This version of the State EMS Forms was posted on this site on 7/9/2010, and revised by the state on 05/30/2006.

4/7/2009. EMS and Trauma Systems Section is pleased to announce the statewide launch of OPHI-PCR.  This software module is an internet-based, EMS information system which provides data entry and reporting capability for the documentation and evaluation of EMS patient care and service performance.

A uniform run sheet has been created for providers to use at their discretion. Upon review of the new bubble form there were two essential data elements not included on the form that document call type (trauma call) and a revised trauma score (vital signs and symptoms are on the form).

Submission of the required EMS data is voluntary without penalty or disciplinary action levied on those providers that are non-compliant with reporting requirements. At this time there is no consistent or concise means to evaluate the current Montana EMS System. However, EMSTS is reviewing current rules which require all services to provide data at least quarterly to EMSTS.  These rules are outdated and a new draft of rules will be available for informal public comment in May/June and formal hearings and adoption sometime this summer.  These rules will require reporting of a minimum data set by all services.  Services using OPHI-PCR will automatically meet these reporting requirements.

Click on the thumbnails below to view a full sized image.

OPHI-PCR Screen shots:

Select the following to view a printable Acrobat (.PDF) version. 

OPHI-PCR Screen shots:

OPHI-PCR screens-billing (.PDF,124.97k)

OPHI-PCR screens-cardiac (.PDF,81.76k)

OPHI-PCR screens-destination (.PDF,73.57k)

OPHI-PCR screens-intervention (.PDF, 97.96k)

OPHI-PCR screens-main (.PDF,95.77k)

OPHI-PCR screens-narrative (.PDF,72.45k)

OPHI-PCR screens-patient (.PDF,118.37k)

OPHI-PCR screens-response (.PDF,105.18k)

OPHI-PCR screens-scene (.PDF,87.18k)

OPHI-PCR screens-trauma (.PDF,186.34k)

Example of a printed OPHI-PCR

OPHI-PCR screens-/Printed_pcr (.PDF,25.20k)

Montana NHTSA Assessment 6/2005(.PDF,121.70k)

Click on the following links to view the corresponding files:

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