MARCO ISLAND, Fla. — Underfunding, understaffing and a never-ending demand for EMS services mean despite the vital role they have in our communities, EMS systems are failing at an alarming rate.
In a session at the Pinnacle 2024 leadership forum, panelists discussed the future of EMS and what must happen for the profession to survive and thrive.
The panel included:
- Thomas Moore, junior partner, Fitch & Associates
- Nicole Henricksen, president, Global Medical Response
- Gerad Troutman, National Medical Director, Innovation for Global Medical Response
Memorable quotes
Following are memorable quotes from the panelists.
- “The patient is calling 911 looking for a solution. We need to get away from every solution is an ambulance” — Dr. Gerad Troutman
- “We have to think about who we’re serving and what resources we have and how we can navigate them to the best resources.” — Nicole Henricksen
- “We’ve talked a lot of doom and gloom, but we’re going to be OK.” — Dr. Gerad Troutman
Top takeaways
Together, the panelists identified 4 things we must change in EMS to become sustainable.
Change how we navigate patients
While EMS is universally challenged with the frequency of non-emergent calls, 911 isn’t going anywhere, Dr. Troutman stressed.He believes initiatives like alternate emergency numbers for mental health crises don’t move the needle because 911 is too engrained.
“It’s really easy to dial those 3 numbers,” he stressed. “Trying to get the public to not call 911 doesn’t work. Everybody from a 3-year-old, to the oldest person with dementia can dial those 3 numbers.”
Instead, change needs to begin with EMS, and how we respond to the myriad of needs that inspire that call. Let them call 911, he urged, and then let us go through the process to get them the right resources.
EMS is up to the challenge, Dr. Troutman noted. “We’re nimble,” he said. “It’s what we do … we’re just good at figuring stuff out.”
Change how we get reimbursed
The obvious challenge in responding with the right resources catered to the patient’s needs is the lack of funding for anything that is not responding with an ambulance and transporting to an emergency department.One of the biggest challenges in obtaining adequate funding is that people don’t understand what EMS has evolved into, Dr. Troutman said. “They don’t understand the impact.” Interpret our data, and show that data to our communities and key stakeholders, he encouraged. “Talk about the stress of reimbursement and staffing,” he said.
Moore asked the audience, by a show of hands, how many educate their communities on stop the bleed – to almost universal hand raising. Then, he asked how many educate their communities about their financial reality – to a few hands standing out.
“We’ve figured out a way to help,” despite our lack of funding, we’ve “MacGyver’ed our way there,” he noted, but now funding is “mission critical.”
Dr. Troutman provided the example of whole blood. We all understand the quicker you administer blood from when blood loss is experienced, the better it is for the patient, and we’ve proven that EMS is capable of delivering that blood, he pointed out. But, when it comes to implementation, there’s a funding challenge because EMS suffers from transport-based reimbursement rather than healthcare reimbursement. Have your medical director take that use case to legislators, he advised. “If you get in a vehicle accident and are suffering from bloodloss, we’d love to be able to provide this blood in the field but we can’t and this is why.”
Change how – and who – we recruit
Our recruitment process in EMS leans into public safety, Henricksen noted, with dark uniforms and badges, and an emphasis on adrenaline-filled emergency calls. “That’s what we lead with,” she said. “It’s fun and exciting, but there’s a skill set we’re missing out on: the human element.”Focusing on the adrenaline as a recruiting tool does EMS a disservice, Henricksen believes. “That’s not what we do.”
For every overturned vehicle, gunshot victim and cardiac arrest, there are many more patients experiencing a mental health crisis, or non-emergent patients who simply don’t have the resources or the wherewithal to get their medications.
Moore likened it to the FBI. He spoke with an FBI agent at a previous Pinnacle, who noted there are TV shows on every evening depicting an FBI agent strapping on a vest, busting down doors and engaging in shootouts, however, this agent had never used his firearm. There is a disconnect between the adrenaline-filled work the general public imagines, vs. the work the FBI actually does. At a federal level, the FBI went into schools and targeted students with science and math backgrounds to recruit a different composition of the workforce.
Similarly, EMS needs to attract candidates with emotional intelligence who can speak with and connect with patients, Henricksen encouraged. What EMS really needs is professionals with extra training and more time to sit with, and comfort and connect the patients with the right resources.
Change how we process data
While there are different service models, organization sizes and deployment models across EMS, they’re all serving the same types of patients with the same problems, Henricksen noted. With all those electronic PCRs, we’re collecting endless data.The challenge, Henricksen said, is to aggregate all this data, to attach outcomes and to connect the dots to discover the best way to serve our patients – to treat a cardiac arrest, for example.
One solution is using AI to analyze millions of data points and spit out commonalities. Were already using AI, in many cases, Henricksen noted, for example, clinical decision pathways. Using tools to analyze our data and make our pathways smarter will help us to better provide for our patients.
Better data interpretation will also aid those funding conversations with stakeholders. Use that data to educate and secure the future of EMS.
ADDITIONAL RESOURCES
