Updated February 2015
Whenever we hire someone new at our company, I am reminded again how acronym-laden EMS is (and that’s emergency medical services, not Eastern Mountain Sports or Express Mail Service, which occupy the first two spots in a Google search of “EMS”). Over the years, we’ve developed a running list that newbies can reference as we rattle off sentences like “NEMSMA recently endorsed NAEMT’s position paper on MIH” without a pause. We also have a running contest about which acronym sounds the silliest when pronounced like a word. (Currently, the National Public Safety Telecommunications Council, or NPSTC—pronounced “nip-stick”—has the title.)
We’ve recently added another acronym to our list. The Federal Interagency Committee on Emergency Medical Services, or FICEMS (pronounced “figh-kems,” with a hard k), has actually been around since 2005, although it’s not likely on your radar. Mandated by Congress, FICEMS coordinates federal agency efforts to support local, regional, state, tribal and territorial EMS and 911 systems. FICEMS members represent federal agencies of the departments of Transportation, Health and Human Services, Homeland Security, Defense and the Federal Communications Commission. In addition, a state EMS director sits on the committee.
The committee meets twice a year, and I’ve had the chance to attend several times. It has a noble mission, to connect the dots among all the various federal EMS stakeholder groups and state EMS directors (with one dot, the Department of Transportation’s Office of EMS, providing staff support for the effort), but it’s a tough task to wrangle all the various interests together with a common vision. It can be even tougher to communicate the importance of what they’re doing to the broader EMS community, which can have a hard time understanding the differences between the executive branch (where these agencies all reside) and Congress. (Congress passes the laws and the executive branch executes them. By law, members of the executive branch can’t lobby or try to influence policy, although they can be called on to make recommendations.)
But I think the interest in FICEMS is about to change. At its most recent meeting, which I attended last December, outgoing chair Ed Gabriel, principal deputy assistant secretary in the Department of Health and Human Services Office of the Assistant Secretary for Preparedness and Response (or ASPR, pronounced “as-per”) announced that FICEMS had developed a strategic plan, unifying the federal EMS effort around six goals, supported by 30 very specific objectives. This means the resources of the entire federal EMS stakeholder interests will be focused around a common vision to improve out-of-hospital emergency care. This is important stuff.
The plan’s overarching strategic goals include:
- Coordinated, regionalized and accountable EMS and 911 systems that provide safe, high-quality care by developing EMS performance measures, identifying and disseminating best practices, measuring EMS care and outcome relationships, promoting best practices to reduce regional care disparities, and partnering with state regulatory agencies for regionalized accountable care systems.
- Data-driven and evidence-based EMS systems that promote improved patient quality by supporting the development and implementation of evidence-based guidelines (EBG), standardization and improvement of prehospital EMS data and the linkages between the National EMS Information System (NEMSIS) and other sources of measurement of clinical effectiveness, outreach to stakeholders to support the development of a culture of evaluation and scientific evidence for prehospital care, and the development of key performance indicators for EMS.
- EMS systems fully integrated into state, territorial, local, tribal, regional, and federal preparedness planning, response, and recovery by developing consistent and reliable measures of EMS system preparedness, providing rapid guidance on emerging EMS issues, improving preparedness through coordinated, multidisciplinary planning, addressing preparedness gaps identified in the National EMS Assessment, and developing training and exercise standards to promote interoperability.
- EMS systems that are sustainable, forward-looking and integrated with the evolving health care system by fostering EMS participation in regional and state Health Information Exchanges, encouraging the development of innovative delivery models for EMS systems that might result in reimbursement modifications, providing coordinated federal support for enhanced EMS and 911 technology, applying lessons learned from civilian and military incidents, and addressing special geographic concerns for limited EMS access.
- An EMS community in which safety considerations for patients, providers and the community permeate the full spectrum of activities, by promoting measurement and prevention of occupational injuries, deaths and exposures to the EMS workforce and promoting the use of safety equipment by EMS personnel, evaluating factors that threaten patient safety, supporting the use of anonymous reporting to record errors, events and “near misses,” and evaluating FICEMS’ role in supporting the development of a “Strategy for a National EMS Culture of Safety.”
- A well-educated and uniformly credentialed EMS workforce, supported by promoting implementation of the EMS Agenda for the Future for uniform EMS education, national certification and state licensing, supporting efforts to enhance interstate recognition and reciprocity of EMS personnel, working with state EMS offices to support the transition of military EMS to civilian practice, and promoting the implementation of the “EMS Workforce Agenda for the Future.”
At the meeting, Gabriel identified four focal areas for immediate action:
- Supporting the development, implementation and evaluation of EGBs according to the National Prehospital EGB Model Process.
- Promoting standardization and quality improvement of prehospital data by supporting the adoption and implementation of NEMSIS-compliant systems.
- Improving EMS system all-hazard preparedness, including pandemic influenza, through support of coordinated, multidisciplinary planning for disasters.
- Working with state EMS offices to support the transition of military EMS providers to civilian practice.
So, there’s an introduction to FICEMS. Progress can seem slow at the federal level, but getting everyone on the same page is a critical first step.
