SELECTED QUOTES FROM SURVEYS AND INTERVIEWS:
On EMS Design “We built this entire system around this 1% of patients, patients with cardiac arrest, patient with life taking trauma…whereas the 99% of the people, which is really what EMS deals with every single day, we designed a system that may be not the best.” “It would be great to have EMS be patient navigators because most of what they’re doing now is navigating in a way that’s not terribly beneficial for patients” “The ability for EMS to enter into the patient’s home and connect directly to providers (e.g. physicians) has limitless opportunities.” “There should be some process that allows the patient, the paramedic, and the physician – the primary care physician for that patient – to have some discussions, some collaboration, some discussion on care continuum so that the right decision is made for that patient.” “The connection to the PCP for 60-70% of our calls has to be considered. The determination of where that patient is going or even a notification that the patient went to the hospital, the connection to that PCP is weak at best and in most cases I would say non-existent.” On Innovation “I think that perception of HIPAA is more of a barrier than HIPAA actually is. I think that HIPAA has become this overwhelming all-inclusive medium to say no to innovation in a lot of areas.” “You meet with whoever may be impacted by the innovation first, in private. The first time that the head of the nursing union for the hospitals should be hearing about the nurse triaging program is not on the front page of your local newspaper”
town, city, county, state or feds. We, as a profession, have done a pretty poor job demonstrating value.”
On Regulation “The current configuration of EMS at least by statute and regulation … doesn’t reflect in any way, shape or form the way we are actually using the service”
“In most states, the EMS provider is [legally] tagged to an ambulance”
On Data “MIH/CP for [my hospital] is a complete non-starter until the EMS providers are fully integrated into our electronic health [record].” On Quality Measurement “I try to get away from documenting how many calls you made and how fast you got there. Everybody can do that.” On Education “It’s time to rethink initial education and integrate more community and population health into the base.” On Becoming a Profession “Becoming more professional, … I mean [EMS] being more like the rest of health care, where nurses have a degree, doctors have degrees.” “If you don’t pay people enough to feel like they are a part of the health care profession and a professional then it is really tough to expect that we will have people in the profession that are looking at it as a lifetime career” “We have for too long cried to be recognized as pro- fessionals, but are not willing to put in the time to be considered a professional.” “100% of our education for EMS professionals is preparing them for 1/5 calls”
“Proving value for your innovation has, by definition, got to be with your local stakeholders. Now, local could be
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CHAPTER 1
MOUNT SINAI HEALTH SYSTEM | UNIVERSITY OF CALIFORNIA, SAN DIEGO
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