EMR interoperability is more than just a hospital issue. The EMS team needs it, too.

There are few buzzwords in healthcare that produce as much confusion or urgency as interoperability. For years, the dialogue has centered on hospitals and EHR suppliers. However, crucial stakeholders are often excluded: Emergency Medical Services (EMS).

As EMS develops into a more integrated part of the care continuum, the need for seamless data exchange between EMS and hospital systems has been overlooked. What is needed now is not only technical compatibility, but also clinical interoperability: ensuring patient data moves with patients, no matter where care begins.

EMR, EHR and EPCR: Understanding the Differences

To understand the danger, it helps to shed some key terms.

• Electronic Medical Records (EMR): Digital charts used by individual organizations (usually hospitals or physician groups) to record and manage patient care. EMR is usually organized.
• Electronic Health Record (EHR): A wider, interoperable patient record spanning multiple providers, designed to follow patients throughout the healthcare system.
• Electronic Patient Care Report (EPCR): The first clinical record of many emergencies was completed by EMS providers in the field. It includes vital signs, medications taken, timestamps and nursing impressions.

True interoperability means hospital teams can access, interpret and use EMS-generated data (EPCR) and vice versa. This ensures a shared understanding of the patient’s condition from the moment of contact and discharge.

Why EMS hospital interoperability is important

EMS and hospital data often remain in disconnected systems. This not only delays care, but also introduces risks, redundancy and administrative burdens. The ability of pre-hospital teams and hospitals to share real-time clinical data improved:

• On-site decision-making – When EMS providers access a patient's medical history (such as medications, allergies, or chronic conditions), they can make safer and more informed treatment options.
• Handover of the hospital – Seamless transfer of EPCR data to emergency department records helps avoid data loss and ensure accurate care continuity.
• Compliance and documentation – Automated, spatio-temporal entries from EMS can support medical audits, quality improvements and defenseful legal documentation.
• System-wide nursing coordination – In a value-based care model, EMS is no longer a disconnected post, it is a front-line data source for public health, chronic care and population health management.

In fact, since 2022, the Office of the National Health Information Technology Coordinator (ONC) has been highlighting the need to include EMS and other first responders more widely nationwide.

The Myth of Interoperability Still

Outdated beliefs slowed progress. Some of the most common myths include:

• “Interoperability is just a matter of hospitals.” no longer. EMS plays a crucial role in the transition and benefits of care directly from integrated systems.
• “Hospital EMR cannot connect with the EMS platform.” Many systems now support open standards such as HL7 and FHIR, which enables two-way data exchange.
• “EPCR data are not part of hospital records.” Instead, EMS documents often contain critical information about prehospital care, sometimes the only record that occurs before arrival.

The National EMS Information System (NEMSIS) repeatedly emphasizes the value of EMS data in national health records and its interoperability potential through standards-based design design.

The role of public standards in narrowing the gap

Technical interoperability only works when it is built on publicly available national standards. The most effective solution uses the following.

• HL7 (Sanitary Level 7): Message standards that allow different health systems to communicate clinical data.
• FHIR (Rapid Healthcare Interoperability Resource): Modern network-based standards support cross-platform real-time data exchange.
• NEMSIS standard: In EMS documentation, these structures are increasingly mapped to a wider range of healthy IT networks.

By staying consistent with these standards, EMS and hospital systems can go beyond exchanging static PDFs and begin sharing real-time, structured data that is readable, machine-readable and clinically operational.

From technology to clinical interoperability

Interoperability is often talked about in terms of systems and APIs. But, essentially, it's about people – doctors, caregivers, nurses – access the information they need when they need it.

When emergency department teams can use pre-hospital vitality, medications, or observed symptoms, they do not start over from scratch. When EMS teams can see a patient’s medical history before managing care, they reduce risks and improve outcomes. It strengthens the relationship between the site and the facility when both parties can share data smoothly.

In short, interoperability turns scattered encounters into continuous patient journeys, providing providers with more patient care time.

The way forward

EMR interoperability is no longer an option for EMS. As healthcare moves towards real-time coordination and data-driven performance, EMS must become part of the equation.

To move forward, EMS institutions and hospitals can:

• Review their existing HL7/FHIR preparation system
• Establish a shared document and data sharing protocol
• Include EMS in a broader interoperability dialogue and funding program
• Advocate for national policies that recognize EMS as a core part of health IT infrastructure

Turning to connected care is more than just technology; data is about building a system where data comes with it no matter where the patient’s care begins.

Image source: iPopba, Getty Images

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