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The road ahead: Resuscitating EMS through trend analysis

Collecting and communicating the big EMS news of 2023

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The American Ambulance Association and the Academy of Mobile Healthcare Integration (AIMHI) collect, collate, categorize and share weekly EMS-based news stories widely with many national organizations and associations, including NHTSA, USFA and NAEMT.

The information contained in the news tracker allows officials and EMS leaders to brief and educate journalists and elected officials, as well as the public as to the current plight of EMS. EMS is delivered on a local level and those experiencing issues with their service can believe it is just them suffering funding shortages, staffing challenges, hospital delays or general poor performance. The tracker can be used to demonstrate that the issues are occurring on a wider regional, state, national and, in some cases, international level.

In this episode of the EMS One-Stop podcast, host Rob Lawrence, who also heads up the AAA-AIMHI news collation effort, welcomes fellow news collator, Rodney Dyche of Patient Care EMS; and AIMHI Education Committee Chair, Matt Zavadsky, chief transformation officer at MedStar Mobile Healthcare. Rob, Rodney and Matt examine EMS news and current trends, and discuss how these themes can be used to inform, influence and educate.

Top quotes from this episode

  • “There’s a perverse ‘incentive’ about response time … if you have the target of 8:59, you arrive on time and the patient dies; that’s a success. If you arrive in 9:01 and the patient lives; that’s a failure. That’s absolute garbage” — Rob Lawrence
  • “There was a quote from Dr. Clawson in a news story that was done in Minneapolis, and I love his quote. He says, ‘there is no evidence that using red lights and sirens have saved more lives than they’ve taken.’” Matt Zavadsky
  • “Every week in this great country, an ambulance is stolen either from hospital or from scene – that’s avoidable.” — Rob Lawrence
  • “Stop being timid. Stop licking your wounds. Get out in your community, talk to your elected officials. Talk to your city managers or county administrators – very factually, not emotionally. There will be time for emotions, but give them the facts and let them know what it’s gonna take to resuscitate their EMS delivery system.” — Matt Zavadsky

Episode contents

00:23 Guest introduction

02:06 – AAA/AIMHI News Tracker and story categories

04:22 – A resource to brief the press and elected officials

04:30 – Operational challenges across many states

05:50 – Massive sign-on bonuses – robbing Peter to pay Paul

06:30 – Staffing and funding issues

08:40 – Communities/local governing bodies facing the fact that they are running out of money, and their EMS isn’t free

09:40 – Transitioning from a volunteer to a paid system

11:00 – Explaining EMS economics to your elected officials

11:50 – Has anyone died? Bring data

13:30 – EMS systems closing

15:30 – “Elected officials get nervous deciding to allocate funding to a service that they haven’t had to fund or haven’t, haven’t had to fund to this certain level in the past.”

18:40 – Response time

19:25 – Increase in low acuity calls

20:30 – Service design

22:50 – Single- versus double-paramedic crewed trucks

25:04 – MEDIC Charlotte – Taking bold steps within categories of response

27:00 – The rate of ambulance crashes across the county at intersections

27:47 – If you are not the ambulance driver … who is?

29:49 – There is no evidence that using red lights and siren have saved more lives than they’ve taken!

30:30 – Stolen ambulances

32:59 – Supply chain and vehicle availability

34:00 – Rurality and ambulance deserts

35:00 – Violence against providers

37:00 – Responding to patients in crisis/agitated patients

38:00 – How to use the media log in your locality to good effect

40:00 – Final thoughts

About our guests

Matt Zavadsky is the chief transformation officer at MedStar Mobile Healthcare, the exclusive emergency and non-emergency public utility model EMS system for Fort Worth and 14 other cities in North Texas that provides service to 436 square miles and more than 1 million residents and responds to over 170,000 calls a year with a fleet of 65 ambulances. MedStar is a high performance, high value EMS system, providing advanced clinical care with high economic efficiency.

Zavadsky is also immediate past president of the National Association of EMTs, and chairs their EMS Economics Committee. He is an appointed committee member to the Joint Commission’s Home Care Professional and Technical Advisory Committee (PTAC), and the Lewin Group’s Hospital Outpatient Quality Reporting (HOQR) Program Stroke and AMI Expert Work Group developing metrics for use in value-based purchasing measures for emergency departments. He is also the co-author of the book “Mobile Integrated Healthcare – Approach to Implementation.”

Rodney Dyche is director of compliance and responsible for risk management with PatentCare EMS Solutions. PatientCare EMS Solutions is a multistate EMS solution, and additionally provides a hybrid online training program and owns a remount facility. As a teenager, Dyche began his EMS career in rural Missouri. He has had multiple system experiences in addition to rural EMS, including MAST (Kansas City, Missouri), REMSA (Reno, Nevada) and Mercy (Las Vegas). In 2010, he became an internal consultant to Paramedics Plus until its sale in 2018. During that time, he led several high-level projects, to include the timely transition of the purchase of Paramedics Plus. Rodney resides in East Texas and in his spare time is a licensed HAM radio operator, and enjoys fishing, off-roading and reading.


Rob Lawrence has been a leader in civilian and military EMS for over a quarter of a century. He is currently the director of strategic implementation for PRO EMS and its educational arm, Prodigy EMS, in Cambridge, Massachusetts, and part-time executive director of the California Ambulance Association.

He previously served as the chief operating officer of the Richmond Ambulance Authority (Virginia), which won both state and national EMS Agency of the Year awards during his 10-year tenure. Additionally, he served as COO for Paramedics Plus in Alameda County, California.

Prior to emigrating to the U.S. in 2008, Rob served as the COO for the East of England Ambulance Service in Suffolk County, England, and as the executive director of operations and service development for the East Anglian Ambulance NHS Trust. Rob is a former Army officer and graduate of the UK’s Royal Military Academy Sandhurst and served worldwide in a 20-year military career encompassing many prehospital and evacuation leadership roles.

Rob is a board member of the Academy of International Mobile Healthcare Integration (AIMHI) as well as chair of the American Ambulance Association’s State Association Forum. He writes and podcasts for EMS1 and is a member of the EMS1 Editorial Advisory Board. Connect with him on Twitter.