I thoroughly understand the reason for leaving a written report at the ED at the time the patient is brought in.   In our system it is standard practice to leave a printed PCR with the staff.  But even with this, reports are lost in the hospital, requiring the trauma registrar and Chest Pain staff to contact our agency on a regular basis because they cannot find the PCR in the patient's chart.  As the state moves to electronic reporting there will be many issues to arise.  One we have experienced is when the EMS printer (multi-agency partnership) at the hospital breaks leaving no way to print the report.  Reports have to be printed somewhere else and brought back to the hospital.  Printing issues will become more frequent  as more agencies use electronic reporting.  Keep in mind that , the agencies are providing the printers, not the hospitals.  This is an expensive, complex, and time consuming program to maintain. The ultimate goal would be to have a way for everyone to send the PCR to a website or offsite server where the information would be automatically sent back to the hospital in an electronic format.  This is going to be very challenging as there are different EMS PCR programs and each Hospital IT Dept. and Agency IT Dept. have their own security rules and measures.   The 24 hr time period is essential when printers are down or the computer will not connect with the printer.  Leaving a PCR with the patient is "Best Practice" and should be  encouraged until electronic data can be sent quickly to the ED. It will take much more than changing the regulation to truely fix the problem.