From mission record to clinical insight: Northern Rescue’s ECR in practice

For Northern Rescue’s clinicians, the clinical record begins wherever the patient is. That may be beside a remote road, on a coastline, at a rural property, or during an inter-hospital transfer. The record has to work while care is underway, including when mobile coverage is limited, and remain useful long after the aircraft has returned to base.

Northern Rescue is a specialist air ambulance and rescue helicopter service supporting Northland, Auckland, and the Coromandel. Its multidisciplinary crews deliver pre-hospital and critical care around the clock and are tasked to more than 2,000 missions each year.

Supporting that work is the Vellox Ops and Safety Suite (OSS), formerly Air Maestro, which Northern Rescue uses for its air medical electronic clinical record (eCR) alongside wider safety and operational workflows. Since the beginning of 2023, more than 6,500 electronic clinical records have been created through the platform.

“Working closely with our clinicians in the design of clinical workflows is paramount to ensuring a smooth user experience,” said William Law, Medical Director at Northern Rescue. That principle helps explain why the eCR continues to evolve, with new fields added to meet changing clinical needs, documentation standards, and reporting requirements.

Built for where care happens

Northern Rescue works across very different environments, many of them remote and without reliable connectivity. The eCR was therefore developed as a progressive web application that allows clinicians to enter and save information on mobile devices even when Wi-Fi or cellular coverage is temporarily unavailable.

Today, the mobile eCR app is deployed on iPads, and most eCRs are completed this way. It allows clinicians to document care closer to the point at which it is delivered, rather than relying on details being reconstructed later.

The system was also designed to reduce unnecessary manual entry. Physiological data from critical care cardiac monitors can be transferred into the clinical record, providing accurate timestamps while reducing the time clinicians spend re-entering observations. For a service managing complex interventions in demanding environments, those practical details influence whether a digital workflow becomes part of normal clinical practice or an additional task around it.

From documentation to clinical governance

The eCR is not only a record of an individual patient mission. The information captured across thousands of records also gives Northern Rescue a structured basis for audit, reporting, and quality improvement.

The clinical leadership team uses reports and dashboard views to meet stakeholder reporting requirements and inform improvement projects. Summary information from eCRs supports audits of advanced airway management, blood transfusion, rescue operations, and significant clinical incidents. Findings are then discussed through regular clinical governance meetings and used to guide further work.

This creates a continuous link between care delivered in the field and the way the organization reviews its performance. A procedure documented during a mission can later form part of a wider audit. Patterns across multiple records can prompt closer review, while dashboards make it easier for clinical leaders to bring relevant information into governance discussions.

Northern Rescue’s current approach includes monthly clinical governance meetings, regular clinical audits, and monitoring against accepted standards and international practice. The eCR provides one of the practical data sources supporting that work.

Designed with clinicians

The strength of a clinical system depends not only on what it can capture, but on whether clinicians can use it naturally in the course of patient care. Northern Rescue has treated clinician involvement as an ongoing part of the eCR’s development.

During implementation, clinical teams worked with the software team to shape user stories around their existing workflows. Pilots, air crew officers, critical care paramedics and doctors contributed to the design, while training and regular governance updates supported adoption.

That collaborative approach continues today. Northern Rescue regularly receives suggestions from clinicians about how the eCR could be improved. Law says this feedback is “hugely valuable” in ensuring the digital clinical workflow remains an enhancement rather than a burden to clinical care.

Rather than treating implementation as a fixed project, the team continues to adjust the form and workflow as practice changes. This feedback loop matters because the system must remain useful to frontline clinicians while still producing consistent information for governance and reporting.

Air medical workflows rarely remain static. Clinical standards change, reporting requirements develop, and teams identify better ways to capture information. The eCR has to respond without losing consistency or becoming more difficult to use.

Connecting clinical data and safety

The decision to place the eCR within OSS also reflects the relationship between clinical governance and the wider safety environment.

Alana Harper, Deputy Medical Director (Safety and Quality) and Prehospital and Retrieval Medicine Doctor at Northern Rescue, described the rationale clearly: “It made sense from a clinical governance perspective to combine our air medical electronic clinical record with our safety management system.”

Within OSS, clinical forms sit alongside broader safety and operational capabilities. This gives Northern Rescue a structured environment for clinical documentation, reporting, and governance, while allowing the eCR to be adapted to the service’s requirements.

The next stage is not without complexity. Work to connect with wider healthcare data is continuing, but these integrations involve different systems, standards and governance requirements. Progress therefore has to be considered carefully, particularly where patient information moves between organizations.

For Northern Rescue, the value is already visible in daily use. Most records are completed through the mobile workflow, more than 6,500 eCRs have been created since 2023, and the resulting information now contributes to audits, stakeholder reporting, and quality improvement.

The eCR now travels with clinicians, changes as their requirements change, and gives clinical leaders a clearer view across the service. Each record captures one episode of care, but its usefulness does not end when the form is complete. Across thousands of missions, those records give Northern Rescue a practical way to review clinical practice, focus improvement work, and carry what it learns into the next patient response.