January 6, 2018
Over 20 years ago, the NHTSA commissioned EMS Agenda for the Future to define the path of paramedicine across the country. At the time, paramedicine had taken hold and prehospital systems had been in active development for thirty years. The NHTSA and EMS leaders wanted to look at where they had been in those thirty years and where they were going in the next thirty. The Agenda for the Future strongly pushed data and evidence-based practice as the upcoming opportunities for improvement in the industry. Fast forward to now, and both foci have become pillars of modern EMS.
Leaders are now assembled yet again under Agenda 2050 with the same mission. Comprised of paramedics, entrepreneurs, physicians, administrators, and others, the technical panel of Agenda 2050 is aiming to find consensus on the future of EMS. The panel is currently in a two year long process of gathering input from community members, stakeholder agencies and the public.
The timing of the Agenda 2050 comes at a crucial time as EMS sits on a precipice of change. EMS systems are finding new ways to utilize the unique training and expertise of Paramedics. Expertise vital to healthcare’s continued adoption of new technology and the battle against rising costs and disease epidemics.
States, such as California, have implemented community paramedic programs to bring coordinated-care into the homes and streets of their communities. These paramedics are addressing a critical need in patient populations. Diseases, such as diabetes, heart failure, and psychiatric illness, place a large cost burden on the healthcare system and have high likelihood of hospital admission or readmission. The programs have shown great success, but have not been widely adopted yet.
The recent vaccination of 109,000 individuals in San Diego, California amid a Hepatitis A outbreak further demonstrates the value of paramedicine in public health campaigns. Paramedics were used in the campaign to vaccinate individuals out in the community. The program required legal maneuvering but was easily implemented given the paramedics pre-existing training. Realizing this potential, insurers are rapidly moving to implement reimbursement models to support non-transportation EMS programs in 2018.
California leadership is actively discussing the creation of a critical care paramedic scope with increased educational requirements. A rise in the minimum requirement of paramedics is viewed as crucial by many in the EMS community. States, such as Oregon, already require a minimum of an associate’s degree to get a paramedics license. Community and critical care programs could be a segway for California paramedics to find parity with nurse training and the international EMS standards.
The continued adoption of informatics and data will remain an important focus. Information previously siloed in separate healthcare networks and EMS agencies is now being shared more freely to the advantage of the paramedics, physicians and patients. Vital signs, electrocardiograms, care reports, and more are being communicated instantaneously between ambulance and in the emergency departments in some systems. New technology such as autonomous vehicles and drones offer exciting opportunity in a multitude of ways, previously unimaginable. And biometric advancements offer the ability for event interrogation by responding crews and distributed monitoring of at-risk populations.
The future for EMS in California and across the United States is changing rapidly, but it is bright. Needless to say, there is a great deal to discuss at EMS Agenda 2050. The technical panel is requesting input from all stakeholders and your attendance is highly encouraged at the upcoming meeting. Please visit emsagenda2050.org for registration and details.
