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The Future of EMS

Discussion in 'EMS Talk' started by Kavsuvb, Sep 15, 2017.

  1. SAREMT

    SAREMT Forum Probie

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    I don't know about by 2020, but unfortunately in the future perhaps for us I imagine we will see more automation.
     
  2. Kavsuvb

    Kavsuvb Forum Crew Member

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    If you all had to predict, what would the Future of EMS would look like in say 2030 and 2040, what would the profession look like and where do you see the EMS profession going in 2030 and 2040.

    My prediction is that by 2030, EMS could be headed in the home health care and preventive care such as medical care to keep the medically fragile from going to the hospital. Home care visits. Medication compliance for those who have medication issues. Even home health care check ins for Seniors and medically vulnerable population. I also see EMT's branching out into post hospital medical care and even medication compliance for those who are diabetics, Asthmatics and those on heart medications.
     
  3. VFlutter

    VFlutter Flight Nurse

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    Why do you think EMS is suited to enter into the home health arena? What skills or training do you think EMS has vs establisher LPN/RN home health roles? It's an area that is definitely needed and understaffed however not sure EMS is the solution.
     
    Summit and Peak like this.
  4. Tigger

    Tigger Dodges Pucks Community Leader

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    I've merged this with the same identical thread that the OP posted a year ago.
     
    VentMonkey likes this.
  5. Peak

    Peak ED/Prehospital Registered Nurse

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    This already exists in many systems, but predominantly powered by social workers and nurses. If we already have nurses and social workers who are trained in this why would we want to expand this into a EMS role?

    Some 911 systems have tried to implement similar programs because they had repeat high volume callers and are trying to save their system money as their primary goal. These are typically staffed with APPs, nurses, behavioral health providers, et cetera who already have experience providing this care to the community.

    I have called and set up follow up appointments the next day at primary care from the ED at a time in which the patient agreed to go, but surprise they skipped out on the appointment and showed up back at the ED within a week. The reality is that some patients either out of low health literacy, general laziness, or some other intrinsic factor just don't take care of themselves and won't go to regular followup. I'm a bit of a cynic when it comes to this particular topic, I don't think that those who already don't take advantage of the resources offered to them are going to be receptive to any kind of EMS home visit. I guarantee you the CHF patient was told to take their lasix and follow up, the fact that they don't take their lasix because it makes them urinate all day isn't going to changed because a EMT or Medic tells them the same thing in their home. Same goes for the respiratory patients who still smoke and don't take their controllers or the diabetics who don't take meds and have awful diets.

    I have had some patients who we helped with home safety projects (installing hand rails, improving outdoor traction ...), getting rides to their primary care, trouble shooting their oxygen concentrator, blood pressure checks, et cetera back when I was in the fire service. I don't think that these really crossed into the type of home health that you are promoting, and regardless were more a function of our department's community outreach than development of a EMS role. I think that in the area of public health that EMS should be promoting things that are the closest to our specialty: when to call 911, treatment of acute hemorrhage, recognition of stokes and ACS, and so on.

    The future of EMS will likely be the same as it has in recent history. Improvement of ambulance safety, development of more efficacious treatments and protocols, and the development of more efficient electronic documentation/record systems.
     
    Summit likes this.
  6. NPO

    NPO Forum Deputy Chief

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    Following up on the NP/PA ideas posted. Year ago; I do not agree that we will see NP/PAs in the field. We are currently seeing this in a few select markets, but the vast majority of areas are using community paramedics. The areas that have NP/PA practitioners are also usually areas that cannot use paramedics in the community paramedic role (looking at you California), although this is changing. As this changes, NPs and PAs will go away in favor of cheaper Community Paramedic programs.

    And my prediction? Is exactly what I mentioned above. We will see a large expansion of EMS into pre and post hospital care. We started as a means of transportation, and we are slowly moving into a acute/subacute role. Hospitals are reducing length of stay more and more to save costs, and are realizing the benefit of home care vs hospital care.

    One hospital based agency near me is piloting their CP program as a home-based pseudo-ER. Their target patient demographic are those patients that are not appropriate for urgent care, but do not need to be admitted to the hospital, and would otherwise be classified as an ESI triage of 2 or 3. Their idea is treat in the home (with telemedicine) and save an ER trip. This is clearly in-line with the hospitals goals to save money by saving on bed time.

    Other things I think we may see is more movement into social work with mental health. I would like to see a diversification between these social calls and the medical calls. For example have dedicated units for each type of call, where a CP team is trained and equipped for these, and a traditional Paramedic is trained and equipped to treat medical patients.
     
  7. Uclabruin103

    Uclabruin103 Forum Lieutenant

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    Please let us have alternate destinations and the ability to refuse transport (I just need more ibuprofen type calls).

    I think the direction of our field will depend upon reimbursements. If agencies start getting paid for more in home care, then we'll see more, or if transport reimbursement goes down.

    I don't think it makes a lot of sense to put np and pas in boxes. In the time it takes to see one patient on a scene call they could've seen two or more in a clinic.

    Please God no drones. I'm tired of this drone craze.
     
  8. bigbaldguy

    bigbaldguy Former medic seven years 911 service in houston Premium Member

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    Probably already mentioned but I suspect in 20 years the training required to be a paramedic will be much more akin to that of a PA (possible higher). On the other hand constant contact with higher level providers durring calls could create Paramedic drones.
     
  9. SandpitMedic

    SandpitMedic Shock&Awe

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    The role of a PA/NP is no where close to that of a Paramedic.
     
    CANMAN and CCCSD like this.
  10. DrParasite

    DrParasite The fire extinguisher is not just for show

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    in 20 years, I see many major EMS system collapsing due to the massive lack of funding to most systems, while the expectations have skyrocketed. I see more outsourcing to private companies who think they can do the job, and in 2-3 years, get thrown out on their *** when they can't deliver what they promised for the price they asked for

    I am hoping that paramedics require a 2 or 4 years degree, where those degrees are 100% focused on paramedicine, which gets most of the fire service out of the ALS field. All EMS managers should have a BS in EMS management, with preference to a master in management (either MBA or MPA).

    Community paramedicine will become more common, but only if we find a way to consistently fund these programs.

    Unless the funding matches all these good ideas, I don't see EMS progressing much. And with all the funding cuts to EMS systems over the past decade or two, as well as outsourcing of municipal services to private entities, I don't see that happeing.
     
    SandpitMedic, CCCSD and Summit like this.

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