Future of EMS will be 'data-driven,' EMS Today session told

Brent Myers, medical director of Wake County, N.C., EMS, told the audience the practice of EMS is currently undergoing big changes — and for the better


By Jamie Thompson
EMS1 Senior Editor

BALTIMORE — The future of EMS in the United States will be data-and-research driven rather than responders "doing their best," according to the keynote address at EMS Today in Baltimore on Thursday.

Brent Myers, medical director of Wake County, N.C., EMS, told the audience the practice of EMS is currently undergoing big changes — and for the better.

Photo Jamie ThompsonBrent Myers, the medical director for Wake County, N.C., EMS, delivers the keynote address at EMS Today in Baltimore on Thursday.
Photo Jamie Thompson
Brent Myers, the medical director for Wake County, N.C., EMS, delivers the keynote address at EMS Today in Baltimore on Thursday.

"We are moving out of our EMS adolescence," Myers said. "What we used to do is respond and do the best we could do.

"We reached out and held the loved one's hand of the patent we were caring for and said, 'We did our best for you.' Now we are moving beyond that as we have enough evidence to know what is required to do.

"This is the future of EMS — not that we do our best, but that we have evidence and a list of what we need to do."

During the speech, Myers drove home the point by referring to Britain's wartime leader, Winston Churchill's quote, "Sometimes it is not enough that we do our best — sometimes we must do what is required."

Myers' address focused on how evidence-based treatments can reliably guide EMS care, having a measurable impact on patient outcomes of cardiac arrest, STEMI and CHF.

EMS in the United States, according to Myers, is working to dispel old mantras, many of which were "lost in translation" and misconstrued beliefs from studies and research papers over the past few decades.

These include:

  • The clinical realm: "We can't confuse doing things to our patients with doing things for our patients"
  • The operational realm: "We can't confuse speed with success (response time, time to procedure, medication, skill)
  • The professional realm: "We can't confuse certification with competency"

Attendees at the keynote were told EMS needs to measure "quality and not speed."

Myers highlighted the misplaced focus on response times being the most vital part of care, saying EMS should not place "citizens at risk for a customer service score."

"Most fatalities involved in EMS crashes are not EMS providers — they are the person in the other vehicle," he said.

"Don't think that you're being a hero, placing your own self at risk. You're placing your entire community at risk."

Myers spoke of his hope and belief that data will begin to drive decisions in the field more and more.

"We are maturing as a specialty, so therefore we should let data drive our decisions," he said.

During the address, Myers also discussed how a federal EMS administration would help to improve the industry. A recent white paper — drafted by The International Association of EMS Chiefs and National EMS Labor Alliance — said a federal EMS administration is needed to improve patient care in the United States and standardize training and certification requirements for responders.

Myers said he was confident it would happen, saying sources indicate the proposal is being fast-tracked.

"We receive 4 percent of the domestic preparedness money; that's disproportionate, I think we will all agree," he said. "Now we are going to have a place at the federal level to change that."

Looking to the near future, Myers told the audience how EMS is moving into the realm of being a subspecialty.

With it, he said, will come a range of benefits such as:

  • Fellowship programs becoming uniform
  • EMS providers will have the opportunity to educate future medical directors
  • Research will be required and expanded
  • Enhanced respect in the "House of Medicine"
  • Accountability for medical directors

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