The history of EMS in the United States is often told through the story of landmark documents. The NTHSA report Accidental Death and Disability: The Neglected Disease of Modern Society (1966) launched the development of a national EMS system, after which the EMS Agenda for the Future (1996), and the Institute of Medicine’s Future of Emergency Care series (2007), among others, laid out the challenges faced by the industry and offered pathways to improving the way Americans receive emergency medical care. In the same tradition, this document aspired to capture the current challenges and offer practical steps toward overcoming those challenges, with particular attention to actions that could be taken independent of federal action. Though this framework for Promoting Innovation in EMS is by nature a forward-looking document, it is instructive to compare the recommendations made in this document with those made in previous documents. Commonalities highlight areas where perhaps insufficient progress has been made since these older documents were published. As shown in the accompanying story, our recommendations often echo those that were offered by the previous documents of national scope. At the same time, each document was shaped by the healthcare environment in which it was created. EMS Agenda for the Future in 1996 was influenced by the increasing use of managed care in the 1990s, and the Future of Emergency Care series in the 2000s proposed a future of EMS incorporation into a wider system of community health. This framework was developed in the healthcare environment at the time, largely influenced by the Patient Protection and Affordable Care Act, and the information and telecommunications revolution, in part supported by the 2009 HITECH Act which facilitated the widespread implementation of electronic health records. This document seeks to build on previous contributions, while exploring the current landscape of innovation and healthcare reform to present a vision of EMS as part of an integrated community healthcare system.
EMS AGENDA FOR THE FUTURE 1996 Integration of Health Services
Education Systems • Incorporate research, quality improvement, and management learning objectives in higher level EMS education (Ed 3) • Commission the development of national core contents to replace EMS program curricula (Ed 3) • Establish innovative and collaborative relationships between EMS education programs and academic institutions (Ed 1)
• Expand the role of EMS in public health (Intro) • Involve EMS in community health monitoring activities (Data 4) • Integrate EMS with other health care providers and provider networks (IC 1) • Incorporate EMS within health care networks’ structure to deliver quality care (IC 2) • Be cognizant of the special needs of the entire population (Intro)
MOUNT SINAI HEALTH SYSTEM | UNIVERSITY OF CALIFORNIA, SAN DIEGO
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