Use of Technology to Aid Clinical Audit in an Asian Emergency Medical Services Department.

Although clinical audit is generally accepted to be an essential part of quality review and continuous quality improvement, there are limited reports on and several barriers to the implementation of effective clinical audit in an emergency medicine services (EMS) organization. The barriers include the significant amount of time, resources, and effort often required to conduct the audit. In this paper, we present a technology-enabled clinical audit tool, termed Medical Service Transformation and Innovation Compass (MYSTIC), which has transformed the way the clinical audit is performed in our EMS department. MYSTIC is a Python program we developed in-house, that extracts data from data fields found in routine ambulance case records maintained by our paramedics, and automatically assigns "pass" or "fail" flags based on pre-defined audit criteria. Compared to previous manual auditing, implementation of the MYSTIC computerized audit system increased the coverage of cases undergoing audit from 10% to 100% of all EMS-attended cases, and we were able to promptly identify and address some deficits in training and knowledge amongst our paramedics.