5 changes affecting EMS in 2014
Patient survival rate is improving, but ambulance crashes are too often creating new patients
By Arthur Hsieh
Developments in technology, policy, and patient care will exert influence on the industry through 2014 and beyond, asserted Brent Myers, medical director for Wake County EMS (Raleigh, N.C.), at the National Association of EMS Physicians annual meeting in Tucson, Arizona on January 18, 2014. Dr. Myers discussed five major points:
1. EMS is now recognized as a subspecialty practice of emergency medicine. This is critical, as it represents a “seat in the house of Medicine,” remarked Dr. Myers. This means not only recognition by other physician specialties, but acknowledgment that EMS is a true medical practice that requires research and diligence to refine it.
2. Despite numerous studies that show certain practices make no difference in patient outcome in cardiac arrest, overall survival rate is increasing. So-called equivalence trials on mechanical compression devices, therapeutic hypothermia and impedance threshold devices have each resulted in dubious results. However, when looking at the overall survival rate from cardiac arrest, there is clear evidence that more patients are being discharged neurologically intact now than before. We need to continue to test not only cardiac arrest procedures, but also carry that discipline across all of out-of-hospital care.
3. EMS healthcare data is being connected to the rest of the medical profession. Not only that, the connection is bidirectional — EMS agencies may be able to better determine how patients did after admission, which can make outcomes research easier and more meaningful.
4. 2014 has to be the year that EMS embraces a culture of safety, Dr. Myers argued. Ambulance crashes have been occurring weekly across the country, killing EMS providers and members of the driving public. What’s even more perturbing is the lack of data that demonstrates the effectiveness of rapid response and transport. In fact, there is no data.
5. Mobile integrated health care will continue to mature and evolve. As health care reimbursement continues to pressure medical providers to demonstrate effective care, EMS is poised as a community partner to fill current gaps in that care. EMS agencies, both public and private, must embrace this movement and position themselves to be a mainstay in the health care industry in 2014.