EMS clinicians routinely identify and treat patients with conditions like hypoxia, hypotension, shock or sepsis before reaching the emergency department. By the time an emergency physician evaluates the patient, the initial instability may have resolved but clinical complexity, monitoring needs and medical decision-making remain.
A new analysis of discharged EMS patients from a set of nearly 4 million linked EMS and emergency department encounters highlights that disconnect. Nearly 90 percent of discharged patients who arrived by EMS still required moderate- to high-complexity medical decision-making.
This report introduces a four-channel framework for recognizing complexity across ED operations, physician documentation, inpatient DRG assignment and status determination, and highlights the potential downstream operational and financial implications.
Inside the report:
- Why arrival by EMS arrival can signal higher patient acuity and operational complexity
- How prehospital stabilization can obscure true patient complexity, impacting resource needs and operational burden
- A model showing the potential impact of clinical under-documentation that approaches $892,000 annually for 50,000 ED visits