The current state regulations require EMS providers to submit their PPCR's (pre-hospital care reports) within 24 hours to the receiving hospital.  EMS patient care is vital to improving outcomes for all types of patients, many of whom are gravely ill or severely injured.   EMS providers render increasingly complex care to these patients, including defibrillation, medication administration, advanced airway procedures, etc.  Additionally, EMS providers have the advantage of observing the patient in a different setting than hospital healthcare professionals.  This observation can provide valuable insight during the course of treatment.   The absence of this information can radically alter a patient's treatment plan and outcome.  Healthcare professionals are expected to leave written documentation of their observations and treatment of patients during handoff to other healthcare providers.   EMS providers are professionals and should be expected to report as other healthcare professionals.    The state regulations should require them to leave basic, critical information (at minimum) when they treat and transport patients to hospitals.  If they are unable to leave a full PPCR, they should leave a written MIVT report, or a draft of their electronic PPCR.  I would like to add that many EMS agencies  have been working collaboratively with the various acute care facilities in the Richmond area to improve EMS reporting.  However, there is nothing in Virginia code to compel them to do it.  Therefore, some agencies/providers have done nothing to solve this very serious problem.   I commend the EMS agencies and hospitals who have been working hard to solve this issue because at the end of the day, this is about improving patient outcomes and patient safety.  Nothing is more important than that.