The Future of EMS?

[Tony Maximilian]

I'm more a romantic than a cynic, but this made me LOL pretty hard. Never in a million years...

 

[SpecialK]

Here's the thing; parts of this are already happening.

In the not too distant future when ePRF is linked fully to the single, national electronic medical record ambulance personnel will be able to see all of the data and this will expand on the current availability. I don't see any reason why smart devices won't have some health monitoring function built into them and this can link to the health cloud in some form. Google reckons self-driving cars are less than a decade away so why not? Power loading stretchers and stair chairs already exist.

And maybe in the future these people won't all look like American cops off TV? Ha ...

 

[Tony Maximilian]

Here's the thing; parts of this are already happening.

In the not too distant future when ePRF is linked fully to the single, national electronic medical record ambulance personnel will be able to see all of the data and this will expand on the current availability. I don't see any reason why smart devices won't have some health monitoring function built into them and this can link to the health cloud in some form. Google reckons self-driving cars are less than a decade away so why not? Power loading stretchers and stair chairs already exist.

And maybe in the future these people won't all look like American cops off TV? Ha ...

You're quite right, and it's fascinating to ponder. My incredulity isn't related to the technology but to the idea that private companies or municipal agencies/departments would ever seriously allocate funds required for most of the tech and equipment featured in the video.

 

[EpiEMS]

single, national electronic medical record

We are so far from that in the U.S., even with the ACA's push towards EHR/EMR solutions. Not to mention the privacy concerns (reasonable or not, some folks will be concerned about privacy).

I think mandating power lift stretchers will do more for EMS than EMR access, honestly.

 

[SpecialK]

My incredulity isn't related to the technology but to the idea that private companies or municipal agencies/departments would ever seriously allocate funds required for most of the tech and equipment featured in the video.

Then that speaks more to the fact there is something dreadfully wrong with your funding model ...

We are so far from that in the U.S., even with the ACA's push towards EHR/EMR solutions. Not to mention the privacy concerns (reasonable or not, some folks will be concerned about privacy).

I think mandating power lift stretchers will do more for EMS than EMR access, honestly.

Privacy is a legitimate concern but honestly, I think it's a bit blown out of proportion. The benefits of a single, national health record does much more good than whatever privacy concerns exist which can be practically mitigated/eliminated. I've seen Australia and England are also wanting to move in this direction. I can't imagine why you blokes wouldn't want something the same given how large your country and population is so people are quite mobile?

And Powerlift stretchers are good yes, I agree and should be mandatory. But so should reasonable access to the health history and recent interactions with the health system of somebody I have never met before and am seeing for the first time at two a.m. and need to decide what to do with ... same goes for anybody seeing them. In other sectors if you call your mobile operator or go to their store 500 km from where you live they will have all your information right there in front of them at the click of a button. Health care should be the same.

 

[luke_31]

Then that speaks more to the fact there is something dreadfully wrong with your funding model ...



Privacy is a legitimate concern but honestly, I think it's a bit blown out of proportion. The benefits of a single, national health record does much more good than whatever privacy concerns exist which can be practically mitigated/eliminated. I've seen Australia and England are also wanting to move in this direction. I can't imagine why you blokes wouldn't want something the same given how large your country and population is so people are quite mobile?

And Powerlift stretchers are good yes, I agree and should be mandatory. But so should reasonable access to the health history and recent interactions with the health system of somebody I have never met before and am seeing for the first time at two a.m. and need to decide what to do with ... same goes for anybody seeing them. In other sectors if you call your mobile operator or go to their store 500 km from where you live they will have all your information right there in front of them at the click of a button. Health care should be the same.

The single healthcae record is something that will happen, but it is many years down the pipeline in the USA. We have a very fractured healthcare IT system consisting of several different vendors each operating with their own file system that is not compatible with all other file systems. Eventually someone will come up with a single standard that all systems will use and that will correctly import all data from the other systems, but it will be financially burdensome to implement and will be driven by Medicare regulation rather then any altruistic notions of caring for the patient. Also the two countries you quoted as having a single healthcare record for all to see are vastly different then the USA, the principals are similar but we are a vastly different country with different healthcare needs throughout the country. Some places are so rural that paper records are still used with no computer records even kept.

 

[DrParasite]

Not going to lie, some of the ideas looked interesting.... I think the video is more optimistic than based in reality (as was mentioned before, funding will be one huge hiccup on many of these things), and I think many of the ideas are along the ideas of flying cars than actual stuff that will happen.

Basicly, it's a sales pitch for a consulting firm Continuum, which describes itself as "a global innovation design firm," which makes me think they are great idea people, but don't actually handle the implementation. So with an unlimited budget, I'm confident many of these ideas could come to fruition; but I don't know anyone who has an unlimited budget.

I checked out the fire one too; the breadcrumb heads up display looked amazing, if they could implement it, but I am pretty sure it will be out of the price range for most departments

 

[GMCmedic]

Then that speaks more to the fact there is something dreadfully wrong with your funding model ...



Privacy is a legitimate concern but honestly, I think it's a bit blown out of proportion. The benefits of a single, national health record does much more good than whatever privacy concerns exist which can be practically mitigated/eliminated. I've seen Australia and England are also wanting to move in this direction. I can't imagine why you blokes wouldn't want something the same given how large your country and population is so people are quite mobile?

And Powerlift stretchers are good yes, I agree and should be mandatory. But so should reasonable access to the health history and recent interactions with the health system of somebody I have never met before and am seeing for the first time at two a.m. and need to decide what to do with ... same goes for anybody seeing them. In other sectors if you call your mobile operator or go to their store 500 km from where you live they will have all your information right there in front of them at the click of a button. Health care should be the same.

We cant trust our government to responsibly spend our tax dollars or hold a legit election, and you expect us to allow them to control our healthcare data? No thanks

Sent from my SAMSUNG-SM-G920A using Tapatalk

 

[Carlos Danger]

Then that speaks more to the fact there is something dreadfully wrong with your funding model ...

There's actually no inherent problem at all with the funding model used in the US. The problem is that our political system is completely broken, and healthcare has been politicized to such a degree that it's become just another piece of our broken political system.

Privacy is a legitimate concern but honestly, I think it's a bit blown out of proportion. The benefits of a single, national health record does much more good than whatever privacy concerns exist which can be practically mitigated/eliminated. I've seen Australia and England are also wanting to move in this direction. I can't imagine why you blokes wouldn't want something the same given how large your country and population is so people are quite mobile?

If you think the privacy concern is overblown, then you are clearly unfamiliar with the impressive degree of incompetence that exists within the federal government (and many of the state governments) of the US. Large data breaches have already occurred at the IRS, the VA, and HHS, as well as many other departments.

Clearly there are benefits to a patient's caregivers being able to access their health record anytime and anywhere. But why does it have to be a "national" health record? Why does the government need to have anything at all to do with my healthcare or my health record? I live on the east coast and I don't see any reason why someone 2000 miles away on the west coast needs to be able to access my health record.

 

[EpiEMS]

Privacy is a legitimate concern but honestly, I think it's a bit blown out of proportion

No disagreement there. The thing is...it's a political problem, not a practical one. We could have a national EMR, sure, but there's no way it happens without a mandate - and such a mandate doesn't seem (politically) feasible.

 

[SpecialK]

Mmm ... you blokes seem to have a funny way of thinking that's for sure, especially when it comes to the Government. In the nations' where I have experience in the health system, it is the Ministry or Department of Health driving the push towards collaborative, electronic health systems to improve coordination and quality of care and lower costs by having, wherever possible, a single record which everybody accesses or a single interoperable standard. Additionally, the ambulance service generally also makes loud noises about being included as well because they want to be able to access information about patients their personnel will be required to treat and decide what to do with having met them for the first time five minutes ago.

Everybody in the NHS has a single NHS number where their health information is tagged to, same with the National Health Index, and this has existed since 1993. Every piece of medical information includes this identifier so it ensures the right patient is being identified and acts as a single aggregate for finding information. Through ePRF now using the NHI, a patient can be looked up and identified and this will enable massive expansion of what data can be seen and shared including automatic notification of various people that ambulance has been involved.

Even outside of the health sphere, Government agencies, in general, across Australasia and in the UK, are pushing people to do things online using a single national electronic identity verified off of, for example, birth or passport records. Passports, social welfare, motor vehicles, tax, all sorts of things which once had to be done on a paper form or by mail or in person are now done online. In the last couple of years, I have renewed a passport, claimed social development benefits, done multiple vehicle transactions, claimed tax refunds and a bunch of other stuff all online without even leaving my house. This is all just an extension of what is happening in the banking sector; I can't even remember the last time I visited a bank or used physical cash ... I just do everything online or on the app; if I need to pay somebody to split a bill, for example, I just use my banking app to send them a text with a link to download the money into their bank account and it's pretty much instantaneous. Same with my phone provider; if I need something I just do it online.

And when it comes to the Government side of things; the more "conservative" end of the voters love this stuff because the politicians can claim it saves money and is more efficient, and they're right, but it's really the populace who has been on about it; we expect them to do this stuff because it's just an extension of what has been happening in the private sector for years.

Yet some of this really simple-seeming stuff which has been being worked on for years in other countries I've been seems to be some sort of far away notion that nobody seems to believe will happen as well in USA? That's really strange considering you seem to consistently tell us you are the best country on earth? ...

 

[Carlos Danger]

Mmm ... you blokes seem to have a funny way of thinking that's for sure, especially when it comes to the Government. In the nations' where I have experience in the health system, it is the Ministry or Department of Health driving the push towards collaborative, electronic health systems to improve coordination and quality of care and lower costs by having, wherever possible, a single record which everybody accesses or a single interoperable standard. Additionally, the ambulance service generally also makes loud noises about being included as well because they want to be able to access information about patients their personnel will be required to treat and decide what to do with having met them for the first time five minutes ago.

Everybody in the NHS has a single NHS number where their health information is tagged to, same with the National Health Index, and this has existed since 1993. Every piece of medical information includes this identifier so it ensures the right patient is being identified and acts as a single aggregate for finding information. Through ePRF now using the NHI, a patient can be looked up and identified and this will enable massive expansion of what data can be seen and shared including automatic notification of various people that ambulance has been involved.

Even outside of the health sphere, Government agencies, in general, across Australasia and in the UK, are pushing people to do things online using a single national electronic identity verified off of, for example, birth or passport records. Passports, social welfare, motor vehicles, tax, all sorts of things which once had to be done on a paper form or by mail or in person are now done online. In the last couple of years, I have renewed a passport, claimed social development benefits, done multiple vehicle transactions, claimed tax refunds and a bunch of other stuff all online without even leaving my house. This is all just an extension of what is happening in the banking sector; I can't even remember the last time I visited a bank or used physical cash ... I just do everything online or on the app; if I need to pay somebody to split a bill, for example, I just use my banking app to send them a text with a link to download the money into their bank account and it's pretty much instantaneous. Same with my phone provider; if I need something I just do it online.

And when it comes to the Government side of things; the more "conservative" end of the voters love this stuff because the politicians can claim it saves money and is more efficient, and they're right, but it's really the populace who has been on about it; we expect them to do this stuff because it's just an extension of what has been happening in the private sector for years.

Yet some of this really simple-seeming stuff which has been being worked on for years in other countries I've been seems to be some sort of far away notion that nobody seems to believe will happen as well in USA? That's really strange considering you seem to consistently tell us you are the best country on earth? ...

SpecialK, you are always comparing the US EMS and greater healthcare systems and wondering why they aren't more like the ones in NZ, Austrailia, the UK, and Canada. You seem very unaware of the vast differences between those nations and the US.

The most obvious difference is sheer population numbers. We have individual cities with populations greater than that of New Zealand. It takes a full 25% of the population of NZ to equal the number of people in our military. It would take nearly the entire population of NZ to equal the number of registered nurses (3.1m) and physicians (1m) in the US. Our population is over 13x that of Australia (which is the largest of the nations whose health system is commonly compared to that of the US), and 5x the size of the entire United Kingdom. If you combine the populations all of those countries, the population in the US is still almost 2.5 times larger. We have a GDP greater than that of the entire European Union and several times greater the combined GDP of all the countries I mentioned above. We have individual states with a larger GDP than NZ and Australia combined and many states whose GDP is greater than that of many developed countries.

Our VA health system serves 9 million enrollees (2x as the entire population of NZ, and approaching half the population of Australia) at 150 hospitals and over 1000 clinics, and by virtually all accounts needs to be substantially larger than it is.

At least as important as the sheer number of people that we are talking about is the dramatic difference in our political system. The US is made up of 50 separate states which were designed to be autonomous and sovereign in almost every aspect. That has changed of course over the decades, but the states still enjoy enough freedom from the federal government so as to make consensus and cooperation on many big political issues very difficult. Which contains inherent inefficiency to be certain, but is actually by (pretty brilliant) design and still serves an important purpose.

Our healthcare system is complicated and has many challenges even aside from the sheer number of citizens and politics. Just one example: the EU and other foreign entities heavily regulate drug prices in Europe, forcing American drug manufacturers to sell at heavily discounted prices, allowing those citizens to enjoy the fruits of drug research, development, and manufacture without being bothered with the high costs associated with it. Those costs are left largely to American citizens.

You might be surprised to learn that we actually do have public socialized medicine in the US; it is provided by CMS and is intended to cover the elderly (Medicare) and those in need (Medicaid) rather than the entire population. The two programs combined cover almost 120 million people which, at the risk of sounding like a broken record, is almost equal to the population the New Zealand, Australia, Canada, and the UK combined. That's right; the US government already provides single-payer healthcare to a population equal to all of the nations that our broken system is often compared to.

So, if you want to continue to provide examples of how things should be done in the US, by all means do. But if you are going to do so, please provide examplars that at least remotely resemble the US so that a reasonable comparison can be made.

 

[SandpitMedic]

SpecialK, you are always comparing the US EMS and greater healthcare systems and wondering why they aren't more like the ones in NZ, Austrailia, the UK, and Canada. You seem very unaware of the vast differences between those nations and the US.

The most obvious difference is sheer population numbers. We have individual cities with populations greater than that of New Zealand. It takes a full 25% of the population of NZ to equal the number of people in our military. It would take nearly the entire population of NZ to equal the number of registered nurses (3.1m) and physicians (1m) in the US. Our population is over 13x that of Australia (which is the largest of the nations whose health system is commonly compared to that of the US), and 5x the size of the entire United Kingdom. If you combine the populations all of those countries, the population in the US is still almost 2.5 times larger. We have a GDP greater than that of the entire European Union and several times greater the combined GDP of all the countries I mentioned above. We have individual states with a larger GDP than NZ and Australia combined and many states whose GDP is greater than that of many developed countries.

Our VA health system serves 9 million enrollees (2x as the entire population of NZ, and approaching half the population of Australia) at 150 hospitals and over 1000 clinics, and by virtually all accounts needs to be substantially larger than it is.

At least as important as the sheer number of people that we are talking about is the dramatic difference in our political system. The US is made up of 50 separate states which were designed to be autonomous and sovereign in almost every aspect. That has changed of course over the decades, but the states still enjoy enough freedom from the federal government so as to make consensus and cooperation on many big political issues very difficult. Which contains inherent inefficiency to be certain, but is actually by (pretty brilliant) design and still serves an important purpose.

Our healthcare system is complicated and has many challenges even aside from the sheer number of citizens and politics. Just one example: the EU and other foreign entities heavily regulate drug prices in Europe, forcing American drug manufacturers to sell at heavily discounted prices, allowing those citizens to enjoy the fruits of drug research, development, and manufacture without being bothered with the high costs associated with it. Those costs are left largely to American citizens.

You might be surprised to learn that we actually do have public socialized medicine in the US; it is provided by CMS and is intended to cover the elderly (Medicare) and those in need (Medicaid) rather than the entire population. The two programs combined cover almost 120 million people which, at the risk of sounding like a broken record, is almost equal to the population the New Zealand, Australia, Canada, and the UK combined. That's right; the US government already provides single-payer healthcare to a population equal to all of the nations that our broken system is often compared to.

So, if you want to continue to provide examples of how things should be done in the US, by all means do. But if you are going to do so, please provide examplars that at least remotely resemble the US so that a reasonable comparison can be made.

This is the second time I agree with Remi.

 

[SandpitMedic]

I like that in 2017... the paramedics who are the "frontline of healthcare" are almost all obese and unhealthy themselves.

In year million they are all fit and in shape.

I look forward to that, and that sweet technology.

While the components of a national healthcare framework and all that jazz will be fractured by the capitalist private sector, I believe the technologies illustrated will be viable for those departments and agencies wishing to adapt to them.

That'll be a cool day.