TrackMi Montérégie Project: A Real-Time Digital Prehospital Data Collection and Analysis Tool for Use During Multi-Casualty Incidents and for Routine Hospital Fluidity Optimization

Introduction: Technology has the potential to improve patient tracking, communications, and management during major events. To ensure optimal use of a digital casualty traceability tool in a “disaster situation,” it is important to train paramedics to use it during routine activities. Hence, in partnership with an EMT technology firm, CISSS de la Montérégie-Centre established the TrackMi Montérégie project. Methods: An existing digital mobile tool designed for rapid exchange of critical information in multi-casualty incidents (MCI) was modified to also collect routine prehospital data to optimize clinical trajectories. The application supports geolocation of patients en route to the hospital and a secure web-based platform for real-time data analysis. As a pilot project (July-December 2024), paramedics in Montérégie voluntarily collected prehospital data into the TrackMi database. Results: Preliminary TrackMi data analysis revealed that paramedic transport priority (11% urgent, 10% immediate, 79% non-urgent) differed significantly from call center (CCS) ambulance assignments (44% P1-Immediate/Urgent, 42% P3-Immediate). TrackMi distribution for age (20% 85+, 65% 65+, 11% 65-, 3% n/a), gender (57% female, 43% male, 0% other) and Medical Priority Dispatch System (MPDS) complaints (27% 26-Sick person, 16% 17-Falls, 11% 6-Breathing difficulty, 8% 10-Chest pain) matched CCS data. However, TrackMi MPDS assessment by paramedics differed from CCS MPDS data in 37% of cases. In a subgroup analysis (85+), results showed that a majority of patients had a short stay in the emergency room without hospitalization (59%), and TrackMi MPDS better matched the hospital final diagnosis category. Conclusion: Optimal hospital management depends on its alignment with prehospital resources and the timely transfer of validated information during MCI events and routine operations. As the health system faces many challenges, including aging populations, scarcity of ambulance resources, and lack of personnel and hospital beds, digital tools are increasingly required to assist in the real-time analysis of prehospital data, improve clinical trajectories, and hospital fluidity.