Development of a Mobile Application for EMS Treatment Protocols Based on a Human-Centered Design Approach

Emergency medical services (EMS) treatment protocols are traditionally static and often complex documents that are not easily accessed during patient care. To optimize medical decision-making and reduce errors, EMS clinicians need rapidly accessible reliable resources to guide decisions in real-time. Incorporating human-centered design (HCD) allows for innovative and purpose-built solutions to suit specific needs grounded in end-user feedback. In this manuscript we describe the development of a mobile application using HCD processes to facilitate rapid access to prehospital treatment protocols, real-time decision support, and just-in-time training for EMS clinicians during field care.

The Los Angeles County EMS Agency, in partnership with Harbor-UCLA Department of Emergency Medicine and The Lundquist Institute, developed a mobile application for EMS clinicians incorporating all EMS policies, protocols, and medical control guidelines to facilitate real-time access to patient care support tools. We followed the principles of HCD in three phases: Inspiration, Ideation, and Implementation. We developed a descriptive report of the major ideas generated from the inspiration and ideation phases, as well as the resulting prototype in the implementation phase.

Through an iterative process engaging system stakeholders, we identified three content areas where the mobile application could most impact patient care: 1) Access to treatment protocols in a concise format digestible in real-time, 2) Quick decision support (e.g., medication drug dosing, risk score calculation, destination guidance), and 3) Just-in-time training for low-frequency, high-risk procedures. We further identified three design functions to optimize use: 1) Interlinking of content based on anticipated needs during a patient encounter, 2) Visible cues to indicate key information or required actions, and 3) Ability to search all policies, and favorite specific ones for personal rapid access. The application prototype consisted of three components: 'Rapid Access Treatment Protocols' (RATPs) for adult and pediatric patients, Quick Reference Guidelines (QRGs), and Just-in-Time (JIT) Videos, and incorporated the identified design functions.

Using HCD principles, we developed a mobile application that enables rapid access to real-time decision support for EMS clinicians. This process and the application features, prioritized by our system stakeholders and EMS clinicians, can inform similar efforts in other EMS systems.