Specify the patient destination

The destination is the physical location where the patient was transported by the EMS Emergency Medical Services unit creating the ePCR electronic patient care record. This can include hospitals, medical centers, nursing homes, another EMS unit, a residence, a morgue, and so forth.

1. (If you have not done so already) Access the EHR module in the ESO Suite.

   1. Do one of the following.

      • (If you are already working in the ESO Suite) Click the Home icon in the upper left corner of the screen.

        

      • (If you have not yet logged in) Log in to the ESO Suite.

        1. In a web browser, go to https://www.esosuite.net/EsoSuite.

           The ESO Suite login screen appears.

        2. Enter your user name, password, and agency name, then click Let's Go.

           If MFA multi-factor authentication is enabled, the Multi-factor authentication dialog box appears, displaying one or more methods you can use to verify your login credentials. The number of methods that appear in the dialog box depends on what MFA methods your ESO Suite administrators enabled in the Admin module.

           Click graphics to open them.

           Information on enabling MFA and specific MFA methods is available in the Admin module online help, in Configure multiple-factor authentication.

           Note: If your ESO Suite administrators have disabled MFA ("opted-out"), this dialog does not appear.

        3. (If the Multi-factor authentication dialog box appears) Depending on which buttons appear in the dialog box, verify your login in one of the following ways.

           With an authenticator application.

           1. Click MFA verification via authenticator app.

              The dialog box updates with boxes for entering the numbers of the authentication code, and the ESO Suite sends an authentication code to the authenticator application installed on your device.

              

           2. Open your authenticator application and note the authentication code currently displayed.

           3. Enter the authentication code displayed in the authenticator application.

           4. Click Log In.

           With a text message (SMS short message service).

           1. Click MFA verification via SMS.

              The dialog box updates with boxes for entering the numbers of the authentication code, and the ESO Suite sends an authentication code to the phone number recorded in your PM records and identified with MFA codes.

              

           2. Enter the authentication code sent to your MFA-registered phone number.

           3. Click Log In.

           With an email message.

           1. Click MFA verification via email.

              The dialog box updates with boxes for entering the numbers of the authentication code, and the ESO Suite sends an authentication code to your agency or department email address, recorded in your PM records.

              

           2. Enter the authentication code sent to your agency or department email address.

           3. Click Log In.

      The ESO Suite landing screen appears.

      Click graphics to open them.

      Note: If MFA multi-factor authentication is enabled, you can access and manage your MFA options through the PM module, on the Settings > Account page, as described in Manage a user account. If your agency or department has enabled MFA but has not purchased the full-featured version of the PM module, you can access your own MFA settings by clicking Change my Multi-Factor Authentication settings on the landing screen, then using the Settings > Account page that appears. If your agency has not enabled MFA, the Change my Multi-Factor Authentication settings link does not appear on the landing screen.

   2. On the top side of the home screen, click EHR.

      Tip: If your screen or browser window is too narrow to display all your agency's ESO Suite module icons, an options icon appears on the right side of the icon bar. If you click the options icon, a menu appears containing additional module icons.

      The EHR screen appears, displaying a list of patient records in the EHR module. The most-recent records appear at the top of the list.

      

      Different record status icons can appear in the list.

      Icon	Status
      	Unlocked/Draft The patient record exists in the ESO Suite database, and all crew members listed in the patient record may edit all fields in the record. ESO Suite administrators and personnel with security roles of either EHR Supervisor or EHR Manager can edit non-clinical fields.
      	Mobile The patient record exists on the mobile device, and has not been synchronized with the ESO Suite database. ESO Suite administrators, personnel with security roles of either EHR Supervisor or EHR Manager, and all crew members listed in the patient record can only access a print view of the record. Once the Mobile record synchronizes with the ESO Suite database. the record reflects its current status.
      	Locked The patient record exists in the ESO Suite database, and is locked. Only non-clinical fields can be edited by crew members listed in the patient record, ESO Suite administrators and personnel with security roles of either EHR Supervisor or EHR Manager.

2. (If you have not done so already) Add a new patient record, or search for the existing patient record you want to work with.

   Information on adding or opening a patient record is available in Add a patient record and Search for a patient record.

   The patient record opens and displays the Incident tab, with the Response bookmark selected in the left pane. Fields appear in the right pane for specifying basic information about the incident

   

   If you manually created a new patient record, the Incident Number and State Tracking Number fields populate automatically with ESO Suite-assigned values. You must enter data in all other required fields.

   If you imported data from a CAD Computer Aided Dispatch system, the Incident Number field populates with the data from that source. Other fields in the EHR module may also populate from these sources, depending on what data was recorded in them before the data was imported into the EHR module.

3. In the left pane, click the Destination bookmark.

   The right pane scrolls down to the top of the Destination section of the page.

   

4. (If applicable) Specify the location of where the patient is transported in one of these ways.

   Use a predefined location.

   Predefined locations are locations where incidents commonly occur for your agency, that your ESO Suite administrators have defined in the Admin module with addresses, GPS global positioning system coordinates, and so forth. With these locations already defined, you can save time at an incident by selecting a location type and then selecting one of its pre-defined locations, instead of manually entering the address each time there is an incident at that location.

   Example: A predefined location might be a local mine or quarry, where injuries happen with some regularity because of the dangerous nature of the work, and to which your agency travels in response to incidents there.

   Information on defining incident locations is available in Configure location information.

   You can still edit some components of the pre-defined location information in the EHR module when you identify an incident location.

   1. At the top of the Destination section, choose Predefined.

      Fields relevant to a pre-defined destination appear.

   2. From Destination Type choose Hospital, Nursing Home, Dialysis, or click Other and select the appropriate single option from the menu that appears.

      The destination type is a general description of where the patient is transported.

      The Destination Name field activates.

   3. For Destination Name, click the field or the list icon to the right of the field, then select the appropriate single option from the menu that appears.

      The locations that appear in the menu are those that your ESO Suite administrator defined, in the Admin module, for that location type.

      Information on defining incident locations is available in Configure location information.

      The Address and Zone fields populate with the selected location's information, as your ESO Suite administrator entered it in the Admin module, and cannot be edited in the EHR module.

      The Additional Address and Apt/Suite/Room also populate with information in the Admin module, if it exists. The and Latitude, and Longitude fields may appear, and will also populate with information in the Admin module, if it exists. You can enter or edit the data in any of these fields in the EHR module as needed.

   4. (If you chose a hospital) Specify additional information about the hospital.

      Note: Each of these fields appears in the EHR module only if your ESO Suite administrator enabled it in the Admin module, under EHR > Incidents Tab > Configurable fields.

      Information on enabling EHR fields is available in the Admin module online help, in Configure tabs.

      1. (If it appears) For Department, click the field or the list icon to the right of the field, then select the appropriate single option from the menu that appears.

         This field also appears only if, for Destination Type, you chose Hospital.

         The location within the hospital that the patient was taken directly by EMS Emergency Medical Services.

         Example: Emergency room, burn unit, orthopedic, pediatrics, and so forth.

      2. For Hospital Designation, click the field or the list icon to the right of the field, then select the appropriate single option from the menu that appears.

         This field appears also appears only if, for Destination Type, you chose Hospital.

         The department is a more-specific indication of the capabilities of the hospital the patient was taken to.

         Example: General hospital, burn center, trauma center, pediatric center, and so forth.

   5. (If necessary) Add or edit information in the Additional Address, Apt/Suite/Room.

   6. (Optional, if the fields appear) Specify the location using latitude and longitude coordinates.

      When looking at a map, latitude lines (parallels) run horizontally. Each degree of latitude is approximately 69 miles (111 km) apart; there is a variation due to the fact that the earth is an oblate ellipsoid (slightly egg-shaped). Degrees latitude are numbered from 0° to 90° north and south. Zero degrees is the equator, the imaginary line which divides our planet into the northern and southern hemispheres. 90° north is the North Pole and 90° south is the South Pole.

      The vertical longitude lines (meridians) converge at the poles and are widest at the equator (about 69 miles or 111 km apart). Zero degrees longitude is located at Greenwich, England (0°, the Prime Meridian). The degrees continue 180° east and 180° west where they meet and form the International Date Line in the Pacific Ocean. Greenwich is the site of the Prime Meridian.

      Note: The Latitude and Longitude fields appear in the EHR module only if your ESO Suite administrator enabled Scene GPS Location in the Admin module, under EHR > Incidents Tab > Configurable fields.

      Information on enabling EHR fields is available in the Admin module online help, in Configure tabs.

      • Specify the latitude and longitude values in one of these formats.

        In DMS degrees, minutes, and seconds

        • In Latitude and Longitude, type the number of degrees from 0° (the equator or the Prime Meridian, respectively), minutes from the degree to the location, and seconds from the minute to the location.

          There are 60 minutes in each degree, and 60 seconds in each minute.

          Example: The United States capitol is located at 38°53'23"N , 77°00'27"W (38 degrees, 53 minutes, and 23 seconds north of the equator and 77 degrees, no minutes and 27 seconds west of the meridian passing through Greenwich, England).

        In DD decimal degrees

        Decimal degrees are an alternative to using DMS degrees, minutes, and seconds . Decimal degrees express latitude and longitude geographic coordinates as decimal fractions and are used in many GIS geographic information systems, web mapping applications such as Google Maps, and GPS global positioning system devices. As with latitude and longitude, the values are bounded by ±90° and ±180° respectively.

        Positive latitudes are north of the equator, negative latitudes are south of the equator. Positive longitudes are east of Prime Meridian, negative longitudes are west of the Prime Meridian.

        • In Latitude and Longitude, type the decimal fraction of the latitude and longitude portions of the geographic coordinates of the location, respectively).

          Example: The United States capitol is located at 38.889722°, -77.008889°.

   Manually enter the location address information.

   If a destination is somewhere other than a predefined location, you can manually enter the address and additional location information, to pinpoint the patient's destination.

   1. At the top of the Destination section, choose Address.

      Fields relevant to a specifying the location of an incident location appear.

   2. From Destination Type choose Hospital, Nursing Home, Dialysis, or click Other and select the appropriate single option from the menu that appears.

      The destination type is a general description of where the patient is transported.

      The Destination Name field activates.

   3. In Destination Name, type the name of the destination the patient was delivered or transferred to.

      Example: Ames North Medical Center

   4. (If you chose a hospital) Specify additional information about the hospital.

      Note: Each of these fields appears in the EHR module only if your ESO Suite administrator enabled it in the Admin module, under EHR > Incidents Tab > Configurable fields.

      Information on enabling EHR fields is available in the Admin module online help, in Configure tabs.

      1. (If it appears) For Department, click the field or the list icon to the right of the field, then select the appropriate single option from the menu that appears.

         This field also appears only if, for Destination Type, you chose Hospital.

         The location within the hospital that the patient was taken directly by EMS Emergency Medical Services.

         Example: Emergency room, burn unit, orthopedic, pediatrics, and so forth.

      2. For Hospital Designation, click the field or the list icon to the right of the field, then select the appropriate single option from the menu that appears.

         This field appears also appears only if, for Destination Type, you chose Hospital.

         The department is a more-specific indication of the capabilities of the hospital the patient was taken to.

         Example: General hospital, burn center, trauma center, pediatric center, and so forth.

   5. For Country, click the field or the list icon to the right of the field, then select the destination county in which the patient was delivered or transferred to.

      Note: This field appears in the EHR module only if your ESO Suite administrator enabled it in the Admin module, under EHR > Incidents Tab > Configurable fields.

      Information on enabling EHR fields is available in the Admin module online help, in Configure tabs.

   6. In Address and Apt/Suite/Room, type the street address and any relevant address components for the street address of the destination the patient was delivered or transferred to.

   7. In Zip, type the zip code for the location, then click the search icon (magnifying glass).

      A list of cities, states, or zip codes matching what you entered appears.

      Example: In Zip, type 50248, then click the search icon. A list of zip codes matching 50248 appears on the right.

   8. Select the entry that corresponds to the rest of the address you are entering.

      The rest of the information from that match automatically populates the City, State, and County fields.

   9. (Optional) Specify the location using latitude and longitude coordinates.

      When looking at a map, latitude lines (parallels) run horizontally. Each degree of latitude is approximately 69 miles (111 km) apart; there is a variation due to the fact that the earth is an oblate ellipsoid (slightly egg-shaped). Degrees latitude are numbered from 0° to 90° north and south. Zero degrees is the equator, the imaginary line which divides our planet into the northern and southern hemispheres. 90° north is the North Pole and 90° south is the South Pole.

      The vertical longitude lines (meridians) converge at the poles and are widest at the equator (about 69 miles or 111 km apart). Zero degrees longitude is located at Greenwich, England (0°, the Prime Meridian). The degrees continue 180° east and 180° west where they meet and form the International Date Line in the Pacific Ocean. Greenwich is the site of the Prime Meridian.

      Note: The Latitude and Longitude fields appear in the EHR module only if your ESO Suite administrator enabled Scene GPS Location in the Admin module, under EHR > Incidents Tab > Configurable fields.

      Information on enabling EHR fields is available in the Admin module online help, in Configure tabs.

      • Specify the latitude and longitude values in one of these formats.

        In DMS degrees, minutes, and seconds

        • In Latitude and Longitude, type the number of degrees from 0° (the equator or the Prime Meridian, respectively), minutes from the degree to the location, and seconds from the minute to the location.

          There are 60 minutes in each degree, and 60 seconds in each minute.

          Example: The United States capitol is located at 38°53'23"N , 77°00'27"W (38 degrees, 53 minutes, and 23 seconds north of the equator and 77 degrees, no minutes and 27 seconds west of the meridian passing through Greenwich, England).

        In DD decimal degrees

        Decimal degrees are an alternative to using DMS degrees, minutes, and seconds . Decimal degrees express latitude and longitude geographic coordinates as decimal fractions and are used in many GIS geographic information systems, web mapping applications such as Google Maps, and GPS global positioning system devices. As with latitude and longitude, the values are bounded by ±90° and ±180° respectively.

        Positive latitudes are north of the equator, negative latitudes are south of the equator. Positive longitudes are east of Prime Meridian, negative longitudes are west of the Prime Meridian.

        • In Latitude and Longitude, type the decimal fraction of the latitude and longitude portions of the geographic coordinates of the location, respectively).

          Example: The United States capitol is located at 38.889722°, -77.008889°.

   10. For Zone, click the field or the list icon to the right of the field, then select the appropriate single option from the menu that appears.

       The response zone label from agency. The zone is a geographical area the incident scene is located in.

       Understand the link between the EHR and Admin module, when selecting a zone.

       The options that appear in the dialog box are defined by the Admin module, by your ESO Suite administrator, under General > Zones.

       Example: In the EHR module, for the Zone field, you may need options such as Zone 1, Zone 2, Zone 3, and Zone 4. Your Admin module administrator must add corresponding ADL agency-defined list items in the Admin module, under General > Zones, for these items to appear as menu choices in the EHR electronic health records module.

       If no options appear, or if the menu does not have an option that meets your needs, contact your ESO Suite administrator and ask them to add the necessary menu choices. You will need to work closely with your administrator to create and maintain these lists, as your department's needs evolve over time.

       Information on defining these options is available in the Admin module help, in Configure zones.

5. Specify identification and tracking numbers.

   1. In Chart Number, type or scan the unique identifier for the patient's medical chart.

      The medical chart is a complete and total record of the patient's clinical data and medical history.

   2. In Patient Number, type the unique identifier assigned by the hospital number to the patient.

   3. (Georgia and Texas) In State Wristband Number, type the unique identifier on the wristband provided by EMS for transported patients

   4. In State Tracking Number, type the unique identifier for each patient encounter that is transferred to each level of care for a patient, from the tracking code assigned to patient by the first licensed agency that arrives at the patient for this specific event.

      Note: This field appears in the EHR module only if your ESO Suite administrator enabled it in the Admin module, under EHR > Incidents Tab > Configurable fields.

      Information on enabling EHR fields is available in the Admin module online help, in Configure tabs.

6. Provide stroke, STEMI ST-Elevation Myocardial Infarction, and trauma registry and system information.

   1. (Alabama only) For Did you enter this patient into the Alabama Stroke System, choose Yes or No to indicate whether or not the patient is eligible to receive tPA tissue Plasminogen Activator.

      An ischemic stroke occurs when blood clots or other particles block the blood vessels to the brain. tPA tissue Plasminogen Activator is administered to patients through an IV intravenous line in the arm, and it dissolves blood clots that block blood flow to the brain.

      The Alabama Statewide Stroke System is developing a stroke emergency care system that will result in 100 percent tPA administration to all eligible patients and a minimum of ten percent administration to all ischemic stroke patients.

      Note: This field appears in the EHR module only if your ESO Suite administrator enabled it in the Admin module, under EHR > Incidents Tab > Configurable fields.

      Information on enabling EHR fields is available in the Admin module online help, in Configure tabs.

   2. For each of the fields below, provide the necessary information.

      Note: Each of these fields appears in the EHR module only if your ESO Suite administrator enabled it in the Admin module, under EHR > Incidents Tab > Configurable fields.

      Information on enabling EHR fields is available in the Admin module online help, in Configure tabs.

      For this field	Do this
      Trauma Registry	Type the unique identifier for the trauma registry that your organization belongs to. A trauma registry is a complex database of the demographics, injuries, care, and outcomes of trauma patients. They are designed to provide information that can be used to improve the efficiency and quality of trauma care. Traumatic injury is a sudden and severe injury caused by a physical force, such as car accidents, falls, drowning, gunshot wounds, burns, stabbings, or other physical threats. Major trauma is any injury that can cause prolonged disability or death.
      Stemi Registry	Type the unique identifier for the STEMI ST-Elevation Myocardial Infarction registry that your organization belongs to. A STEMI registry is a complex database of the demographics, care, and outcomes of STEMI patients. The goal of a STEMI registry is to timely obtain real-world knowledge about STEMI patients. STEMI ST-Elevation Myocardial Infarction is a common type of heart attack caused by a blocked artery that supplies blood to the heart muscle. STEMI is a severe heart attack that affects the heart's lower chambers when the artery to the heart is completely blocked.
      Stroke Registry	Type the unique identifier for the stroke registry that your organization belongs to. A stroke registry is an online, interactive assessment and reporting system, that measures, tracks, and improves the quality of care for acute stroke patients. A stroke occurs when a blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot or bursts (or ruptures). When that happens, part of the brain cannot get the blood (and oxygen) it needs, so it and brain cells die. Stroke can be caused either by a clot obstructing the flow of blood to the brain (an ischemic stroke) or by a blood vessel rupturing and preventing blood flow to the brain (a hemorrhagic stroke). A TIA (transient ischemic attack), or "mini stroke", is caused by a temporary clot.

7. Describe the ED emergency department and hospital dispositions.

   Note: Each of these fields appears in the EHR module only if your ESO Suite administrator enabled it in the Admin module, under EHR > Incidents Tab > Configurable fields.

   Information on enabling EHR fields is available in the Admin module online help, in Configure tabs.

   1. In ED Disposition, type the known disposition of the patient from the emergency department.

      Depending on a patient's specific medical condition, physicians will either admit the patient to the hospital, discharge the patient, or transfer the patient to a more appropriate medical facility.

   2. (If the patient was admitted to the hospital) For Hospital Disposition, type the known disposition of the patient from the hospital.

      The hospital disposition is the destination of the patient after hospital discharge. It can also describe the destination within the care pathway following early assessment and treatment in the ED.

8. For Reportable Condition, select Yes or No to indicate whether or not the patient has a disease or illness considered to be of great public health importance.

   Cases or suspected cases of illness considered to be public health emergencies, outbreaks, exotic diseases, and unusual group expressions of disease must be reported to the local health department or DSHS immediately.

9. For Request for Review, select Yes or No to indicate whether or not the PCR patient care report needs review by anyone.