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Master's thesis: The evaluation of the data content selection process for Finnish electronic Patient Care Record in the Emergency Medical services

In her thesis, Pia-Marie Lahti examines the process by which the structure of the data content for the Finnish electronic patient care record was selected.

In her thesis, Pia-Marie Lahti, a student in the Degree Programme in Global Development and Management in Health Care, assessed the process by which the structure of the data content for the Finnish electronic patient care record (ePCR) of out-of-hospital emergency medical services (EMS) was selected. The questions serving as the basis of the assessment are answered based on the information collected on the development process of the Finnish emergency medical services (EMS) and on recording it electronically. The thesis presents the timeline on the development of the data content of the ePCR of out-of-hospital EMS and the actual selection process of the data content. In addition to describing the process, the thesis compares the complete data content to the nationally recognised needs for the management of EMS data. Based on the results, it presents views on how to manage future processes.

National information management to support the provision of emergency medical services

The development of Finnish emergency medical services has been rapid during the 21st century due to such accelerating factors as legislation, the development of medicine and infrastructure, and digitalisation. Digitalisation has brought with it changes in health care and, as part of it, also in EMS. Systems, digital solutions, new modes of communication and more efficient perception and identification of care chains have become an integral part of everyday work. The benefits of applying management by knowledge to health care are recognised at a national and local levels, and its significance in reporting and decision-making has become emphasised.

Reliable information systems and information management methods are needed in support of management by knowledge, which, for its part, underlines the importance of the consistency and quality of data. National solutions support the consistency of data collected on health care and open up opportunities for new kind of decision-making based on reliable up-to-date data. Identifying processes, and management and organisational models in health care and, in this case, EMS, and care chains through reliable data provides a good basis for the establishment of nationally uniform goals and, consequently, for better and more equal treatment and care.

ePCR of out-of-hospital EMS, national solution for patient care record entries in EMS and management by knowledge

The information collected on EMS has been fragmented, and no electronic patient care record system serving the purpose of information management has been available. This has affected access to reliable and consistent data on the actual state of EMS. When examining the current state of EMS and the quality of services, it has been noted that the management by knowledge system has created a need for an ePCR in EMS. The Ministry of Social Affairs and Health has tried to respond to this need by initiating the development of a national ePCR of out-of-hospital EMS. The development of the ePCR of out-of-hospital EMS is linked to the ongoing development of the information systems of the national safety and emergency response authorities.

A significant part of the development of the Finnish ePCR of out-of-hospital EMS has involved the construction of the data content that has been implemented within the EMS for the first time in Finnish history. The data content has been built to meet the needs of national information management without forgetting the patient work in EMS. It is structured on the basis of the data content and standard used in American emergency medical services, NEMSIS (National Emergency Medical Services Information System). The definition and structure of the data content have been created in collaboration between EMS and national actors, and it has been published on the Kanta services code server.

Description and assessment of the data content of ePCR of out-of-hospital EMS

The thesis describes and assesses the selection process of the data content for the national ePCR of out-of-hospital EMS by modelling it by means of Program Theory-driven Evaluation Science. The examination of the assessment process and the selection process of the data content opens up new perspectives for the management of national projects and serves as encouragement to explore similar processes at a more in-depth level. The thesis suggests that a more in-depth examination of processes will help make the working methods used in similar projects in the future more efficient. The assessment also opens up research opportunities on the content of the ePCR of out-of-hospital EMS and, in the future, on its deployment and on establishing a comprehensive picture of the national development project.

The assessment was carried out in 2019–2020, and the materials used included published national sources, expert interviews, project memoranda and data content of national EMS records.

The Master's thesis can be accessed through Theseus.

Further Information:

Pia-Marie Lahti
Degree Programme in Global Development and Management in Health Care
Puh. +358 41 544 6002