As part of the 2016 ZOLL Summit, industry leaders hosted pre-conference attendees for a deep dive into the transformation EMS should undertake to survive, and even thrive, in the new healthcare environment.
EMS 3.0 Explained
The workshop opened with an explanation of what the term EMS 3.0 means. The early days of EMS, just prior to the publication of the landmark document “Accidental Death and Disability, the Neglected Disease of Modern Society” in 1966, were when funeral homes ran 50% of the country’s ambulance services, ambulances were ill-equipped and personnel were inadequately trained. This was EMS 1.0.
Starting in the 70s, more modern delivery systems developed and ambulance design changed substantially. Physicians took the clinical lead, training became more formalized and advanced life support became the norm in many communities. The economic model for EMS has been based on fee-for-transport and the main (really the only) performance measure has been response times. EMS 2.0.
Today, with the healthcare system and its payers focusing on patient outcomes, the patient care experience and, most importantly, the cost of the healthcare system, we are introduced to EMS 3.0.
EMS needs to change its delivery model to one that can prove value. The days of payment for “you call, we haul” are waning as our healthcare system partners look to reward providers that can demonstrate value with new economic models that share the risk for improved patient outcomes and reduced costs.
New Economic Models & Value-Based Purchasing
Workshop participants worked through an exercise to identify the true cost of EMS delivery as a foundation to exploring economic models that are not reliant on the traditional fee-for-transport model. These new models included capitated, population-based payment models and models that pay for the response as opposed to the transport. Specific examples were used from MedStar Mobile Healthcare in Fort Worth, Texas, which is currently negotiating with several payers to establish capitated rates and rates based on responses vs. transports.
There were also presentations on what value-based purchasing may mean to EMS and the role of patient experience in the overall value proposition. Bobby Hopewell from EMS Survey Team demonstrated how using an external agency to survey patient experiences is part of the shift to EMS 3.0 and precisely how the rest of the healthcare system conducts patient experience surveys.
Rob Lawrence from Richmond (Va.) Ambulance Authority and the Academy for International Mobile Healthcare Integration (AIMHI) walked the participants through the main tenants of what it takes to deliver high-performance EMS (HPEMS). He explained how the use of data, flexible deployment models, system status management and effective public policy development contribute to improved patient outcomes and reduced delivery system costs—the main components of EMS 3.0.
Lawrence also explained the role of advocacy and community relations to help get your message out about the value your EMS agency brings to the community.
Christie Hempfling from the University of Pittsburgh Medical Center‘s Center for Emergency Medicine, explained the role of MIH-CP in EMS 3.0 and provided an overview of the recently released MIH-CP Outcome Measures Strategy. The Outcome Measures document is a collaboratively developed method for uniformly reporting outcomes from MIH-CP programs related to program structure, patient safety and quality, utilization, and costs and balancing metrics. Hempfling also presented MIH-CP updates from around the country, showing what the profession has learned over the past five years and what we still don’t know, yet.
Building Community Trust
Finally, Josh Weiss from 10 to 1 Public Relations took all the information from the day and provided numerous examples of the ways EMS agencies can build public affairs strategies that work. Important points included how to effectively tell your story to demonstrate value, how to position your agency as a valued partner in the local community, and how to conduct effective media relations strategies. Weiss used several videos and a physical demonstration of how important it is to build strong positive branding to help counter a possible negative event.
In all, it was a jam-packed eight hours that left the participants with countless “to-dos” for when they get back and do the real work making a difference in their local community, and better prepared to survive the EMS 3.0 transformation.