PCS Cross Check — The ePCR

Demographics, done for you

Scan the card — the chart writes itself ePCR

Point the tablet at the patient's health card and the demographics are done: name, date of birth, health number and version code are read on the device — never saved, never uploaded — checked against the card's own check digit, and committed into the chart with the age derived for you. Add what the platform already knew — the call number and pick-up address straight off the CAD link, the service identity, today's dates, the truck, monitor and station from the shift log — and most of page one is filled before a single tap. Every field the platform filled wears a green AUTO badge, so what the medic typed and what the machine filled are never confused — and auto-filled fields stay fully editable.

The Scan Health Card sheet at the review step: last name, first name, middle names, date of birth, health number and version code parsed from the card, with Scan again and Use these details buttons

The scan stops for a human first: check the parsed details, fix anything, then use them. Nothing else from the card is kept.

The demographics section dense with green AUTO badges — service identity, dates, the CAD-delivered call number and pick-up address, name, date of birth, derived age, formatted health number and version code all auto-filled — with the Community Paramedic patient banner showing the on-file history and the Known patient — 3 prior calls · CP client row

One scan, and the demographics block fills itself — every platform-filled field wearing its green AUTO badge — and the recognition check has already come back: Known patient — 3 prior calls · CP client, with the on-file history, meds, allergies, substitute decision-maker, physician and DNR surfaced right on the chart.

Prior history — tick what belongs on this chart

Importing is a choice, not a dump: every item carries its source — the CP profile or a specific prior call — duplicates are flagged, and "charted 2×" shows what past crews corroborated. Import only adds; anything already typed stays exactly as typed.

How the recognition works — and why you can trust it5 features

Fires from the identifiers you already chart — the moment a health number or a name-and-birthdate lands on the chart, the platform checks the service's own records for prior 911 calls and an active Community Paramedicine enrolment. No extra step, nothing to remember.
Wrong-patient safety gate — on a name-and-DOB-only match the full summary stays hidden until the medic confirms it's the right person; only a health-card match opens directly.
Import fills only blank fields — one tap pulls history, meds, allergies and demographics into the report without overwriting a single thing the medic typed.
Reads like a record, not a guess — every imported item is source-labelled to the call or profile it came from, so the chart stays defensible.
Scan stays on the device — the health-card image is read on the tablet and never saved or uploaded; identifiers travel only in encrypted request bodies, never in a URL.

Measured, not promised

A million charts. No loading screens.

That patient-recognition answer has to be instant to be worth anything at the bedside — so it was measured against a one-million-chart database seeded with the platform's own encryption, on the ordinary two-core server the demo platform runs on, with the live application running beside the benchmark. The app itself never makes a medic wait on the network: every screen is local-first, drafts save on the device and sync in the background, and lookups appear when they're ready — there is no spinner between a medic and the chart. The only waits are on external devices, like the monitor case pull.

0.72 ms

median health-card lookup against a 700,000-chart service — 99th percentile 2.52 ms.

1,835/s

lookups per second sustained by twenty concurrent workers in the noisy-neighbour test.

24.7 ms

the worst answer another service saw while that hammering was under way. Still instant.

23 / 23

adversarial correctness checks passed — McDonald never returned a MacDonald chart, twins stayed ambiguous, services stayed walled.

The full scale story →

Electronic Ambulance Call Report

The ePCR that does the paperwork with you ePCR

An Ontario MOH-aligned call report with a real-time completeness check, native scanners that kill the typing, and a glove-friendly interface built for the back of a truck — online or off. Every signed chart renders as the official ministry-format document. Below: a real chest-pain call's treatment record, start to finish.

The Clinical Treatment / Procedures flowsheet: the pinned new-entry editor with the call-times reference strip, above time-stamped crew-attributed rows — PPE, patient assessment, vitals with computed MAP rendered as inline chips, rhythm interpretation, ASA per the ischemia directive, a normal 12-lead, repeat vitals to the second, IV cannulation — each row carrying its clinical note and insert-above/below controls

Charted the way Ontario medics actually write: every row time-stamped, crew-attributed and carrying its note — "As per ischemia Directive.", "Pulse matches monitor." — vitals with the MAP computed for you, times down to the second, and the call times pinned right on the entry editor for reference. Missed something? Insert a row above or below and the timeline stays honest.

The treatment entry editor mid-entry: 'morph' typed into the procedure search with the ranked dropdown open showing 604 Morphine and 420.05 Medication Wastage — Morphine, and the dose field already rendered because the code drove the entry type

Type a fragment, get the official code — and the code drives the form: pick a medication and the dose, units and route fields are already there. Printouts stay letter-perfect because the code, not the shorthand, is what's stored.

Daily Shift Log vehicle and equipment check sheet, filled out

The Daily Shift Log, filled out — truck, crew, narc kit, monitor and the 30-joule test — and the truck, monitor and station backfill the shift's charts automatically.

Everything the chart does for you14 features

Health-card scanner — in the native iPad app, scan the patient's OHIP card to auto-fill demographics; the scan is read entirely on the device and never saved or uploaded.
Medication scanner & safety flags — snap the patient's bottles in the native iPad app to capture their meds against Health Canada's drug database; a banner warns the moment a contraindicated drug is added (nitrates against a PDE-5 drug, bleeding risk on an anticoagulant).
Medication lookup with real depth — the patient-meds search runs against a 14,896-entry Health Canada DIN index; type a fragment and generics, brand names and class tags surface together ('metf' brings back 7 matches, Glucophage, Janumet and Xigduo among them).
One chronological flowsheet — every vital, medication and procedure on a single time-ordered timeline; type an official code and the right structured fields appear (IV, IO, intubation, defibrillation, CPAP, Apgar), midnight-rollover aware.
Vitals that do the math — a keyboard-driven grid with an interactive GCS calculator (E/V/M auto-total, even from a partial set), auto-computed MAP, and carry-forward of the unchanging qualifiers.
Never hunt for a code — long ministry code lists become type-to-search boxes that show plain English while storing the exact code, so printouts stay letter-perfect.
Guaranteed 24-hour time — type 1645, get 16:45; impossible times are rejected, and every date/time renders in exact ministry format (YYYY:MM:DD, dispatch to the second).
Midnight-aware — an overnight call's event times roll past 2400 onto the next day automatically, and the chronology checks understand the rollover — so nobody is hand-editing dates at 0200.
The official ministry document — every finalized chart renders as a clean, boxed MOH 1881-45-style Ambulance Call Report: ministry sections, the full treatment table, captioned ECG strips and embedded signatures. The same document at review, in the portal, on print and in a disclosure — and blank fields render visibly, so an auditor never misses one.
Signed, versioned amendments — once signed the chart locks read-only forever; any correction is signed as a stacked, immutable numbered version, and a disclosure automatically carries the latest version with an amendment notice. The original is never altered.
Refusal of service, done properly — the full ministry refusal workflow: a four-question Aid-to-Capacity Evaluation, bilingual declarations, and patient/SDM, attending and witness signature blocks, each drawn and timestamped.
Built so a record can't be lost — chart with no signal; every draft backs up silently and syncs when signal returns, and a local copy is only cleared once the server confirms it has the report.
Knows your CP patients — if the patient is enrolled in Community Paramedicine, their on-file history, meds and care goals surface behind a wrong-patient confirm gate and import with one tap, filling only blank fields.
Built for gloves and night cabs — a form-wide night mode, big tap targets, an immersive full-screen treatment editor, and Return-key field walking so a medic's hands never leave the keyboard.

Sign-off that follows the crew, not the tablet5 features

Up to 5 crew co-sign one report — on the tablet at finalize, or later from each medic's own login; the chart locks only when every required signer has entered their PIN.
Cross-crew "Reports waiting" queue — a partner who stepped away adds their signature from any device later; nothing sits half-signed in a drawer.
Every signature timestamped — a per-signer PIN-attestation ledger locks who signed and exactly when into the legal record.
Returned-report queue — a chart sent back for review or amendment reopens only after the named medic's own PIN, so corrections stay accountable.
18-hour backstop & end-of-shift flush — an unsigned report past 18 hours is reopened and routed for a real signature; at shift end the tablet pushes every open report up and clears only the confirmed ones.

The rest of the shift's paperwork, handled3 features

Daily Shift Log — the vehicle and equipment check, digitized: auto-prompted at shift start (it never blocks a call), defect photos, reference stock lists, and the truck, monitor and station backfill the shift automatically.
Incident reports on the call — each crew member PIN-attests their own incident report, prefilled from the chart; standalone shift incident reports file straight to the portal as PDFs.
Start at base, finish in the truck — open shifts are server-backed, so the crew, truck and shift log follow you from the base computer to the truck iPad and back.

Call-Type Tailored Charting

Pick the call type — the chart rebuilds itself around it ePCR

Every ePCR hands the medic the same blank form, whether it's a stubbed toe or a stroke. PCS Cross Check reads Ontario's BLS Patient Care Standards instead: tell it the call type, and the report injects that standard's focused assessment — the exact items the standard asks about — into the anatomically right section of the chart. Chest pain lands in the chest exam, a GI bleed in the abdomen, stroke in head & neck. Below: a chest-pain call, tailored in two keystrokes.

The Call Type picker with 'chest pain' typed, the dropdown open on the Chest Pain (Non-Traumatic) standard, two standards already selected, and the Tailored summary naming exactly which fields each standard added and where

Type it, arrow to it, Enter — and the running summary spells out exactly what each standard added and where it landed: "Shortness of Breath · 6 fields → Physical Exam · Chest".

The chest exam card marked TAILORED: the injected Chest Pain (Non-Traumatic) Standard block with the life/limb/function threats group — acute coronary syndrome selected — the secondary-survey group attested None observed, and a filled chest-findings narrative

The standard's own assessment, injected right where a chest exam lives: one threat ticked, a recorded "None observed" on the survey group — a defendable negative in one keystroke, never a blank checklist.

A stroke call: the BLS standard's focused assessment injected into the chart — onset and last-known-well times, stroke mimics considered, secondary survey findings, and a live LAMS score reading 4, LVO screen positive

The stroke standard carries its own tools: onset and last-known-well times, the mimics considered — and a built-in LAMS scorer that sums to 4 and raises the LVO flag on its own.

The two-pane standards browser: the Medical category's standards listed on the left (24 of the 41 across all categories), the Chest Pain standard open on the right with a live preview of exactly which documentation fields it adds and where

The two-pane browser: every standard on the left, and a live preview of exactly which fields it adds — and where — before you commit it to the chart.

How the tailoring works8 features

All 41 BLS PCS 3.4 standards — medical, trauma, obstetrical and general patient-care standards in one type-to-search picker; select several for a multi-problem call. 215 focused assessment fields in all.
Injected where it belongs — each standard's fields land in the anatomically correct section of the report: chest pain in the chest exam, GI bleed in the abdomen, stroke in head & neck, tox and hazmat in the clinical picture. The section's own notes always stay last.
Only what the standard asks — every pack was built from the standard's own text: assessment and history items, never treatment prompts. The packs document the call — they don't direct care.
A defendable negative in one keystroke — "None suspected / none observed / none met" attestation chips on 102 assessment groups turn a blank checklist into a recorded clinical judgement — and they're mutually exclusive with findings, so a chart can never say both.
Stroke severity like the GCS — the LAMS motor scale is a built-in scorer: facial droop, arm drift and grip auto-sum to the 0–5 total, flagging "≥ 4 · LVO likely" the moment the score crosses the line.
A map of what changed — the picker keeps a running summary of every standard on the chart ("2 fields → Physical Exam · Chest"), and a tap jumps straight to the injected block.
Age-aware where it's defendable — the seizure standard's long differential list trims itself to the patient's recorded age: it never hides a ticked finding, "show all" is always one tap away, and it only engages when a full date of birth is on the chart.
Nothing lost, nothing forced — tailored answers autosave and restore with the draft like every other field, and removing a standard removes only its block. No standard selected? The chart is exactly the ACR you already know.

Key Nav — chart the whole call without leaving the keyboard

Answer with number keys, advance with Enter, and let the fields the platform already filled step out of the way. On a base computer or a truck tablet with a keyboard, a full chart becomes one continuous top-to-bottom walk.

Key Nav, in detail4 features

Enter walks the chart — every hand-entered field, option group and picker is a stop on one top-to-bottom walk: Enter advances, Shift+Enter makes a new line, ↑ and ⇧Tab step back, and a floating hint shows the keys for exactly the field you're on.
Numbers answer questions — options wear small numbered keycaps: press 1–9 to record findings, N to record the "none" attestation and move on.
Auto-filled fields step aside — whatever the platform filled itself — service identity, today's dates, the truck, monitor and station from the shift log, a scanned health card, a CP import — is badged AUTO and skipped by the walk. Everything stays editable: ⇧A pulls the skipped fields back in, and editing one returns it to the walk.
Built for a real tablet shift — scrolling or tapping the screen never kicks you out of keyboard mode, and it stays out of every pop-over and search sheet. One tap on the Key Nav pill turns it off.

The Cross Check

Every dose checked twice — as it's typed, and before it's signed

Two layers, one engine. The moment a dose is entered, it's checked against the ALS-PCS protocol maximum for that patient's age, weight and route — a slip is flagged while the medic is still standing next to the drug box, not hours later. Then, at finalize, the Cross Check reads the whole chart: every dose again, plus every missing or inconsistent required field, in plain language. Red flags have to be resolved, or formally overridden and attested, before the chart can be signed.

The treatment entry editor — the call-times reference strip across the top, 604 Morphine with dose 30 mg IV typed, and the live red medication-safety warning naming this patient's 10 mg ceiling at 84 kg and asking for a BHP patch or physician order

Typed, not signed: 30 mg of morphine trips the red flag the moment it's entered — this 84 kg patient's ceiling is 10 mg — long before finalize.

The Cross Check documentation audit over a staged chart: one required red issue — the 30 mg morphine dosing-range flag — and three yellow cautions with Confirm acknowledgements, plus the supervisor-override-code and override-red-flags paths and the Review final draft button

The pre-signature audit: the dose slip is the one red that blocks, the cautions each take a deliberate confirm — tap "go to field" and it jumps you to the fix — and if a supervisor can't be reached, the override path is a signed four-point attestation that rides straight to the top of the review queue. The call times stay pinned on the entry panel behind it, always in reference.

What the Cross Check catches6 features

Dose-safety against the directives — every medication dose checked to the ALS-PCS protocol max for age, weight and route; catches overdoses, decimal slips and unit mix-ups (fentanyl entered in mg gets caught).
Warnings as you type — the dose flag fires the moment the entry is made, not just at finalize, and the entry check and the final audit share one engine, so they can never disagree.
Required-field audit, disposition-aware — the full Ontario Data Dictionary closed-call set, keyed to how the call ended (transported, treat-no-transport, refused, no patient…), listed in plain language before signing.
Authorization-aware — when a Base Hospital Physician order is documented, a hard dose block softens to a non-blocking physician-order note, matching real patch rules; the documentation requirements stay hard.
A documented override, never a silent one — if a supervisor is unreachable, a blocking flag clears only through a signed four-point attestation, and the record escalates straight to the top of the supervisor's audit queue. Who, when and exactly which items ride the record — fully offline.
Tap a flag, jump to the field — each issue scrolls straight to the offending entry and highlights it.

911 Shift Dashboard

A dashboard for the shift — and a screen that belongs to the call

The moment a dispatch address lands, the shift chrome stands down and the screen becomes the call's: the address goes display-size with every call time — call received to transfer of care — in one line, a full-height navigation map takes the left of the screen, and the right panel carries the dispatch problem, the live dispatch feed, the receiving facility, and the two actions that matter: Open ACR and Cancel call.

The active-call screen — a display-size dispatch address over a linear row of the call times, a large live map with the route to scene, Navigate-to-scene and Navigate-to-hospital, and a right panel carrying the dispatch problem, CTAS priority, incident feed, receiving facility, driving distance and time, Open ACR and Cancel call

A dispatch address is all it takes: the call gets its own screen — the address readable from the driver's seat, the times recorded so far in one line, the route already drawn, and the nearest-ED chip standing by.

The 911 shift dashboard: a tile for every call of the shift — a red ACR-not-started dispatched call, an ACR underway and a completed-and-sent call — beside Needs finalization and Completed today cards, the crew bar and a live map

Mid-shift, the dashboard runs the board: a colour-coded tile for every call — the freshly dispatched one in red, the draft underway, the filed — with what still needs a signature and what's filed today in cards beside the map. Nothing owed leaves the base unsigned.

Everything on the dashboard8 features

A screen that belongs to the call — type the dispatch address and the active-call page takes over: display-size address, all eight call times — Call received to Transfer of care — in one linear row, and a dispatch problem that writes straight into the chart.
The live dispatch feed — dispatch updates stream into a scrolling panel on the call screen; until a CAD link is connected, the same panel is where the crew types what dispatch relays. The CAD link is built in — it activates when a dispatch feed is connected.
Every call is a tile — one colour-coded tile per call: red not started, orange underway, yellow awaiting signatures, green sent, grey cancelled. Tap a tile to jump back into that call — even a completed one, read-only.
The shift's work, in cards — Needs finalization, On server and Completed today sit beside the map, with the Daily Shift Log riding the same list until it's filed.
Cancel — and reopen — a cancelled call takes a PIN-attested reason, keeps a quiet grey tile, and can be reopened; all of it works offline and syncs when signal returns.
An honest End Shift — ending the shift lists exactly what is still owed, item by item, before anything is cleared off the tablet.
Live moving map with GPS, a nearest-ED chip and a day/night cab theme — plus a graceful offline fallback that hands the address to the device's own maps app.
Real turn-by-turn navigation — traffic-aware routing, live ETA, spoken and lane guidance, automatic re-routing — and arrival hands off into the call report.

Cardiac-monitor integration

Pull the cardiac monitor straight into the chart Monitor

No cables, no re-typing, no waiting on a slow full-case download. The medic picks the case off the monitor and the 12-leads, vitals and events drop into the treatment record in seconds — with the ECG waveform attached and auto-attributed to the monitor.

ECG appendix section of the crew-signed ministry-format document — the time-stamped rhythm strip and full labeled 12-lead acquisition rendered as clean captioned figures

The signed document's ECG appendices — the rhythm strip and the full 12-lead, big, labeled and time-stamped.

How the monitor pull works9 features

Instant case list — see the cases on the monitor immediately; pull only the one you need.
Every vitals set imported and time-stamped into the treatment timeline.
12-lead waveform image attached, with interpretation (e.g. Abnormal — non-STEMI).
Rhythm interpretations, pacing & events carried across automatically.
Auto-attributed to the monitor as the source, so the record stays auditable.
Tap any 12-lead to zoom — open the waveform full-screen, and it prints as a clean labeled appendix, not a squashed table row.
Works in Community Paramedicine too — the same one-tap pull drops vitals and ECG captures into a CP home-visit encounter.
Cloud-ready — built to connect to the same manufacturer cloud your monitors already upload to; cloud pull can be enabled per agency.
Faster than the incumbent, which forces a full download of every case before you can choose.

The small stuff

A hundred little things a medic notices by day three

The headliners sell the platform; these are the things that make it feel like it was built by someone who does the job — because it was.

The postal code finds itselfType the street and town — or let the call's own location do it — and the postal code fills in from a province-wide address register on the platform's own server. Nothing leaves the box; it's badged AUTO and stays editable.

Midnight-awareAn overnight call's times roll past 2400 onto the next day by themselves — nobody hand-edits dates at 0200.

GCS & MAP do their own mathE/V/M auto-total — even from a partial set — and mean arterial pressure computes itself on every BP.

Plain English, exact codesMinistry code lists are type-to-search boxes that show words and store the code, so printouts stay letter-perfect.

14,896-entry drug indexPatient-med search runs on Health Canada's DIN index — brands, generics and class tags surface together.

Refusals, done properlyThe four-question Aid-to-Capacity Evaluation, bilingual declarations, and drawn, timestamped signature blocks.

Disposition-aware requirementsThe required-field set keys to how the call actually ended — a refusal isn't held to a transport's field list.

Cancel — with a reasonA cancelled call takes a PIN-attested reason, keeps a quiet grey tile, and can be reopened if the night changes its mind.

Night mode everywhereOne tap flips the whole screen — map included — for the night cab, and big targets stay glove-friendly.

Up to 5 co-signersCross-crew signatures follow the medic, not the tablet — and an 18-hour backstop routes anything unsigned for a real signature.

Incident reports on the callEach crew member PIN-attests their own IR, prefilled from the chart, filed straight to the portal.

A record can't be lostDrafts persist on the device and clear only when the server confirms receipt — signal or no signal, by design.

The whole call, charted — and checked before it's signed.