Fourth Nordic-Baltic EMS Data Workshop in Tallinn: A Fruitful Collaboration

Following three successful workshops earlier in 2024, we had a very productive fourth workshop in Tallinn, Estonia, with the Nordic-Baltic EMS Data co-operation. This workshop focused on assessing data gathering, once again revisiting the indicators and reviewing the draft of the third Nordic-Baltic EMS benchmarking report, set to be published in 2025. We assessed data inputs from participating countries and discussed the indicators that should form the basis of our mutual EMS systems' benchmarking.

Estonian Hosts Present Their EMS System

As is customary, the workshop began with a presentation of the host country's EMS system.

Estonia's EMS system is unique, with most ambulances manned by physicians, resulting in a dispersed EMS physician presence throughout the country. Estonia faces challenges similar to other countries, with a high number of EMS missions dispatched through Emergency Dispatch Centers where calls are handled by non-healthcare professionals. This often leads to over-triaging, where many missions result in the EMS unit finding that the patient does not need urgent care.

In the following discussion it was noted that under-triaging is also a significant issue in some countries, with one recent study showing that non-healthcare call handlers often fail to identify clear stroke symptoms.

Data Input Assessment

Countries were to send their 2021-2023 EMS data based on the definitions agreed upon in the previous reports and the earlier workshops this year. The Finnish Institute for Health and Welfare is setting up a Nordic-Baltic EMS Database that hosts this data that comprises of EMS missions and their time stamps. We are still looking at the viability of showcasing more patient-centered data but also well aware that we want to handle only aggregated data where there will be no general and personal data protection issues.

Some of the participating countries managed to gather their data and we had an overview on the current data deliveries. A lot of the entries were done just before the workshop, as you know, there's no minute like last minute, so we concluded to return to the subject on our next meeting in Oslo in February 2025.

Indicator Review and Discussion

A recurring theme in this fourth workshop was the review of the Nordic EMS Quality Indicators. This work has a history spanning ten years, starting with the first report published in 2018. Through our review and refinement, we agreed that the current set of indicators needed some work in terms of terminology to make data gathering more precise and easier. We hope this will enhance the quality of the data.

During this workshop, we focused more on future indicators, many of which are not strictly quality indicators but common indicators for benchmarking. The Nordic and Baltic countries face similar challenges that our EMS systems try to mitigate and manage. Therefore, we need more sharing of practices, a common understanding of our EMS systems, and more indicators to show where each country stands and why. This will enable us to continue working in this Nordic-Baltic EMS setting for years to come. Forming a more permanent co-operation or network is one of the goals for this project. First, we agreed to take a closer look at the methodology for gathering and presenting the reasons for EMS calls or encounters in our countries. As they say, you eat an elephant piece by piece.

Draft Report Review

To bring our workshop to a concrete and logical conclusion, we reviewed the current draft of the upcoming Nordic-Baltic EMS benchmarking report 2025. The working group had some homework to do before this workshop, and we were pleased to see the report coming to life with that collective effort. We now have an all-new background chapter, up-to-date descriptions of each country's EMS systems, and progress in other chapters as well. Our dynamic duo of an editorial board will have their hands full as we work towards the final version of the report, set to be published by June 2025.

Viljami Lampilinna
Development manager
Finnish Institute for health and welfare
viljami.lampilinna(at)thl.fi

Futher information:

• Previous workshop: Nordic-Baltic EMS Data Co-operation Intensifies! (thl.fi)
• Identifying stroke patients during the emergency call: Streamlining a Thrombectomy Candidate’s Care Outside the Hospital District of a Comprehensive Stroke Centre: Focus on the Emergency Call and Expedited Transportation with Helicopter Emergency Medical Services - Tampere University Research Portal
• First Nordic Emergency Medical Services report: The Nordic Emergency Medical Services Benchmarking Report 2014-2018 (pdf, helsedirektoratet.no)