Nordic-Baltic EMS Data Co-operation and Benchmarking: A Progress Update
In January, the Nordic-Baltic (prehospital) Emergency Medical Systems (EMS) co-operation was successfully launched. Representatives from each Nordic country and Estonia reconvened during the Easter week for the second workshop. While the initial workshop primarily focused on orientation and catching up with the previous reports from 2018 and 2021, this time, it was all about rolling up our sleeves and diving into the work.
Understanding the Swedish EMS System
Dr. Bruno Ziegler, representing the Swedish National Board of Health and Welfare (Socialstyrelsen), kicked off the workshop with a presentation on the Swedish EMS system. A crucial factor supporting EMS development in Sweden is the Ambureg prehospital registry, which collects nationwide patient data from the EMS system.
Revisiting the Nordic EMS Quality Indicators
The workshop continued by revisiting the previously defined Nordic EMS Quality Indicators. The discussion was robust, providing valuable insights into the similarities and differences among the participating countries. Notably, all countries have access to nationwide mission data, consisting of timestamps of EMS units’ movements during missions and the total number of EMS missions categorized by urgency.
However, where we diverge - consistent with previous reports - is in the number of urgency levels. This discrepancy prompted discussions on how to obtain comparable data. Ultimately, it was decided that the definition of an urgent versus a non-urgent mission is straightforward across all countries: Is it a “lights and sirens” situation or not?
ICPC-2: An Opportunity for Benchmarking
Rather than solely focusing on the prevalence of specific health problems, we embraced a worthy challenge: comparing the top 5, 10, or 20 causes for EMS missions. All participating countries collect some form of “reason for encounter” data in their EMS systems. During the 2014-2018 project, the World Health Organization (WHO) recognized ICPC-2 was identified as the most potent classification for EMS, followed by a formation of a common Nordic EMS ICPC-2 dataset.
However, in practice, ICPC-2 remains underutilized. Nevertheless, it serves as a foundational structure that allows us to map national patient-specific “reason for encounter” listings. This mapping opens up exciting opportunities for benchmarking. For instance, in Finland, mental health problems have emerged as a significant concern among EMS patients. We aim to explore whether similar trends are occurring in other countries.
Next Steps and Homework
As our workshop concluded, we assigned homework to all participants: investigate data availability, especially for 2021, and potentially extend it to 2022 or even 2023. The Finnish Institute for Health and Welfare’s (THL) EMS “office” will provide real-world ICPC-2 listings, forming the basis for identifying the most common reasons for encounters in the Nordic-Baltic EMS. Our report, due for publication at the end of 2024, will also begin the formalization process before our next meeting.
Stay tuned for further developments in our benchmarking journey!
Viljami Lampilinna
Development manager
Finnish Institute for health and welfare
viljami.lampilinna(at)thl.fi
Futher information:
- Blog post from the first workshop: Nordic-Baltic data co-operation in Emergency Medical Services
- Swedish preshospital EMS registry Ambureg (rcsyd.se)
- Variable list for Ambureg (rcsyd.se)
- ICPC-2 classification of primary care (who.int)
This text has been refined with the help of Copilot, an AI language model.
