STATE EMS DIRECTOR FACILITATING INNOVATION Maine’s State EMS Director, Jay Bradshaw, saw the value of community paramedicine early, and his support for community paramedicine in Maine serves as a model for how state EMS directors can foster innovation. Before community paramedicine programs had become common in Maine, he held a forum of about 100 stakeholders, both supportive of and opposed to community paramedicine. This forum opened communication between all stakeholders, and helped assuage fears while giving everyone input. A steering committee, which was formed out of the forum, allowed the state to foster innovation in community paramedicine while also shaping its future development. The steering committee supported twelve pilot programs in the state, which were subject to a number of requirements. These requirements included medical direction involvement and partnerships with primary care providers in the community. This pilot award structure fostered interest among EMS agencies that were not originally interested in innovating in this area, while the requirements on the pilot programs allowed the state EMS director to shape the industry and ensure quality. The example of Maine demonstrates that state EMS directors who see their role as supporting EMS in their state, rather than simply regulating it, can strongly influence the quality of care provided to state residents. State EMS directors often have relationships with state lawmakers, can support innovation with funding, or can simply offer a big-picture perspective that is helpful to individual EMS agencies. Maine’s success in community paramedicine shows that state EMS directors who foster innovation in their state can be an invaluable resource for EMS providers and their patients.
OPTIMIZING THE ROLE OF STATE EMS MEDICAL DIRECTORS Selection of state and local EMS medical directors benefit by open, competitive selection processes. Therefore hiring practices should be transparent and well-documented. Selection criteria for such positions should take into account the candidate’s professional and administrative skills. Among many necessary talents, the state EMS medical director must possess outstanding communication skills. The role of the state EMS director should be clarified in law by all states. Furthermore, a state Office of the EMS Medical Director should be provided sufficient funding and authority to encourage collaboration, innovation, and modernization of regulation. State EMS medical directors (along with their state EMS offices) should function as facilitators with the capacity to engage the machinery of government. State EMS medical directors should drive innovation by taking advantage of their unique role to shape the future of EMS in their state. They should nurture promising pilot programs and sustain those that demonstrate success. In no case should they function as mere bureaucratic entities or regulatory bodies. They should act as the critical link between agency medical directors and the state and advocate for providers and patients at the state and federal level.
MOUNT SINAI HEALTH SYSTEM | UNIVERSITY OF CALIFORNIA, SAN DIEGO
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