AI may feel like the newest revolution in EMS, but the industry’s relationship with data has been evolving for decades. In this episode of EMS One-Stop, Rob Lawrence sits down with FirstWatch founder Todd Stout, whose 28 years working with EMS data gives him a particularly long view of where the industry has been and where it is heading.
Todd traces the journey from an era when monthly reports printed on green-bar paper were considered normal, to today’s world of real-time dashboards, cloud-based systems and enormous volumes of operational and clinical information. The challenge has changed: EMS no longer suffers primarily from a lack of data; leaders now need technology that can identify what matters, separate signal from noise and turn information into decisions.
That makes AI extraordinarily promising — and potentially dangerous. Todd explains why he is more excited about the next 3-5 years than at any point in his career, while simultaneously being more concerned about the next 8-10 months. Rob and Todd discuss unreliable AI outputs, data security, HIPAA and privacy, the risks associated with startups and what EMS leaders should ask before entrusting vendors with organizational or patient data. They also examine the urgent need for EMS agencies to establish AI policies and train their workforce on responsible use.
Todd concludes with a preview of FirstWatch’s next generation of AI-enabled tools and a broader message for EMS leaders: the organizations that thrive through this technology shift will not necessarily be those with the newest technology, but those capable of adapting, learning and using it responsibly.
Additional resources:
- EMS1 Leadership Institute: 2026 Spotlight on AI in EMS: On-demand: Smart tools, strategic choices: EMS puts AI into action
- Why EMS must measure the human side of care: What patients remember
- No rulebook is coming: EMS must take control of AI now: Why EMS must govern AI locally as adoption accelerates
- Hyper-turbulent times: EMS economics and AI guardrails with Matt Zavadsky and Dr. Shannon Gollnick: Why EMS needs AI guardrails and Medicare reform today
Memorable quotes
- “I’m more excited about the next 3-5 years than I’ve ever been, I am also more scared about the next 8-10 months for our industry than I’ve ever been because it’s so messy.” — Todd Stout
- “Nobody gets into EMS to be excellent data enterers.” — Todd Stout
- “AI well formed — with the proper bumpers, guidelines, rules around it — is astonishingly good at processing through lots of data.” — Todd Stout
- “If you’re not paying for the thing that you’re using, you are the product.” — Todd Stout
- “AI to many people seems like magic. And it’s the opposite of magic almost. It’s a lot of work and plumbing to get it right.” — Todd Stout
Episode timeline
- 00:27 – Rob introduces the episode and the evolution of EMS data, information and AI
- 01:54 – Twenty-eight years of FirstWatch: from Stout Solutions to today’s real-time data environment
- 03:57 – Looking back at EMS’s early adoption of real-time operational data
- 05:18 – Why immediate data can improve individual performance and expose problems with systems and protocols
- 06:24 – The “ah, buts:" gut instinct versus what the data actually shows
- 07:19 – Dirty data, disconnected systems and why organizations sometimes don’t believe their own numbers
- 09:45 – EMS has moved from too little information to information overload
- 10:31 – How AI can sift through enormous amounts of data and identify what leaders actually need to know
- 11:22 – The accuracy problem: AI can produce impressive outputs while struggling with surprisingly basic tasks
- 12:39 – Todd explains why he is simultaneously excited and concerned about the immediate future of AI in EMS
- 14:35 – How EMS leaders can become better, more discerning customers of AI technology
- 15:10 – Established technology partners versus innovative AI startups
- 17:00 – What happens to your organization’s data if an AI vendor fails or goes out of business?
- 17:41 – HIPAA, privacy, cybersecurity and employee data obligations
- 18:11 – Sponsor break
- 19:26 – Part two: protecting patient and organizational information when using AI
- 20:18 – AI training models, data sharing and why leaders need to understand vendors’ default settings
- 22:44 – The pace of change: today’s AI expertise can become outdated within weeks
- 23:08 – Preparing for the wave of “AI everything” appearing in EMS exhibit halls
- 23:45 – Questions EMS leaders should ask prospective AI vendors
- 25:20 – Why AI isn’t magic — and why implementation requires significant work behind the scenes
- 27:08 – The case for every EMS organization having an AI policy now
- 27:41 – Todd warns that employees are almost certainly already using AI, sometimes without understanding the privacy implications
- 28:21 – Why AI education should resemble cybersecurity education: policy, training, suspicion and continual reinforcement
- 30:13 – Preview of FirstWatch Collaborate and the company’s next generation of technology
- 31:02 – FirstWatch 2.0, AI-enabled mobile tools and workload management
- 31:55 – Reflect: incorporating patient satisfaction alongside operational and clinical performance
- 33:34 – Why rapid patient feedback can be more meaningful to crews than retrospective monthly scores
- 35:19 – Todd’s closing message: EMS is good at adapting and improvising, and technology can make the job easier
- 36:22 – Rob’s takeaway: adapt, innovate, become a discerning AI customer and establish an organizational AI policy
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