Target state for the utilisation of emergency medical services data in the health and social services system

The accumulation of data on emergency medical services begins when a resident calls the emergency response centre as a consequence of an accident or some other request for help. The emergency response centre operator will enter the data in the ERICA system used by emergency response centres and a first response unit is dispatched. 

A first responder will make structured entries on the patient and his or her care in the national electronic patient care record (ePCR) for prehospital EMS of the Command and Control System KEJO in accordance with the ICPC-2 standard. The structured data entries ensure that the data will be nationally and internationally comparable. Data are also automatically recorded in the KEJO system from the emergency response centre’s information system, including the task address, the starting time of the telephone call and the EMS unit dispatch time. 
 

The patient data entered in ePCR for prehospital EMS in the KEJO system are automatically transferred to the Patient Data Repository in the Kanta services. From the services, the data can be utilised in the work of both professionals in health and social services as well as the authorities. For the first time, the data recorded in the emergency medical services are available nationwide in Finland thanks to the structured data entries and electronic system. As EMS data are only recorded in national systems, controllers (wellbeing services counties) will obtain the data contained by their data file for the purposes of section 41 of the Act on Secondary Use of Health and Social Data as feedback data under section 5 a (3) of the Act on the Finnish Institute for Health and Welfare. 

The data recorded in emergency medical services are available for assessment, steering, supervision, statistics and other use by the authorities as part of the national health and social services database. The data are processed and utilised in an anonymised and information secure manner. 

Professionals in health and social services can utilise the data originating from the emergency medical services in planning care and services for patients or clients. The data enables the comprehensive development of the entire treatment chain. 

Under section 29 of the Act on Organising Healthcare and Social Welfare Services, a wellbeing services county is obligated to monitor the health and wellbeing of its population and lead its operations in accordance with the minimum data content. The data recorded on care and services provide wellbeing services counties with reliable, topical and comparative data for knowledge-based management. This enables it to, for example, monitor the quality of the emergency medical services and, if necessary, make changes to the resources allocated to EMS units.

In addition to their regional systems, wellbeing services counties also obtain social welfare and health care data from the national social welfare and health care database. The data can also be utilised in the tasks of municipalities (social and welfare services) and cities. 

The data from the emergency medical services enables Valvira and regional state authorities to target supervisory measures to those areas considered to have the most development needs. This also enables providing guidance and support for service producers and further shifting the emphasis on self-monitoring. The monitoring aims to influence client and patient safety. 

The Finnish Institute for Health and Welfare (THL) produces and utilises health and social services data in areas such as the assessment of the health and social services system by specialists, compiling statistics and register activities. THL is also responsible for the assessment of the health and social services system by preparing annual specialist assessments of all wellbeing services counties in accordance with section 30 of the new Act on Organising Social Welfare and Healthcare. These involve the assessment of the quality, functionality, impact and costs of the health and social services system to support national steering. The assessments are based on cost and impact indicators (KUVA), qualitative evaluations compiled in cooperation with the wellbeing services counties, and reports prepared by Valvira and the regional state authorities.

Under section 31 of the Act on Organising Healthcare and Social Welfare Services, the Ministry of Social Affairs and Health prepares an annual report that evaluates the equal implementation of social welfare and health care and the adequacy of funding. The report utilises the national specialist assessments prepared by THL.

The ministry negotiates separately with each wellbeing services county on the implementation of health and social services tasks included in the responsibility for organising services. The purpose of the negotiations is to examine a shared situational picture and carry out steering at the strategic level for the duty to organise services (section 24 of the Act on Organising Healthcare and Social Welfare Services.

In its task in steering the wellbeing services counties at the strategic level, the Ministry of Social Affairs and Health can use the data to allocate resources for the wellbeing services counties to better correspond with their needs. In the future, the funding provided to the wellbeing services counties for emergency medical services will be based on the need for emergency medical services, morbidity and accident rates, and the quality of treatment chains.

In the future, the smoothness and effectiveness of social and health care services can be assessed over the entire treatment chain, and data from different wellbeing services counties can be compared to form a national situational picture. At the local level, the planning of care and services for residents will be based on topical and optimal information. This information will also guide the assessment, guidance and monitoring by the authorities. 
The utilisation of health and social services data in the management of the service system will serve the residents using the services: we will receive effective and equal services that meet our needs whenever we need them.

The utilisation of the data obtained from the emergency medical services in knowledge-based management and the assessment, steering and monitoring tasks of the authorities is developed in the Valtava project carried out under the Toivo programme by the Ministry of Social Affairs and Health. Forming a national data resource on emergency medical services requires the implementation of the KEJO system in all wellbeing services counties.