Prior to the late 1960s, emergency medical service (EMS) in the United States didn’t exist—at least not in the manner that it is provided today. Ambulances were used to transport patients to hospitals or other healthcare facilities—and not much else. In 1960, only six states had standard education programs for rescue personnel—paramedics and emergency medical technicians didn’t come into being until the early 1970s—and only four states regulated ambulance-design specifications. By 1965, the vast majority of emergency medical services from coast to coast largely were unregulated.
Today, more than 23,000 EMS agencies exist in the U.S. today, according to the 2020 National EMS Assessment report published by the National Association of State EMS Officials (NASEMSO). These agencies provide all manner of advanced life support and basic life support services. But significant challenges still exist for the EMS community. The most vexing ones are as follows:
Staffing—Recruitment and retention continue to be a huge challenge for most EMS agencies. Recruitment is being affected negatively by an acute shortage of candidates who are qualified to fill paramedic or emergency medical technician (EMT) positions.
Funding and billing—Fire-based EMS agencies and private EMS agencies have very different funding models. But one challenge that they share concerns an inability to bill patients for services rendered. Contributing to this challenge is the rugged laptop and tablet computers that are found in most ambulances and fire engines. They require someone to type to input electronic patient care reporting (ePCR) data. Emergency medical technicians (Ems) and paramedics are adept at performing cardiopulmonary resuscitation, conducting an electrocardiogram test, or stanching a wound that is bleeding profusely. But typing? Not so much. Exacerbating the situation is that collecting such data is not their priority—saving lives is.
Response and patient care—The environments in which EMS agencies and their personnel operate are becoming increasingly complex. Consequently, paramedics and EMTs are finding it more difficult to perform their jobs well and provide the quality of care needed and expected by patients. PTSD often contributes to this challenge.
Apparatus and equipment—The high cost of ambulances and related equipment is an age-old challenge for the EMS community. Moreover, ambulances and the equipment that resides in them have to be maintained regularly and well, because patient lives are on the line. This adds considerably to an EMS agency’s operating budget. These cost pressures are exacerbated for agencies that have pronounced funding and billing challenges.
A whitepaper can be found on the MCP website that goes into much greater detail on these challenges and, more importantly, suggests solutions for overcoming them. (Click here to read it.) In addition, we have more than 160 subject-matter experts who collectively are well-versed on the challenges and solutions presented in this whitepaper, from providing grant application guidance and writing, to performing staffing assessments, to helping agencies adapt their operational strategies and implement new technologies. Please reach out.
Chris Kelly is a senior leader with 18 years of telecommunications consulting experience. His role at MCP is managing all technology, operations, and facility project teams.