Sacred Cows & Data Cubes: This Is How We Share a Foxhole

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Leveraging ePCR Data to Identify the Risk of Post-Traumatic Stress Disorder

This special episode of “Sacred Cows & Data Cubes” was recorded at the Hospital Corporation of America (HCA) EMS Kansas City Symposium in November 2021. It features an emotional anecdote of post-traumatic stress and recovery by Atchison County (KS) EMS captain and retired Fire Chief Rob Brader.

There is safety in numbers: both the math and statistics — and the herd, where one stay anonymous by choice without worry that exorcizing the demons of Mobile Medicine will result in persecution for the dark thoughts that inevitably spawn of this emotional work.  

“Let the numbers do the talking” is a core tenet of the approach first revealed to Jonathon Feit, chief executive of Beyond Lucid Technologies by Ron Nichols, director of Chambers County Emergency Medical Services in Texas. Ron uses a questionnaire to see sparks of mental health stress among his personnel in a manner similar to how others might identify infections (say, COVID-19) before they spiral out of control. His crew members have to write an ePCR after every call; and any member of the crew can catch a bad call. He recognized that this offers two opportunities for insight:

  1. The ePCR not only offers details about what happened on the call, it also offers details about what the crew experiencedduring the call;
  2. If every member of every crew completes a wellness survey after every call—or even after every call involving specific sentinel events—then the requirement to complete a mental wellness or trauma impact survey becomes, by definition, randomly distributed.  There is no longer a need for anyone to “step forward” because everyone has the same requirement. Anyone can catch an unfortunate call.

The result is compelling: The data in ePCRs become vital to crews’ mental wellness and health.  No longer are ePCRs mere busywork; no longer should they be despised.  Instead, they become something akin to a recurrent Rorschach test for each member of the crew, revealing how they are doing call-by-call, and in aggregate — inviting management to pay attention.  At the end of this discussion, we’ll ask: Can agencies really afford not to step in to help, especially amid a talent crunch?

If the analytics can be automated and tuned to examine ePCRs over time, then they can reveal who needs help without a crew member saying anything.  This empowers watchful management to step ahead of a health crisis in-the-making, bolstering agency morale and resiliency, satisfaction and safety.  ePCR data—maximized to their potential and strung together over time—therefore go beyond the collection of legal, billing, and NEMSIS data.  They become a tool to safeguard Mobile Medicine’s most precious resource: its professionals on the line.

View the slides from the presentation below:


  • Jonathon S. Feit, MBA, MA, is co-founder & chief executive of Beyond Lucid Technologies, Inc., the award-winning company behind the MEDIVIEW ePCR and BEACON Prehospital Health Information Exchange. He is a columnist for JEMS, and a regular contributor to multiple EMS publications on topics related to data sharing, patient care reporting, Community Paramedicine, Mobile Integrated Health, and technology for tracking and intervening in the cycle of opioids/opiate and amphetamine addiction. Jonathon holds advanced degrees from Carnegie Mellon and Boston University and has been a credentialed journalist for over a decade. Learn more and get in touch via social media or at

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