Nordic-Baltic EMS Co-operation: More Than Just Reporting Data
Over the past year, representatives from Denmark, Estonia, Finland, Iceland, Norway, and Sweden have gathered in five workshops to create the next installment of the Nordic-Baltic EMS benchmarking report. Our focus has been to gather mutually defined indicator data into a common database hosted by the Finnish Institute for Health and Welfare (THL).
Throughout this co-operation, we have discovered that there are indeed other aspects beyond just reporting pre-defined indicators that we could mutually benefit from. After all, the name of the previous reports on this co-operation already suggests that there is benchmarking to be done between the countries!
Norway Setting the Stage for Workshop #5
We met in early February in Oslo, where the weather was sunny and mild for the time of year. Personally, it felt like spring had arrived with the sun shining in a blue sky and water dripping down the drainpipes!
As usual, the hosting nation's Emergency Medical System (EMS) was presented to us. Norway has a reputation for being at the forefront of EMS and emergency care development, with their famous trials, for example, testing whether adrenaline (epinephrine in the US) works as a resuscitation medicine (spoiler alert: it doesn't make a difference in long-term survival or neurological outcomes).
The Norwegian Index for classifying Emergency Medical Dispatch Center (112 or a specialized number in some countries) calls is currently used alongside Norway in Denmark, Estonia, and partly in Sweden. Norway has a fleet of 527 ambulances, 45 ambulance boats, 9 fixed-wing aircraft, and 14 HEMS units, with an additional 9 search-and-rescue helicopters at their disposal.
The national medical emergency number 113 received 778,444 calls in 2023, an increase of over 150,000 calls in just five years. This is one example of the similar challenges that all the countries are facing. Another identified common denominator is that 12-15% of Norway's 113 callers are so-called "heavy users" of the emergency services.
Data Flow is Always Nice
THL presented findings based on the data provided to the common database by the countries. It is always a sound practice to have the data first or as soon as possible and then start working on the issues that arise from the findings. When the data was checked for quality and structured under common indicators, this principle once again proved its value in highlighting some errors and the need for updating the data.
We also had a good discussion on how to interpret the data. Since we are Emergency Care professionals, we got right down to business and formed a data interpretation team immediately.
The next iteration of the draft report will surely have a lot more for us to chew on! Our appetite for getting more patient-centered data flowing among the countries (with GDPR considerations clearly in our minds, of course!) led us to discuss a standardized EMS dataset that we could publish and keep developing together.
The common basis for Finnish and Icelandic EMS electronic patient record systems is in the NEMSIS dataset, which is used in the over 60 million electronic health records gathered in the United States' NEMSIS database.
Towards Future Nordic-Baltic EMS Co-operation
It has already been identified that we are in a unique setting with national EMS operators collaborating on common data and indicators. However, as the heading for this text suggests, there are more domains that we could benefit from in our co-operation.
Our Norwegian colleagues informed us of an upcoming Nordic-Baltic Ambulance Safety conference in June, where we could reach a common understanding of how the European Union should regulate ambulances and their equipment to promote safer working environments for EMS professionals.
As we head towards our last meeting, a seminar in Iceland in May, we are looking to set the scope of our co-operation to benefit the participants and allow us to gain funding to continue our work. At least for the autumn of 2025, we are covered, but we need to start laying the groundwork to secure funding from 2026 onwards.
Viljami Lampilinna
Development manager
Finnish Institute for health and welfare
viljami.lampilinna(at)thl.fi
Further information:
Previous workshop (9.1.2025): Fourth Nordic-Baltic EMS Data Workshop in Tallinn: A Fruitful Collaboration - THL
Norwegian adrenaline admission study: Outcome when adrenaline (epinephrine) was actually given vs. not given – post hoc analysis of a randomized clinical trial - Resuscitation (resuscitationjournal.com)
