Effects of the COVID-19 pandemic and the introduction of information and communication technology in emergency scenes on the emergency transport environment in Japan

Objective In April 2014 and March 2017, Saitama Prefecture, Japan, implemented the use of tablets and smartphones in ambulances. This study examined whether the introduction of tablets and smartphones at emergency scenes in Saitama City reduced the occurrence of cases in which emergency personnel make four or more requests to medical institutions for admission or remain at the scene for 30 minutes or more (hereinafter, "difficult emergency transport cases") and investigated the time from emergency vehicle arrival to its departure from the scene (hereinafter, "time spent at the scene"). We also assessed the impact of the coronavirus disease 2019 (COVID-19) pandemic on emergency medical transport operations. Methods We analyzed emergency statistics data compiled by the Saitama City Fire Bureau for the period 2013 to 2021. Using an interrupted time-series design, we estimated the effects of the introduction of tablets and smartphones and the COVID-19 pandemic on emergency medical transport operations. Cases in which patients were transferred between hospitals or not transported were excluded. Results The introduction of tablets did not significantly reduce the occurrence of difficult emergency transport cases or time spent at the scene. However, the introduction of smartphones significantly reduced the time spent at the scene. During the COVID-19 pandemic, the occurrence of difficult emergency transport cases and time spent at the scene increased, but these effects were not significant. Conclusion Emergency medical information systems must be further improved to cope with rapid increases in the number of injured and ill patients due to infectious disease outbreaks and large-scale disasters.