The ePRF system improves transfer of patient care between emergency ambulances and secondary care facilities by making Ambulance Care Summaries (ACS) available electronically.  The handover process is facilitated by better-quality patient documentation and reduced congestion in the triage area.

Note the scope of the following discussion is ambulance encounters by individuals.  For information on gaining access to bulk encounter information for multiple individuals (e.g. for research) please contact your St John representative

How can we be notified of inbound emergency ambulances?

Hospitals are not always aware of incoming emergency ambulance patients. Patient receiving points (e.g. ED, Maternity) may choose to receive real-time electronic advice of inbound ambulances.

The Arrivals Board lists all ambulances heading towards a point or recently arrived, with estimated or actual arrival time and some details about who is on board and why they are being bought in. The ACS can be retrieved by clicking on the patient's Chief Complaint on the Arrivals Board.

The Arrivals Board can be displayed on screens, computers or tablets and is a useful tool to help prepare secondary care facilities for admissions, in terms of equipment and personnel capacity. Because some patient information is shown it should not be positioned in view of the public.

The Arrivals Board can optionally be configured to show ambulances that have dropped patients off and left up to 24 hours previously. This can be helpful if there is a need to get additional information from the ambulance crew, if a patient's belongings were left in the ambulance, or to retrieve an ACS that is not otherwise available. This is the only way to retrieve an incomplete ACS.

The Arrivals Board can be accessed by clicking here and entering the credentials provided by Hato Hone St John. A Connected Health Network connection is required.

On occasion an emergency ambulance will arrive without showing on the Arrivals Board. This is usually because of an ambulance operational error and should be reported to your St John representative. This may also happen in the rare cases of mass casualty incident (MCI).

How can we access an ACS from our Clinical Workstation?

Authorised third-party users (such as DHBs) can configure their clinical workstation (CWS) systems to reach into the ePRF system and read Ambulance Care Summaries (ACS).

This means that individual CWS users can see all ACSs for patients they are treating.  A patient-centric view is provided; i.e. all ambulance attendances are shown regardless of:

  • which ambulance operator attended
  • whether or not the patient was transported

When the CWS requests a list of ACSs for a particular NHI Number, the ePRF system also returns ACSs for any associated NHI Numbers; i.e. if you request a minor NHI Number then ePRF will return any ACSs for that minor number, any other minor numbers, and the major number.

This document describes how to configure a CWS to access Ambulance Care Summaries.

The CWS must be configured to retrieve, format and display an ACS; the ACS remains in the ePRF system.

Hato Hone St John must grant your organisation access credentials before your CWS can access ACSs.  Please contact your St John representative to arrange this.

Access on transfer of care

The transfer of care process has evolved over time at each patient handover point.  It may need to change to accommodate CWS integration.

The crucial point is that Hato Hone St John and facility staff agree the patient’s identity (especially their NHI Number) before the Ambulance Officer finalises the record on the tablet.  It is possible to change the NHI Number on a submitted record, but this takes time and the ACS will not be available through CWS during that time.  Care must be taken in the case of unidentifiable patients – hospital and ambulance must both record the same temporary NHI Number to allow the CWS and ACS to connect.

Hato Hone St John operational managers will work with hospital clerical and clinical staff to establish a process that works well for both teams at each handover point

Access during and after an episode of care

The ACS is easily available at point of care through the CWS - not just in an emergency or acute inpatient setting but perhaps months later:

  • in an outpatient clinic when a paper record may not be available
  • for clinical coding

for other purposes allowable under New Zealand’s health information privacy framework

Clinical Workstation integration is not available, how can we retrieve an ACS?

There are two methods by which Ambulance Care Summaries can be retrieved if Clinical Workstation integration is not in place:

From the ACS Website

Ambulance or hospital staff may access the ACS by clicking here. and entering the ACS Access Code and patient’s date of birth (from the Ambulance Officer’s tablet).  This will retrieve the ACS, which may then be printed.

From the Arrivals Board

If your facility is using the Arrivals Board then you can retrieve the ACS for up to 24 hours after the patient was handed over.  For more information please see “How can we be notified of inbound emergency ambulances?” above.

What do we do with a handwritten ACS?

If the ePRF system is unavailable for some reason, then Ambulance Officers will complete and deliver a hand-written clinical record.  This will be keyed into the ePRF system at some later date, at which time it will become accessible through the CWS – provided the patient’s NHI Number was recorded.  In the meantime, the paper copy should be kept.

Something has gone wrong, what do I do?

I can't retrieve an ACS from the ACS Website

If you can’t retrieve an ACS from this website, then there are three likely reasons:

1.     Site not found message.  Check your firewall settings allow

2.     Site behaves strangely.  For example, the layout is scrambled, your browser terminates unexpectedly, you receive unusual error messages.  Clear your browser’s cache and try again.

3.     Website gives an error message “No record exists against provided Ambulance Care Summary Access Code”.  This is probably because the Ambulance Officer recorded the patient’s date of birth incorrectly. Use the date of birth on the tablet even if it is wrong, because that is the date we have recorded.  After five unsuccessful attempts you will be locked out of the website for 10 minutes; try again after that.

I can't access any ACS from my Clinical Workstation

The most common situations are:

1.     Network issue.  Something has happened to cause the Connected Health Network connection between your organisation and Hato Hone St John to become unavailable.

2.     System outage.  One of the system components is non-functional.  This could be either a CWS or a Hato Hone St John issue.

If this is a scheduled outage, then you will have been advised by your IT team.  For an unscheduled outage please contact your organisation’s IT help desk.  They will arrange for the appropriate action to be taken, including contacting Hato Hone St John if necessary.

If you are advised that the ambulance system is still operational (i.e. the issue is with the CWS or network) then you can manually retrieve the ACS (see “Clinical Workstation integration is not available, how can we retrieve an ACS?”) above.  The ACS will be available through CWS when normal operation is restored, and the paper copy may be securely disposed of.

If the ambulance system is not operational then Ambulance Officers will produce handwritten ACSs. (see “What do we do with a handwritten ACS?” above).

A single ACS does not show in my Clinical Workstation

If an occasional ACS is not viewable through the CWS then this will usually be for one of three reasons:

Ambulance called away for a high-acuity case before the ACS is completed.  This will only happen if the current patient is low acuity, verbal handover has been done, and the new patient is in a very serious condition (e.g. a cardiac arrest).  The ambulance crew will complete the first patient’s ACS as soon as is possible, in the meantime the incomplete record can be retrieved through the Arrivals Board as described in “How can we be notified of inbound emergency ambulances?” above.  The first patient’s ACS will appear in the CWS as soon as the ambulance crew complete it, after they have finished with the second patient.

Wrong patient NHI Number: The ambulance clinical record has been stored under the wrong NHI Number so the CWS cannot find it.  The record can still be retrieved through the Arrivals Board as described in “How can we be notified of inbound emergency ambulances?” above.   Please contact your St John representative and ask for the NHI Number to be changed in the ambulance record; as soon as this is done the ACS will be accessible.

Handwritten ACS: The ambulance system is unavailable for some reason and the clinical record is on paper.  For more information please refer to “What do we do with a handwritten ACS?” above.

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