NEMSAC Recommends Federal Priorities & Prepares for New Appointments

In its final meeting of 2014, the members of the National EMS Advisory Council (NEMSAC) made several recommendations to federal policymakers on a range of issues. With several council member terms due to expire in 2015, the Council focused on topics to be addressed by the next council.

Community Paramedicine Advisory
Several of the Council’s recommendations came in an advisory report about community paramedicine, addressing some of the challenges to implementing innovative community paramedic and mobile integrated health programs.

“Preliminary studies and pilots have shown that using paramedics in a preventative way can reduce healthcare spending,” the Council wrote. “Field EMS agencies and practitioners can be a powerful resource as the United States struggles to reduce the cost of healthcare through preventative interventions.”

In the report, NEMSAC members called on the EMS community to identify barriers to innovation, define ways to measure programs’ impact on healthcare costs and patient health, and continue to conduct research and publish results in peer-reviewed formats.

They also made specific recommendations to the Federal Interagency Committee on EMS (FICEMS), which includes representatives from several of the federal agencies that work on EMS issues. Those recommendations include:

  • Bringing together experts who can evaluate strategies for collecting and analyzing data to monitor and improve community paramedicine
  • Determine the data elements necessary for Federal agencies to evaluate performance and cost effectiveness
  • Identify ways to increase the role of field EMS providers in the national effort to reduce costs and improve quality in healthcare
  • Look for ways for Federal agencies to support innovation and research projects with grant money

In order to help accomplish these goals and to develop consensus on community paramedicine and mobile integrated health, NEMSAC recommended that the Federal government convene a “national healthcare stakeholder strategy meeting” that brings representatives of physicians, nurses, hospitals, home health, EMS and others together to discuss the implementation of these innovative programs in the community, and specifically:

  • Integration between EMS and other medical professions and the entire healthcare system
  • Expanded roles for EMS providers, including educational requirements
  • Data collections and performance measures
  • Financing community paramedic and mobile integrated health programs
  • CP and MIH programs’ impact on the patient experience
  • Medical direction and regulation of CP and MIH programs

FICEMS Strategic Plan
The NEMSAC report also provided guidance to FICEMS regarding which objectives of the FICEMS strategic plan should take precedence, and which ones are considered lower priorities.

Recognizing that some objectives may be easier to achieve than others, the members of NEMSAC categorized them by both priority and whether objectives would be short-term or long-term priorities.

Three FICEMS goals that members of the advisory council feel should receive Federal support for short-term implementation are:

  • The application of lessons learned from military and civilian incidents into EMS response
  • Better reporting, measuring, and prevention of occupational injuries and illnesses in EMS, and
  • the use of an anonymous adverse event and near-miss reporting system.

The panel also included the continued development and use of evidence-based guidelines in its list of short-term priorities that the federal agencies could facilitate.

Priorities Moving Forward
During the meeting, Chairman Aarron Reinert also gave all NEMSAC members a chance to talk about issues they felt were the most pressing in EMS and needed to be on the council’s radar in 2015, when about half of the council is expected to be replaced by new members due to term limits.

A wide range of topics was discussed, with the ever-changing world of healthcare financing clearly on everyone’s mind. Thomas Judge, director of LifeFlight of Maine and representative of the air medical sector, said EMS would very likely see a simultaneous decrease in reimbursement and increase in demand.

“We cannot continue to do things as we are,” he said. “Money [in healthcare] is changing so fast. What do we change to use less money for increased demand?”

Other items council members raised included data collection and data use. Some suggested that after a decade of collecting information via NEMSIS, it was time to create a collective vision for how to use that data and Reinert even suggested an “EMS Data Agenda for the Future” might be needed.

“We’ve got so much data we don’t even know what to do with it,” agreed Terry Mullins, the chief of Arizona’s Bureau of EMS. He also said the way EMS collected patient health information could be improved. “The more quickly we can flee from the ePCR concept to a health record, the better.”

The current members of NEMSAC will hold the last meeting of their current term in Washington, DC, in April. More information on NEMSAC and upcoming meetings, which are open to the public, can be found here.