The future is here…

We just don’t realize it.  There’s a lot of discussion about community paramedicine and what that entails. For a while now, there has been additional training and education available for EMS providers in the tactical and critical care arenas.  Our care methods are changing.  In many EMS systems, we are gradually moving from blindly following the recipe in a cookbook to standing orders where we are actively encouraged to exercise and apply our clinical judgment. Selective spinal motion restriction and pain management are but the first steps.   I truly believe that point-of-care labs are coming soon to an ambulance near you.

We may not “officially” recognize it, but we’ve grown.  At this point, with all of these additional areas of EMS growth, we are becoming de facto mid-level providers, specializing in delivering unscheduled care in out-of-clinical settings.

If we can change the reimbursement model for EMS to focus on care delivered rather than transportation and we can continue enhancing our education requirements, who knows what might happen?

Deep enough thoughts for you on a Monday?


  1. Mike Smertka says:

    Point of care labs have been out for ages. The issue with bringing them to EMS is really logistical. One of the biggest hurdles is they have to be overseen and signed for by an expert usually with a PhD. It includes considerable paperwork, inspections by accrediting agencies, and daily documented controls. Unfortunately, I just don’t see many EMS systems embracing that cost or maintaining enough discipline to make it a go. Perhaps a few agencies here and there, but not as a standard.

  2. Robert Ball says:

    As far as POC labs; it’s the benefit of hospital-based agencies. They have the compliance resources already in place.

    Another logistic issue is cost. iStat (for example) is spendy.

    Finally, EMS needs to become more nimble in the business sense…something not every agency embraces yet.

  3. “If we can change the reimbursement model for EMS to focus on care delivered rather than transportation and we can continue enhancing our education requirements”.

    Wes this is the main reason our profession has such a hard time implementing any new processes or point of care testing. Thank you again.

  4. And there is the problem with not only our current model, but also definitively the private, both profit and not for profit, EMS models. Few, if any, are willing to output money that either isn’t currently reimbursed for or likely to reimbursed for in the very near future. There will always be the exception to any “rule”. One of course, being things required contractually, by law, statue, protocol, etc. The other is the municipal and/or hospital owned services. They’re much more likely to implement things along these lines. Now, I see either those private providers will need to be forced, cajoled, or otherwise convinced that these things are in the best interest of that patients or simply put out of the business of providing EMS. There’s got to be a better way than what we do now. From where I sit, the privates want to take all the IFT(profit, profit, profit) and only do the 911(no $) business when they are forced and/or it looks good for them. Leaving the municipals to handle a lot more of the non paying clientele since municipals are “so greedy”.

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