News & Updates

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  • 4 Aug 2022 4:34 PM | Matt Zavadsky (Administrator)

    This is very typical of what’s happening in many communities across the country, regardless of provider type… 

    And, not surprisingly, people are not dying in the streets. 

    Using effective emergency medical dispatch (EMD), low-acuity calls can be safely identified with appropriate response time expectations for the caller and community….


    Less serious 911 calls put on standby due to Durham EMS staffing shortages

    August 2, 2022

    By Monica Casey, WRAL Durham reporter

    DURHAM, N.C. — Less serious 911 calls in Durham are being put on standby, as Emergency Medical Services deals with a higher call volume and short staffing.

    Just after midnight on Sunday, scanners captured this: No units available, and right now it's holding chest pain. Alpha response.

    That low priority call was held for just over 13 minutes, until a unit was available, according to Durham EMS Chief Mark Lockhart.

    Having no crews to respond - and leaving a less serious call on standby - is becoming more common.

    "I can't say that it actually happens daily, but it is an almost near daily event," said Lockhart.

    He says the issue is a combination of increased call volume, almost 9.5% over Fiscal Year 2021, and short staffing.

    Out of 165 total positions, EMS currently has 22 vacancies: 5 are for EMT positions, and 17 are for paramedics.

    Lockhart is hoping the profession will attract those with a desire to serve others.

    "There are very few jobs I think where you can come in each and every day, and have the contact that we do with people, some of them experiencing perhaps their worst day, but at the end of the day go home knowing that you've made a difference," he said.

    He believes the county's new thriving wage initiative will help with recruitment and retention.

    "It looks like the average increase is 18%," he said.

    Durham EMS also has to wait with patients when bringing them to a local hospital. That can take up to 30 minutes, delaying things even more.

    Lockhart says low priority calls can be held from 10 to 30 minutes, but they try not to keep anyone waiting longer than that.

  • 2 Aug 2022 7:04 AM | Matt Zavadsky (Administrator)

    This is something we’ve really needed to address in our profession for a long time, with sadly little progress. 

    During one of the great Pinnacle EMS sessions last week, an EMS chief from a major urban fire agency explained why they switched away from dual-role FF/Medics to flex-staff daytime ambulances in his department. 

    He said that when they recruited for FF/Medics, the applicants all looked like the rest of the sworn department members, who did not look like the rest of the community. 

    When they opened of the flex staffing to non-sworn personnel, the applicants looked more like the rest of the community.

    It’s THAT kind of thinking, along with EMS agencies offering training scholarships for paid training and employment post-graduation, that may start to bend the diversity curve in our profession!


    From low pay to workplace culture, obstacles litter the path to diversity in EMS

    By Akila Muthukumar

    Aug. 1, 2022

    A single mother, Tashina Hosey quit her job at a Pittsburgh post office when she was assigned to work a seventh consecutive day just as her second daughter was about to be born. Desperate to find her next paycheck, she stumbled upon a free 10-week emergency medical technician course.

    Called Freedom House 2.0, the program trains people like Hosey – unemployed, single parents, low income – following in the footsteps of the original Freedom House, a pioneering Pittsburgh ambulance service staffed by predominantly disadvantaged Black residents that was at the vanguard of efforts to modernize the delivery of pre-hospital care in America in the 1960s and 1970s.

    Emergency medical services have since become predominantly white, as well as mostly male, in Pittsburgh and nationally. Programs like Freedom House 2.0 have sprouted across the nation in an effort to diversify EMS. As of 2000, less than 5% of certified EMS professionals were African Americans, and that proportion remained until 2017. As of 2019, it had increased slightly: non-Hispanic Black people accounted for 8% of EMTs and 5% of paramedics.

    When the race of EMS crews doesn’t match the population they serve, studies show inequities in care proliferate – strokes are overlooked in Black women, and Black children are less likely to receive pain medications for long bone fractures. There are even differences in hospital transport destinations for Black and Hispanic patients in comparison with their white counterparts.

    “A lot of those health inequities: stroke recognition delays, trauma care delays, and pain control differences, start to go away when you have a workforce that looks similar to your patient population,” said Ben Weston, medical director of the Milwaukee County Office of Emergency Management.

    Yet the diversity efforts face big challenges. EMS is notorious for low pay, long hours, limited career-advancement potential, and high turnover; many services are staffed by volunteers looking for experience before going into firefighting, police work, or medicine. Gallows humor and bullying disguised as banter are part of the culture in many EMS workplaces, and in a 2021 survey, 61% of female EMS workers said sexual misconduct was a major issue in the industry.

    During her 10 weeks in the Freedom House 2.0 program, Hosey woke up at 6 a.m. in her apartment on a street with nothing but a Rite Aid and “heavy, heavy, heavy drug activity.” She’d pack diaper bags, bottles, and leftover dinner for lunch before waking her children up from the bed she shared with them.

    “They call it a two-bedroom but I’m gonna say it was one and a half because the other one was not possibly big enough to be a bedroom,” she said.

    Battling heavy traffic in her white 2014 Chevy Malibu, she’d drop her kids off at daycare before driving to the Hill District to learn about injuries, medications, and triage skills from 8 a.m. to 4:30 p.m. five days a week. After retracing her morning commute, she’d finish errands and sometimes only begin studying at 11 p.m. Still, she loved ride-alongs and began to think being an EMT “is something I can do.”

    Upon graduation, however, Hosey did not take the EMT licensing exam, even with the program covering all fees and offering a $250 stipend. In fact, of the 30 graduates from the first four cohorts of Freedom House 2.0, only one is an EMT. Of the 22 who are employed, 10 are patient care technicians, five are medical assistants, three entered other allied health fields, and three became community health workers, including Hosey.

    “They were starting out at maybe $14 [hourly pay],” Hosey said. “With me being a single mom with two children and a car and rent and all types of bills, it just didn’t seem like something that would be beneficial to me. They do 12-hour days … it would have never worked.”

    Instead, she helps other single mothers move out of mice-infested homes and navigate the intricacies of obtaining housing subsidies. The regular hours, remote-work option when her kids are sick, and increase in pay allowed her to purchase a 2,474-square-foot, three-bedroom home with a basement and attic – luxuries she never imagined having before Freedom House.

    Before Freedom House, police officers and morticians used to transport patients, but the death of the Pennsylvania governor from a heart attack en-route to the hospital in 1966 cast a spotlight on avoidable deaths. In Pittsburgh, Freedom House saw an opportunity to improve care for its neighborhood while providing training and jobs for its poor, unemployed Black residents.

    After completing a 32-week, 300-hour course, 25 paramedics previously deemed “unemployable,” most of them Black men, were assigned to two ambulances. They were pioneers of CPR, intubation, and IV administration in the field and helped pave the way for national standards for pre-hospital emergency care.

    But within a few years, the city’s EMS crews became almost entirely white.

    “EMS started in Pittsburgh on the backs of African American men and women from the Hill District,” said Sylvia Owusu-Ansah, the diversity and inclusion director of the National Association of EMS Physicians. “A new regime came in the early ‘70s that basically, through the acts of racism, eliminated probably the most elite, astute paramedics that were there at the time.”

    The city terminated funding of the Freedom House service and built a new paramedic force from scratch. Driven by police officers eager to maintain control of ambulances, the Freedom House crews were split up, despite the city originally agreeing not to do so. Those with criminal backgrounds were fired or reassigned non-medical work, and tests on material they had not been taught were used to dismiss others. Their replacements were all white, and white employees with less experience began to take on leadership roles. By the late ‘90s, Pittsburgh’s paramedic program was 98% white.

    Owusu-Ansah said the picture nationally is similar. EMS is clearly “very much an old boys club,” especially in EMS-fire services, she said. “I’m pretty much on the national committee of every EMS organization that exists out there, and over 90% of the time, I’m one of the few women, I’m the only person of color, and I’m the youngest person.”

    Because EMS in most places is a part of the fire or police agency, it has a similar culture and draws recruits from the same pool of applicants. “There’s a lot of fraternity involved in the way of ‘my uncle did this’ or ‘my grandfather did this,’” Owusu-Ansah said.

    Much like Hosey, Douglas Randell – now division chief of EMS in Plainfield, Ind. – was married with a young kid trying to “make ends meet” when he joined an EMT program through a scholarship for disadvantaged students.

    “When you have the exposure of something generation after generation, it almost becomes an expectation that you follow the path,” he said. “For Blacks, especially in urban areas, we didn’t have that exposure.”

    There is also a widespread perception that EMS is a part of law enforcement, and that deters Black applicants and others from communities that have long been victims of police violence. Meg Marino, director of New Orleans EMS, turned on her Zoom camera mid-interview to show how her uniform and badge look like a police uniform. Even small visual cues like wearing a pride pin or Black Lives Matter shirt can increase patient trust in EMS providers, she said.

    While the paramilitary structure of EMS promotes organization and high performance, it comes with deep-seated cultural values such as not questioning authority and “toughing it out” that may also make the job less appealing.

    “We can do all the recruitment in the world” but it is meaningless without changes to workplace culture,” said Jordan Rudman, a former EMT who is now an emergency medicine resident physician at Beth Israel Deaconess Medical Center in Boston. Referring to the hierarchical structure of EMS agencies and cases of sexual assault, he said, “It’s pretty hard for me with a straight face to say: come work here. It’s gonna be great.”

    Hosey saw first-hand the difference a diverse workforce, and its absence, can make in the way patients are treated on ambulances in low-income neighborhoods in Pittsburgh. Once on a ride along, Hosey remembers the team visited a mental health facility that was “almost like a jail.”

    “The guy we picked up was a Black guy and you can tell that he was suffering from some type of mental illness,” she said. “But they [the EMTs] chose not to listen to him. It was just like ‘shut up’ and ‘you don’t know what you’re talking about,’” she said.

    “I wasn’t an EMT at the time so I couldn’t pinpoint what the issue was, but I was vocal about the way that they chose to talk to him,” she said, adding that the EMTs were receptive and apologetic.

    Diversity can improve communication with patients, whose accounts are often as useful to ambulance crews as clinical examinations. A bilingual EMT can be invaluable, especially since translators are not practical given the need for speedy treatment.

    Even without perfect provider-patient racial concordance, a more diverse workforce can indirectly benefit patients. Randell says conversations he has with white providers in the station – about barber shops, soul food, and his favorite TV shows – makes them a bit more comfortable with treating patients who don’t look like them.

    “When we go into a house and it is predominantly Black, I am the lead person because I know the environment,” Randell said. When someone asks for albuterol for their asthma in a poor neighborhood, he says he has “a level of compassion” and is willing to believe they couldn’t afford to get it filled while someone without his background might think the patient is just abusing the system.

    Alongside Freedom House 2.0, EMS agencies across the country – in New Orleans, Chicago, Milwaukee, Durham, N.C. – are implementing efforts to diversify their workforces, but it can be slow-going and providers of color feel the extra work of promoting diversity frequently falls on them.

    With a million-person county, 125,000 EMS encounters per year, and 14 fire-EMS stations, Milwaukee’s service is one of the largest in the United States. In early 2020, it found that race and ethnicity status of patients was recorded less than 50% of the time, which made it difficult to study inequities in care. “The data was garbage,” said Weston, the county emergency management medical director. After making it a required field in the patient care records system, he said, the agency was able to identify and show providers specific disparities in patient care.

    “It’s not just data from other systems, but showing that right here in Milwaukee County, our system also has disparities in how we care for patients,” Weston said. Rather than making blanket statements about improving patient care, this focuses the conversation on how to improve care for patients from disadvantaged racial and ethnic groups. The issue is framed at the population-level so providers don’t feel like their medical competence is being called into question, nor that they are being attacked for bias.

    Joshua Parish, assistant chief of EMS in the Milwaukee Fire Department, said traditional recruitment efforts involve highlighting the job – the fires and trucks – at career fairs, which attracted people who were willing to commit immediately.

    Now, when speaking with someone from an underrepresented group, he tries to “anchor our recruiting messaging in what my target audience already understands.” He asks people what they like in their current job, what differentiates a job from a career, and how money factors into their family’s current situation. He gives them time to think about the decision.

    He’s hyper-intentional about visual images: a feminine silhouette or a child wearing a hijab on flyers, websites, and photos can serve as psychological cues for inclusivity “without having to say ‘we’re inclusive,’” he said. Younger firefighters – who have dreadlocks and cornrows and get their hair done – are serving as a recruiting tool for the next generation to enter into this space, he says.

    EMS certification is equivalent to an associate’s degree, and Parish said learning so much content quickly can be a barrier to entering the profession. For non-university-educated students unfamiliar with anatomy, or without any exposure to Latin, making sense of medical prefixes is not easy. Parish worked on making the EMT curriculum more accessible to under-resourced students by finding ways to teach basic numeracy and health literacy.

    “This is so much harder than I thought it would be,” he said. “I was sitting in some high school classrooms and I realized that that’s where the deficit was.” The training program started teaching students structured note-taking and implemented academic probation for those with less than a B average, which led to students seeking additional help; though labor intensive for the leaders, it was beneficial to push students.

    Now, the firefighters he is recruiting and promoting are the most diverse the department has ever seen; over 50% of new hires in the last five years have been women and people of color, but it will take time for that diversity to be reflected in leadership.

    “[People] who just got promoted today, that’s because I hired them seven years ago,” Parish said. “They’re going to be my cultural trendsetters. So it’s my job, when they want to do something out of the norm and they get crap from our old guys to go, ‘No, that’s cool. Let them roll.’”

    Workers are evaluated using objective metrics like the speed and accuracy of taking patient vital signs, Parish said, as opposed to an officer “telling you that you did a bad job because they think you did.” He said he assigns the “old guys” to work alongside colleagues from different backgrounds — say, a younger woman of color. After a while, he added, the older workers will accept that “people who look like her and sound like her can be EMTs.”

    In New Orleans, EMS Director Marino said her agency has blinded hiring decisions and promotion reviews in an attempt to overcome unconscious bias or overt instances of candidates being excluded because of an “ethnic name” on a resume.

    She said she’s not deterred by pushback from some veteran employees. The old guys’ pejorative whispers about the “diversity agenda,” she predicted, will be phased out by a workforce that wants to include maternity pants for pregnant providers, ask questions about pronouns for trans patients, and make diversity a core part of their agenda.

  • 1 Aug 2022 3:43 PM | Matt Zavadsky (Administrator)

    This is a significant problem in many communities!

    MedStar has several processes in place to prioritize 911 calls to help assure our emergent calls get the fastest response time.

    Thankfully, our hospitals do a fantastic job NOT holding MedStar crews!


    Sunburn, a UTI and insomnia are some of the calls Douglas EMS gets, causing big delays for real emergencies

    Some things people called Douglas County 911 for this week include a sunburn, UTI, and insomnia.

    By: Dawn White

    Published: July 31, 2022

    DOUGLASVILLE, Ga. — Emergency services throughout metro Atlanta are being stretched thin and making it harder to respond to those who need help right away.

    Douglas County reports that its ambulances are having to wait at area hospitals for at least 30 minutes more than 500 times in both May and June. They report two reasons are behind this and are asking for people's help to improve public safety.

    Responding to emergencies is where Douglas County EMT and firefighter Jordan Reid wants to be.

    “We do love to be out there serving the community. It is frustrating to be stuck at the hospital and stuck not being able to serve the emergency calls that are coming in," Reid said.

    Douglas County ambulances have responded this week to a variety of non-emergency calls.

    “We had a young lady who was a newer parent whose baby would not go to sleep at about 3 o’clock in the morning, and she just couldn’t put the baby down," Reid said. "She didn’t know what to do, so she called the ambulance.”

    “We’ve had everything from a sunburn to I can’t sleep to a UTI," Douglas County EMS Chief Stacie Farmer said.

    Farmer said the problem isn't just responding to those non-emergency calls but also ambulances waiting at hospitals due to high call volumes.

    “To turn that patient over is sometimes taking one, two, three hours," Farmer said. "A couple of days ago, [it took] five hours. The highest we’ve had is eight.”

    Douglas County posted a public service announcement this week asking people only to call 911 for emergencies.

    "We’re asking them to evaluate whether this is a true emergency or if there are avenues that are more appropriate," Farmer said.

    Those avenues include telemedicine and urgent care, Farmer explained.

    “If you have a situation that’s non-emergency that you’re using an ambulance for, that ambulance is not available for the other citizens in Douglas County," Reid said.

    This isn’t just a problem in Douglas County. It’s a regional problem. DeKalb and Cobb counties said they're experiencing similar issues. Fire and rescue services in Clayton and Gwinnett counties said they'd get back to us, but we didn't get information on if they're seeing these problems by the time this story aired.

  • 29 Jul 2022 4:11 PM | Matt Zavadsky (Administrator)

    Boswell Fire Department ending emergency ambulance service Sept. 30

    July 29, 2022

    By David Hurst

    BOSWELL, Pa. – Saddled by escalating costs, Boswell Fire Department is cutting its emergency ambulance service Sept. 30.

    Fire department officials announced the move with a “heavy heart” Thursday, saying ambulance costs racked up a $150,000 budget deficit over the past two years alone.

    That’s a massive sum for a department that operated on a $321,000 budget last year, including equipment, payroll, fuel and other costs, board member and financial secretary Jonathan Adams said.

    “This isn’t something anyone wanted to do. But it was getting to a point our entire fire department’s reserves were down to months and weeks (of funds remaining),” Adams told The Tribune-Democrat in a telephone interview Thursday.

    He said the division operated on a $121,000 deficit in 2021.

    The fear is that if the department didn’t do something, volunteer fire service itself would be threatened, he said.

    “Make no mistake, while the thought of not having a professionally staffed ambulance in our community full-time concerns us, the fear of not having a fire department in our community concerns us far greater. Without a “course correction” from our current financial state and trajectory, the possibility of completely shutting down both ambulance AND fire-rescue operations could be a very real scenario,” the department wrote on Facebook in a post to the community.

    By announcing the move early, department officials are hoping to give nearby agencies time to research the idea of adding the Boswell area to their coverage zones.

    The department’s ambulance division has a roster of 25 employees, including paramedics and EMTs who mostly cover shifts on a part-time basis in addition to handling calls for other departments, Adams said.

    Boswell also serves parts of Jenner and Quemahoning townships.

    Regardless of what happens, rest assured that an ambulance will be dispatched Oct. 1 – and beyond – through Somerset County 911 even after Boswell’s lights go dark, Somerset County Emergency Management Agency Director Joel Landis said.

    It may mean an ambulance is traveling further to serve the Boswell area.

    “But we have a system in place to send out ambulances when a call comes in from Boswell. It already works that way now when Boswell’s department is already out on another call,” Landis said, noting the next closest available would step in for that particular call.

    “We’re saddened to see us lose another emergency medical service in the county,” he said, “but I can completely understand with the state of things the way they are. In today’s economy, it must be a challenge for every service to continue operating.”

    Landis said the decision should serve as a reminder across the region that communities need to “gather around” the emergency medical service providers that serve the area and support them in any way they can.

    “We’ve got to support them to keep them running,” he said, “so that we don’t lose any more.”

  • 18 Jul 2022 7:05 AM | Matt Zavadsky (Administrator)

    Conversations like these are happening in many communities across the country.

    Safe, accurate emergency medical dispatch (EMD) can help preserve crucial first medical response resources for the time-life sensitive calls they can truly make an impact.  Tying up first medical response resources on calls they are likely not needed, creates an opportunity for patients with a life-threatening medical condition to receive a delayed response.


    KY City Looks to Cut Non-Emergency Responses

    Owensboro fire and city officials said many of the department's 7,600 calls last year were not serious emergencies.

    July 17, 2022

    Jul. 16—The Owensboro Fire Department would like to reduce the number of nonemergency medical runs firefighters make.

    But Paul Nave, director of Owensboro- Daviess County 911, said dispatch attempts to screen medical calls already, and that the default is to send firefighters when a caller says they have an emergency.

    According to the fire department's 2021 annual report, the agency responded to 295 fire calls that year. However, OFD crews responded to 1,596 calls of respiratory distress, 1,024 reports of traumatic injuries and 982 calls of cardiac issues, the report says. Other types of EMS calls include accidents with injuries and falls.

    In all, the department made 7,361 emergency medical service runs last year, of all types.

    Mayor Tom Watson said firefighters have told him they sometimes go on medical runs that turn out not to be emergency situations.

    "There are calls they don't necessarily need to make," Watson said.

    City Manager Nate Pagan said talks on the subject at City Hall are preliminary.

    City Fire Chief James Howard said responding to medical runs that are not emergencies wears down fire crews.

    "Our call volume has gone up and up," Howard said. Calls for service increased by about 12% in 2021, Howard said.

    "We have the same number of trucks and personnel," Howard said. "Any time you are doing more work with the same workforce, you have to consider what that is doing to the workforce."

    The agency provides basic and advanced life support and makes runs along with AMR, the ambulance service. Howard said OFD is looking at how fire departments in cities such as Bowling Green and Evansville handle medical runs.

    The goal, Howard said, is "to make sure we are always going out when we are needed," but the agency would like to find a way to reduce runs to non-emergencies.

    "It depends on the reliability of the caller," Howard said. "When we deploy resources, we have to do it in a smart way, that we are (providing) life-saving services when needed."

    When there is a medical emergency, "we want to be there and be the first to put hands on the patient," he said.

    Nave said the dispatch center "is communicating with Chief Howard on some possible changes to accommodate the reduction in calls." But when a medical emergency call is received by dispatch, "it's not always black and white," he said. "We can only respond to the call based on what the caller tells us."

    When a person says they need medical help, dispatch sends the alert to firefighters while taking additional information from the caller.

    "Multiple times, the (caller) will say, 'Just send them,' " Nave said. "They don't want to answer questions, and I get that."

    Dispatchers will keep talking to the caller, to determine the nature of the emergency, even while responders are already rolling, Nave said.

    Regarding firefighters being dispatched on 911 calls that aren't medical emergencies, Nave said, "I understand once they get there it's not always true, but the majority of time it is true.

    "I don't want anyone to not call" if they think they have a medical emergency. "If in doubt, you call us."

    Dispatch does screen calls to try and determine if there is an emergency, Nave said, and if the criteria isn't met, firefighters aren't punched out.

    In April, dispatch did not call out firefighters to 114 calls because they did not meet the criteria for needing OFD responders, according to data from dispatch. There were 135 medical calls that didn't meet the criteria for OFD dispatch in May, and 161 medical calls where city firefighters weren't dispatched in June. Those numbers do not include medical calls OFD is regularly not dispatched to, such as reports of back and abdominal pain, Nave said.

    Daviess County Fire Chief Jeremy Smith said the county department made some changes earlier this year to reduce the number of medical runs it makes. For example, the agency no longer responds to calls of threats of suicide, because firefighters would be on standby at the scene while law enforcement works with the person involved, Smith said.

    The department does respond to all calls of suicide attempts. Smith said another change limited runs firefighters make to some medical offices, because they are already staffed with medical personnel. But the agency does respond to urgent care centers.

    If a medical call does not require advanced life support, volunteer firefighters, who are EMTs, can handle the call without DCFD responding, Smith said. Other exceptions aside, the county department does respond to most medical calls.

    "Overall, if the ambulance service dispatch deems it an emergency response, we go," Smith said.

  • 7 Jul 2022 9:49 PM | AIMHI Admin (Administrator)

    Leadership in Integrated Healthcare Award | This award recognizes an individual who has made significant impact on the integration of EMS, or the advancement of the integration of EMS into the healthcare system.

    Matt Zavadsky

    Matt Zavadsky, MS-HSA, EMT, 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 Emergency Medical Services system, providing advanced clinical care with high economic efficiency.

    MedStar is one of the most well-known EMS agencies in the country, and operates a high-performance system with no tax subsidy, and the recipient of the EMS World/NAEMT Paid EMS system of the Year, and the only agency to be named an EMS10 Innovator by JEMS Magazine.

    He is also the co-author of the book “Mobile Integrated Healthcare – Approach to Implementation” published by Jones and Bartlett Publishing.

    He has 42 years’ experience in EMS and holds a master’s degree in Health Service Administration with a Graduate Certificate in Health Care Data Management. Matt is a frequent speaker at national conferences and has done consulting in numerous EMS issues, specializing in high-performance EMS operations, finance, mobile integrated healthcare, public/media relations, public policy, transformative economic strategies, and EMS research.

    Matt is also immediate past president of the National Association of EMTs, and chairs their EMS Economics Committee.

  • 7 Jul 2022 9:33 PM | AIMHI Admin (Administrator)

    Leadership in Integrated Healthcare Award | This award recognizes an individual who has made significant impact on the integration of EMS, or the advancement of the integration of EMS into the healthcare system.

    Dr. Veer Vithalani

    Veer Vithalani, MD
    Medical Director
    MedStar Mobile Healthcare

    Dr. Vithalani has been an incredible advocate for the expanded role of EMS and EMS practitioners in the community and healthcare system. All of the MIH programs conducted are with the full support, education, credentialing and often, suggestion of Dr. Vithalani.

    Most notably, to support the use of non-CLIA waived Point of Care testing that supports clinical interventions by MedStar's MIH Team, Dr. Vithalani took the required training, and became a Certified Lab Director, that allowed us to become certified as a Moderate Complexity Lab, facilitating the use of non-CLIA waived POC tests and processes.

  • 7 Jul 2022 9:29 PM | AIMHI Admin (Administrator)

    Advocacy in Integrated Healthcare Award | This award recognizes a legislator or regulator who has made significant impact on the integration of EMS, or the advancement of the integration of EMS into the healthcare system.

    WI Representative Amy Loudenbeck

    Originally from the Detroit and Chicago area, Wisconsin Representative Amy Loudenbeck graduated from the University of Wisconsin–Madison in 1991. She was elected to the Wisconsin State Assembly in 2010 as a Republican.

    Despite serving in a deeply politically polarized state, Representative Loudenbeck's relationships with fellow legislators span both sides of the political aisle and engage all corners of Wisconsin. She has an exemplary record of support for emergency medical services and fire departments, and has authored numerous mobile healthcare bills with bipartisan support that were signed into law by Governor Walker and Governor Evers.

    Most recently, Representative Loudenbeck championed legislation that directed the Wisconsin Department of Health and Human Services to implement certified public expenditure and upper payment limit Medicaid match programs in her state. This legislation had the support of PAAW, the Wisconsin State Fire Chiefs Association, Professional Fire Fighters of Wisconsin, and the Wisconsin EMS Association. Once instituted, these programs will infuse governmental, non-profit, and for-profit EMS providers of all types with millions of dollars in desperately-needed additional funding.

    The Professional Ambulance Association of Wisonsin and its members are confident that Rep Loudenbeck will continue her tireless support of EMS in her next role in government. (Rep Loudenbeck is currently running for the office of Wisconsin Secretary of State.)

    Supporting Links

  • 7 Jul 2022 9:24 PM | AIMHI Admin (Administrator)

    Excellence in Value Demonstration or Research: This award recognizes an EMS or non-EMS organization that created and implemented an analysis of data and/or research project to demonstrate the value impact of the services provided by the organization.

    Niagara EMS EMS Response Time Performance Plan

    Niagara EMS is being honored for their total redesign of their response system to improve ambulance availability for life-threatening calls and reduce the use of lights and sirens for a response.


  • 7 Jul 2022 9:16 PM | AIMHI Admin (Administrator)

    Excellence in Public Information or Education: This award recognizes an EMS or non-EMS organization that has developed and implemented an effective public information or education campaign designed to encourage patients, members, or the public to develop or maintain healthy lifestyles, or to more effectively utilize healthcare resources.

    KPS|3 for Public Awareness of REMSA MIH Initiatives

    Since 2012, when REMSA Health was awarded a Health Care Innovation Grant from the Center for Medicare and Medicaid Innovation, KPS3 has been sharing the message about the importance of incorporating patient navigation into the region’s EMS system. At that time, KPS3 was tasked with launching a public awareness campaign intended to change behavior related to three key interventions - a Nurse Health Line, Alternative Destination Transport and Community Paramedicine.   

    While the specific message and program element has changed in the last decade, KPS3 has remained a committed partner in conceptualizing and implementing comprehensive campaigns to promote proper patient navigation. It’s clear the purpose of the campaign is to change behavior (don’t call 911 for non-emergencies) but there are strong attitudes and deeply held values related to the public perception of 911/ambulance transport usage. KPS3 understands these nuances and works with REMSA Health’s PR department, subject matter experts and leaders to figure out how to move the needle on public behavior without threatening the closely-held belief of a right to a timely emergency response and access to quality care.       

    In 2021, REMSA Health’s Regional Emergency Communications Center managed 276,281 calls. In the same year, the Ground Operations EMTs and paramedics responded to 67,730 calls for 911 service; of that 47,705 patients were transported to the ER. The number of calls and responses is significant and to preserve medical emergency response resources for true emergencies, EMS providers and community members needed to be educated about accessing the right level of care. KPS3 recognized the need for a public relations PESO content model (Paid, Earned, Shared, Owned) which is useful when there is a need to explain complex, in-depth concepts - which mobile integrated health has plenty of.    

    Under the direction of REMSA Health and with the support of the Washoe County District Board of Health, KPS3 brought a public-facing communications strategy to life to help people understand the appropriate use of medical 911 resources. Named “Choose The Right Care,” the campaign focuses on preserving 911 for emergencies and helping the public embrace alternatives to an ambulance response and/or transport to an emergency room. The campaign reinforces the safety and efficacy of other care pathways including transferring Alpha/Omega calls to a Nurse Health Line, transportation to an alternate destination, a protocol program called “Assess and Refer ” and Treatment in Place via telehealth.   

    Key elements of the (PESO) communications and content management plan included:   

    • P - PAID  English and Spanish language advertisements were purchased on local buses  Four-second animated call to action television station identification ads  Sponsor lines on local NPR station  Explainer video looped on concourse monitors at local AAA baseball team stadium   Sponsorship of a local business networking organization       
    • E - EARNED  12-minute segment on Face The State (CBS affiliate)   Misc morning/evening television news coverage (CBS affiliate)  In-studio three-minute television news segment (ABC affiliate)  Subject matter expert interview misc morning/evening coverage from pitch (NBC affiliate)  Local NPR affiliate reporter ridealong (story scheduled to run in June 2022)   
    • S - SHARED   REMSA Health leaders and supporters, healthcare partners, community influencers and KPS3 staff share organic social media posts on Instagram, Facebook, LinkedIn and related media coverage links  Reno-Sparks Chamber of Commerce membership email inclusion   
    • O - OWNED - The creative development, design and build-out of an animated and interactive microsite/landing page (available in English and Spanish) which lives on This helps visitors understand levels of care based on a few different healthcare scenarios. The site also features contact information for community health resources.   An easy-to-understand, animated explainer video was developed to share across REMSA Health’s channels and for community partners and influencers to share, as well. A three minute version and a 30 second version were developed in English and Spanish, as well as with subtitles to ensure as much access to the messaging as possible.  Flyer and poster distribution to frequent users and community locations, respectively (ie libraries, pharmacies, etc)    

    Other strengths of the program:  KPS3 committed to a library of consistent creative visuals and easy-to-understand language to help the public understand the key point, despite the delivery channel   The focus on using phrases and talking points free from jargon, such as:  The 911 call is changing and that’s ok.  Thirty percent of the calls REMSA Health receives are for first-aid level care - things like sprained ankles, toothaches and sore throats.  Use 911 for emergencies only.  A true emergency are things like cardiac arrest, stroke symptoms, uncontrolled bleeding and serious allergic reactions.  Helping patients get to the right level of care is safe and is approved by our medical directors.  We need the public’s help. It’s ok if a medical dispatcher transfers you to a registered nurse to get care guidance at home. It’s also ok if the paramedics or EMTs that respond to you suggest that you visit a doctor, an urgent care clinic or a pharmacy instead of being transported to the emergency room in an ambulance.

    Organization Overview
    This nominee is not a payer, a hospital system or a hospice agency. They may not be the conventional choice for this award because they are a digital/marketing/communications agency. However, they are most certainly an EMS agency partner. KPS3 describes itself in the following way: We build brands and create technology that move people to action. We don’t fit the mold. A marketing company, a PR firm, a digital agency - none are quite enough. We create brands and advertising campaigns for companies and organizations across the nation. We build enterprise-level web and mobile applications. We handle crisis communications for clients we can’t mention. And we are able to do it all because we have smart, dedicated and well-researched professionals who like debates, data, human psychology and the unexplored.     REMSA Health describes KPS3 as: KPS3 is not just a three-plus decade vendor of ours. They are a friend, champion and an extension of our PR team, as well as of the organization. The REMSA Health account team at KPS3 applies strategy, creativity and innovation to our work. They engage us in meaningful dialogue about what we want to achieve because they understand how it improves the quality of life for the people in the communities REMSA Health serves. From their founder who landed REMSA Health as her first client 30 years ago and still contributes to our account to the new college graduate hired to curate our digital content, KPS3 understands the profession of emergency medical services and believes in the future of mobile integrated health.

    Date of Implementation: January 2021 (additional phases of the campaign continue to launch)

    Description of Outcomes / Utilization / Change
    Year to date, there has been an impact of five percent in terms of referring people out of the 911 system, across all alternate care pathways. Resetting expectations for a healthcare model that is more than four decades old is slow-going. KPS3, REMSA Health and the Washoe County Health District understand that the Choose The Right Care campaign is a starting point for helping patients, elected officials, municipal managers, healthcare partners, employees and community influencers understand that the delivery of out-of-hospital healthcare must change. Since it is still in the early stages, research and measurement about reach, awareness and behavior change have not yet been conducted. However, local healthcare partners, as well as elected/appointed officials who have seen elements of the campaign are enthusiastic and invested in supporting the message.

    Budget: All of the funds for the Choose The Right Care campaign were invested back into the Washoe County community through funds that REMSA Health pays to the Washoe County District Board of Health for any non-compliant responses.    

    Total Budget: $72,444 

    • NPR - $750 
    • NBC affiliate - $5000 
    • landing page - $26,581 
    • Explainer Video - $25,328 
    • Flyers/Poster/Bus interiors - $2470 
    • Account coordination - $12,315

    Estimated Reach: Since the campaign has only recently fully launched, these figures are preliminary. landing page: 

    • 630 Unique Pageviews 
    • Average Time on Page is 2:24    
    • Explainer video viewing via  65 Unique Viewers 
    • 194 Unique Impressions   
    • Approximate earned media publicity value: $17,802   
    • Audience reach for the baseball stadium, NPR, NBC and bus interiors are unknown as these elements are still running.

    Supporting Links
    Assess & Refer Patient Material (English)     

    Assess & Refer Patient Material (Spanish)      

    Every Call Is Important (English)     

    Every Call Is Important (Spanish)      

    Explainer Video       

    Baseball Stadium       

    Face the State earned media interview     

    NPR Ride Along     

    NPR Sponsor Lines

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