Objectives Emergency Medical Services (EMS) are central to acute care, disaster response, and public health. Yet prehospital data in many systems remain disconnected from hospital and follow-up outcomes. This paper examines how fragmented, unidirectional data flows limit quality assurance, system learning, and crisis preparedness, using Switzerland as an illustrative case. Methods We analyze data flows across the rescue chain based on regulatory context, current handover practices, and international reference models. The analysis is supported by existing registry initiatives and a conceptual systems framework. Results Across EMS systems, information is generated in silos and transferred through brief handovers without systematic outcome feedback. Evaluation is therefore reduced to operational metrics such as response times, obscuring the clinical impact of prehospital care. In Switzerland, decentralized governance and the absence of national standards reinforce these dynamics. Existing registries demonstrate that outcome tracking is feasible using minimal standardized datasets. Conclusion Bidirectional EMS data exchange is essential to transform linear rescue chains into learning health systems. A national EMS minimum dataset with mandatory reporting and outcome feedback would enable transparency, quality improvement, and resilient emergency care.
Gerlach et al. (2026) studied this question.