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We know working in EMS often has intense physical, mental, and emotional effects that likely contribute to profession’s high turnover rate. However, there has been little published research in the last 20 years on the topic of burnout among American EMS workers.
Occupational stress among EMS caregivers has been attributed to factors such as hazardous environments, exposure to traumatic situations, physical strain, the demands of shift work, and hierarchal cultures prevalent in the industry. In other healthcare professions, such as among emergency nurses and physicians, occupational burnout has been tied to lower-quality patient care.
Earlier this year the National Registry of EMTs (NREMT) announced the launch of a new web tool to streamline EMS professionals’ recertification tracking. It was the latest of several tools the Registry has built since launching a new model for recertification, the National Continued Competency Program (NCCP), in 2012.
The NCCP is a foundational part of the Registry’s efforts to support the EMS profession’s shift toward a model of lifelong professional learning and evidence-based education. The model offers state and local agencies, along with medical directors, more say in specifying training requirements for their EMS providers.
Nearly 800,000 strokes happen in the United States each year. Like heart attacks, strokes are time-sensitive emergencies. Nearly two million neurons are at risk of permanent damage for every minute that elapses until the blocked artery is opened up and circulation is restored, meaning “time is brain” during a stroke. At Memorial Healthcare System in South Florida, a team of physicians and EMS professionals have transformed stroke care and more than halved the median door-to-needle time for the administration of IV tPA from 82 to 34 minutes from 2014 to Q1 of 2016.
Results of a recent study suggest that advanced automatic crash notification (AACN) technology, which sends telemetry data in the event of a motor vehicle accident, can be used to accurately predict the injury severity of vehicle occupants.
New technologies, including advances in remote monitoring systems, offer the promise of transforming the delivery of EMS, impacting everything from dispatch to treatment and diagnosis in the prehospital setting and moving EMS toward a more predictive, rather than reactive, response model. Remote monitoring systems, offer the promise of transforming the delivery of EMS, impacting everything from dispatch to treatment and diagnosis in the prehospital setting and moving EMS toward a more predictive, rather than reactive, response model.
Recently, Ashoka India selected WHP’s Founder and President, Gopi Gopalakrishnan to be one of its new class of twelve 2015 fellows. The fellowship is aimed at fostering the work of leading social entrepreneurs who present innovative solutions to social problems in India.
Last May, Brent Myers, MD, joined Evolution Health, a Dallas-based, national integrated medical practice, as the chief medical officer and executive vice president for medical operations, and AMR, the nation’s largest ambulance service, as an associate chief medical officer. Before making this move, Myers had been widely recognized for his work to build a mobile integrated healthcare program there to offer in-home care, care referrals and a better system for treating people with mental illness.
For many people who don’t work in the EMS industry, the inner working of the ambulance system is a black box. We hope we never need an ambulance, but we understand if we have a medical emergency we can call 911 and an ambulance will show up at our door. Those types of calls–emergency calls–lead to some 44 million emergency medical transports every year in the US. Nearly just as many—42 million medical transports—are non-emergency medical transports, which often means moving people from one healthcare facility to another.
Last week, Sheryl Sandberg, Facebook’s COO, published an emotional commentary on her experiences of grief after losing her husband, Dave Goldberg, in early May. Many have applauded Ms. Sandberg’s willingness to share her experiences publicly, to be vulnerable and open, and write about the difficulties of returning to life after loss and trying right a world that will never really be the same.
Last week, World Health Partners (WHP) began training ten local entrepreneurs—six of them women—to use a special, mobile phone-enabled device developed by WHP to connect rural communities and doctors far away through a telemedicine-linked Sky network in Western Kenya. The entrepreneurs are being trained to use basic SIM card-powered cellphones to offer community members a way to share vital medical information with network doctors.
Recently, a number of headlines have claimed that the mobile-enabled car service company, Uber, now offers faster service than an ambulance. Granted, the business models for Uber and EMS are not the same and the services provided by a paramedic and an Uber driver are not comparable. The articles call attention to longstanding and ill-conceived quality and value measure in EMS: response times and beg a larger question of the EMS industry.
Last month, hackers broke into Anthem Inc, the second largest health insurance company in the United States. The hackers stole personal information from 80 million people, including Anthem’s CEO, Joseph Swedish. The latest estimates suggest the breach will cost Anthem $100 million to remedy.
This week at the 2014 mHealth Summit in Washington, DC the conversation on the integration of pre-hospital care into the larger healthcare system was practically non-existent. The absence of this conversation in the mobile health space, and it’s limited engagement in the EMS sphere, reflects a fundamental disconnect between EMS and the larger healthcare industry. It is two-sided disconnect, and it’s an opportunity.
This article was originally published by EMSWorld News and Medlert Inc.
Under the Affordable Care Act, hospitals, as well as physician groups starting in 2015, are being rewarded or penalized by Medicare based on scores on value-based metrics such as clinical outcomes, patient experience, and efficiency. Part of the push for higher-quality care focuses on eliminating hospital readmissions for the same problem within a short period of time. Nationally, hospital penalties for preventable readmissions are predicted to hit $756 million in 2014, and will likely have a trickle down effect in many other health industries, including the ambulance service industry.
Last week, I spoke with Matt Zavadsky, Director of Public Affairs at MedStar Mobile Healthcare in Ft. Worth, Texas about how to define value in EMS and the ambulance service industry.
“When we talk about defining value, we have to remember what audience are we talking to,” said Zavadsky. Zavadsky, a leading expert in mobile integrated healthcare, is an advocate of new care models in EMS as well as new ways of defining the value of EMS and ambulance services within an integrated healthcare system. Zavadsky was quick to point out that EMS serves many groups: patients, providers, healthcare organizations, and hospitals. Each group’s understanding of value may differ.
“If you are a patient, you perceive value as having your pain relieved or your breathing difficulty resolved. But the patient’s perspective on value may be different than the payer’s perspective,” said Zavadsky. “The payer may say, ‘What money have you saved me? How have you made an impact on the economics of caring for this patient?’ ”
Zavadsky pointed out that as healthcare providers, one of the value-adds of EMS is the reliable compliance with clinical bundles that have been proven to make a difference in patient outcomes.
Part of the recognition of EMS professionals as healthcare professionals has come out of the push towards more evidence-based approaches to EMS care.
“You can’t be recognized as a player in healthcare today if you’re aren’t based in sound science,” said Ed Racht, MD, Chief Medical Officer at AMR. “Evidence-based EMS and the accountability to be evidence-based is a dramatic change.”
A third big change, Racht pointed to, is a shift towards more sophisticated performance metrics for EMS.
Recently, GigaOm published “Coffee & Empathy: Why Data Without a Soul is Meaningless,” in which author Om Malik argues that consumer habit tracking tools will find their most meaningful, and presumably successful, application when they can interpret the emotional context behind people’s habits.
Earlier this month, the Pew Research Center released the Mobile Health 2012 report and the Groupe Speciale Mobile Association (GSMA) published its review of sub-Saharan Africa’s mobile markets. Mobile phone ownership is growing, and has grown, at a staggering pace worldwide. In five key African markets, the sale of mobile devices grew by 80% in just the last three years. In the United States, the number of phones already exceeds the number of people; and 85% of adults have a phone; over 50% have a smartphone.
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The U.S. healthcare system has been criticized as fragmented, inefficient and costly. But Eric Beck, DO, MPH, president and CEO of Evolution Health in Dallas, and his staff are proving it doesn’t have to be. They’re building new models of team-based delivery and processes that offer patients and providers a better experience. And they’re making healthcare more efficient and effective.