ground.
It found an answer in a trio of cloud-based, software-as-a-service products from : , and . In fact, E-Care is the first service to use the cloud capabilities of all three platforms.
鈥淚鈥檝e used the product probably for about 20 years and have used Dispatch and Billing throughout different operations,鈥� said E-Care鈥檚 COO, Michael Arguelles. 鈥淥nce we started the new company, the expense of the equipment and servers and all that was a challenge, as was being in a relatively remote location. So I wanted to look for web-based products, and I knew ZOLL Data Systems had been working on them.鈥�
It鈥檚 still early in the young service鈥檚 experience, but for E-Care the results thus far have been everything Arguelles hoped.
THE CLOUD RESOLVES KEY CHALLENGES
Benefit No. 1, obviously, is not having to invest in major hardware to drive efficient operations and quality service. In the subtropical Keys, such hardware comes with considerations. For one, extreme heat isn鈥檛 beneficial to the performance of computer servers 鈥� it can lead to problems like slow operation and circuit board malfunctions. For another, South Florida is prone to hurricanes, which can disrupt and destroy physical infrastructure.
Cloud-based operations give E-Care the flexibility to circumvent such challenges. As just one example, allows remote dispatching from any web browser 鈥� a workforce-flexibility advance many services embraced during the COVID-19 pandemic. 鈥淲e do that at times,鈥� said Arguelles. 鈥淏ecause we鈥檙e a small operation, our overnight dispatcher will sometimes dispatch from his house.鈥�
ZOLL Dispatch is a streamlined CAD solution that provides a simplified, single-source display to let operators oversee the process of matching assets to calls. It can prioritize and assign appropriate responders automatically, with real-time situational analysis to support decision making for all levels of user experience.
In an emergency setting, the platform can identify the ambulance with the fastest ETA based on distance, traffic and road conditions. With nonemergent transport like E-Care鈥檚, the optimizing of resources to patient needs can be trickier, encompassing various systems and data sets as patient conditions require certain provider levels and care interventions. An intuitive, map-centric interface helps dispatchers keep that all organized and visible. ZOLL Dispatch users can schedule trips in advance and monitor them as they progress with real-time mapping and alerts. The manages the transfer of data between dispatch and crews, reducing required touches and the opportunity for error inherent to manual processes. This lets crews keep their focus on patients.
Beyond proving a valuable safety measure during the pandemic, the remote dispatching ZOLL Dispatch permits is a potential measure against workforce shortages. 鈥淲ith the remote dispatching capability, you don鈥檛 have to have that person in the office,鈥� noted Matt Moriarty, ZOLL Data Systems鈥� director of product marketing. 鈥淭hey don鈥檛 even have to be in the same city or state, so it opens up that staffing pool a bit.鈥�
ZOLL Dispatch also integrates with and , providing a more seamless start-to-finish experience.
鈥淗aving everything in what鈥檚 basically one platform, even though there are three different databases, is definitely a big improvement,鈥� said Arguelles. 鈥淭hey communicate well between them, and it鈥檚 pretty much instantaneous.鈥�
E-Care was able to get its dispatch system up and running in 48 hours. And while it functioned a bit differently than some of Arguelles鈥檚 young providers were acquainted with, it was easy to learn.
鈥淭he way it鈥檚 laid out might be different than what some people are used to,鈥� he added, 鈥渂ut once they get past that, they see all the other advantages it brings.鈥�
REVIEW CALLS IN NEAR-REAL TIME
As important as it is for dispatchers to function quickly and smoothly with their technology, it鈥檚 just as important for crews in the field. While they鈥檙e not generally answering 911 calls, that鈥檚 no less essential for the E-Care crews and the medically fragile patients they transport.
provides easy guidance and automation through their charting of care, helping produce complete ePCRs that can avert billing and other problems later. Beyond and , it also integrates with the company鈥檚 bidirectional health data exchange platform, allowing the easy import of demographic, insurance and background health data from other sources.
A key aspect allows quality assurance review of calls in virtual real time.
鈥淵ou can do it live as crews are finishing,鈥� said Arguelles. 鈥淲e can actually see the report as they鈥檙e completing it, and once they push it through, we鈥檙e really only waiting for any trailing documents to come in, because we don鈥檛 have the cameras set up. We haven鈥檛 done that yet, but it has that capability. With those, we鈥檇 be able to scan the paperwork and push it through and bill a trip within minutes of running the call.鈥�
Designed with input from EMTs and paramedics, ZOLL emsCharts lets administrators customize workflows to facilitate collecting data on calls, prioritizing vital fields and hiding unnecessary ones. CAD and ECG data is imported to auto-populate ePCR fields, and users are prompted when key items are missing. A RescueNet CaseReview link opens entire case files with one click from the chart, allowing side-by-side review with files from ZOLL鈥檚 . Users can create rules-based review procedures and produce quick custom reports to examine aspects of care and notable trends.
With data collection fully optimized, ZOLL emsCharts lets reports be completed in as little as 5鈥�10 minutes. The extends its capabilities to mobile devices. Data is saved locally at times of poor connectivity, then moves to the cloud once it鈥檚 able.
鈥淭here are a few nuances to the setup, but it鈥檚 extremely user-friendly,鈥� said Arguelles. 鈥淚t鈥檚 been a really smooth transition.鈥�
FASTER BILLING MEANS FASTER REIMBURSEMENT
An even better transition occurred with billing: let E-Care bring that temporarily outsourced service back in-house 鈥� and just as the service鈥檚 embrace of platforms helped trip billing happen faster, it鈥檚 also led to faster reimbursements.
The platform combines prebilling activities, claims processing and Medicare coding with convenient workflows that reduce both labor and errors. Integrated confirms patient details and insurance coverage, ensuring claims are submitted correctly. Being cloud-based allows automatic updates whenever fee schedules or Medicare codes change, eliminating time-consuming manual changes, and everything is fully HIPAA-compliant.
A novel analytic feature predicts anticipated reimbursement values and timing, allowing more precision in forecasting income. For patients lacking coverage, self-pay analysis helps determine who can pay and who likely can鈥檛 鈥� a feature that鈥檚 been useful for maximizing E-Care鈥檚 returns.
鈥淲e had one patient say, 鈥業 want to pay you $5 a month,鈥欌�� recalled Arguelles. 鈥淭hen I saw they had a super good, high credit score and all these other factors, so I put a little more pressure on. They went up to $200 a month. So it gives you a lot of insight into when you can push a little harder. Without it, I might have decided, 鈥極K, I鈥檒l at least take that,鈥� but I felt comfortable enough to push more.鈥�
鈥楾HE DIFFERENCE HAS BEEN NIGHT AND DAY鈥�
It鈥檚 no secret that many EMS organizations are struggling 鈥� smaller agencies, rural agencies and many others. While there may not be magic-bullet solutions, there are ways they can save on hardware, simplify core operations and produce better returns with less time and manpower.
Embracing 鈥� end-to-end array of cloud-based capabilities provided all that for E-Care. Its integration lets data flow seamlessly from dispatch to crews to hospitals/receiving facilities and on to billers and payers.
鈥淚鈥檝e been very happy with what we鈥檝e been able to do, even in a relatively short time,鈥� said Arguelles. 鈥淭he ease of use and quick access to information is very impressive. And we鈥檙e a relatively small operation 鈥� we run four or five calls a day. So I see the benefit for us, but I could see even greater potential for larger services. For us the difference has been night and day.鈥�
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ZOLL, emsCharts, RescueNet, X Series and AR Boost are registered trademarks of ZOLL Medical Corporation.
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