Administration and Leadership, EMS Insider

Building a Team to Help Shape Our Future

More than 20 years ago, a team of experts created the EMS Agenda for the Future, a pioneering document that has inspired leaders, researchers, educators, and policymakers for the last two decades.

In 2016, several federal agencies came together and commissioned the creation of a new EMS Agenda—one that looks 30 years into the future.

Try to imagine what your life, your career and our profession will look like in the year 2050. Chances are a flurry of ideas will fill your mind. It’s common for thoughts to bounce back and forth between trying to predict what will evolve with healthcare, disease, disasters, injuries, technology, funding, prevention and more. And, dreams of what you hope it will be like.

As Yogi Berra said, “Prediction is difficult, especially if it is about the future.”

In fact, we don’t presume we’ll be able to anticipate how technology and society will evolve by 2050. But that longer time frame—a generation at least—means we can create a vision that includes a workforce and profession that’s adaptable and agile, whatever changes occur.

Creating Our Own Future

It’s been said that, “The best way to predict the future is to create it.” Our task as a community is to create a vision for what we want EMS to be in 2050. We’ll need to describe the role of EMS in our communities and how EMS fits in with other systems, from healthcare to public safety and more.

We’ll have to address how to integrate technological innovations for diagnosis, treatment, and prevention that we cannot even conceive of today.

To make sure that the vision isn’t just a pipe dream, we’ll also create a series of pathways for how we might be able to traverse from where we are now to there. This isn’t something that can be done by one person, one organization, or one group of experts. We need your help.

Our commitment is that everyone in the EMS community can contribute to the creation of EMS Agenda 2050. When the Agenda is published in 2018, we’d like you –  yes, you – to look at it and say that you helped craft it and perhaps played a role in making it happen in the future.

This inclusiveness will come as no surprise to people who know me. I’ve been to nearly 400 Grateful Dead and Dead-inspired concerts over the last 40 years. The band has the most loyal fan base in the history of rock and roll.

The band members will tell you that it’s not possible to make their brand of music without the audience. The songs are created through a back-and-forth exchange of energy with throngs of people in brightly colored tie-dyed shirts.

While the team that’s charged with crafting EMS Agenda 2050 might not play guitars (although at least one of them does!), they need to exchange high energy, thoughts and dreams with everyone involved in EMS to produce the best result. And that’s the goal.

If we do what we are challenged to do, you and your colleagues will be inspired to commit the next few decades of your professional life to bringing the vision to reality.

Radical Inclusion

Chances are good that you’ve heard folks over the years say that they need to get “buy-in” from a person or group to make something new successful. For this project, buy-in won’t cut it. It’s got to be full commitment.

Peter Senge, PhD, a professor at the Massachusetts Institute of Technology and author of The Fifth Discipline, explained this to me during a conference on organizational learning in Boston several years ago. He said, “The phrase ‘buy-in’ refers to someone’s level of engagement in a project, improvement or change.” He described four levels of engagement:

  1. Terrorism: This is someone who actively works against whatever you’re trying to implement.
  2. Buy-In: With someone who’s “bought in” you get non-terrorism. People who are bought in give no energy or active support to the implementation, however they will not work against it.
  3. Enrollment: This literally means putting your name on the roll. Someone who’s enrolled has volunteered to help make things happen.
  4. Commitment: Someone who’s committed has that, “Get the heck out of my way, we’re going to make this happen no matter what obstacles we face,” energy. It’s this level of full engagement that’s needed to construct the smart drone ambulances, pocket-size non-invasive genome-sequencing custom-just-for-you pharmaceutical makers, adequate reimbursement for everything we do, or whatever is actually described in our vision for the future.

Our goal with this important project is to inspire commitment from you, your colleagues, your professional associations and everyone involved in EMS in America. Experience tells us that people are much more likely to commit to building something they helped design rather than some idea that they are sold.

So our process for crafting this Agenda is best described as “radical inclusion”—inclusion of ideas, concepts, dreams, people, groups and professional associations.

Where You Can Go to Provide Input

Our website has a page where you can share your dreams, thoughts, and ideas anytime.

Anyone is welcome to participate in one of our regional public meetings:

  • Sept. 25, 2017 Silver Spring, Md.: Silver Spring Civic Building
  • Nov. 7, 2017 Minneapolis, Minn.:  University of Minnesota, Humphery School of Public Affairs
  • Jan. 17, 2018 Los Angeles, Calif.: California Science Center
  • Mar. 1, 2018 Dallas, Texas: Sheraton Dallas Hotel

The EMS Agenda 2050 Technical Expert Panel

While participating in EMS Agenda 2050 won’t be exactly like attending a Grateful Dead concert, there will be similar elements. The band in our case is the Technical Expert Panel (TEP), talented individuals with a wide range of perspectives drawn from a group of nearly 150 applicants.

The team’s mission is to listen deeply to you and your colleagues—to inspire and gather your dreams, your hopes and your vision for the future. Throughout the next several months, they’ll sort through and organize your feedback, eventually presenting them back to you in the form of a straw man for you to react to and help refine.

Then they’ll craft the final EMS Agenda 2050 next year. See the EMS Agenda 2050 Timeline for specific information about opportunities to participate and provide input.

The Technical Expert Panel is a remarkable team. There’s no way that we can cover everything that’s in their 214 pages of CVs and letters of recommendation, but here are a few highlights:

  • While the panel’s makeup is not intended to represent all the varied groups in EMS, its members have a wide range of perspectives including rural, urban, volunteer, career, fire, private, military, public health, pediatric, primary care, academic, disaster preparedness, international and more.
  • They’ve earned dozens of academic degrees, published hundreds of peer-reviewed research studies, received hundreds of professional awards, managed millions of dollars’ worth of grant funded programs, and presented at conferences throughout the world.
  • They have a combined 182 years of experience in EMS and healthcare and include currently practicing EMTs, paramedics, and physicians with specialty training in EMS, pediatric and adult emergency medicine and primary care.

How & Why This Panel Was Selected: The Federal Sponsors received 148 applications for participation on this important panel. While many had significant experience, the selection committee decided to focus on competencies and building a team with a as wide a variety of perspectives as possible.   


Meet the Panel

We asked each member how they would introduce themselves at a cocktail party. Here’s what they had to say:

Derek Bergsten, MPA, CTO, CFO, CEMSO, MIFireE

Fire Chief, Rockford Fire Department, Rockford, Ill.

As someone who’s been a paramedic for more than 20 years and who certified his three children in scuba diving, Derek obviously doesn’t shy away from a challenge.  Rockford Fire Department serves a population of about 150,000 people.  Located outside of Chicago, Rockford is the second largest city in the state.   

How I would introduce myself at a cocktail party? I really enjoy challenging those around me to work as part of a team to solve difficult problems and together find innovative ways to meet our common goals. I think the best way to learn is to hear about the experience and perspectives of others.

Marianne Gausche-Hill, MD, FACEP, FAAP, FAEMS

Medical Director, Los Angeles County EMS Agency, Los Angeles, Calif.

Even though she provides clinical leadership for over 4,000 paramedics in the country’s most populous county, Marianne finds time to root for the basketball and football teams of LA’s universities. Her work as an EMS researcher and educator is known internationally, especially in the field of pediatric emergency medicine. She’s no stranger to asking critical questions, exploring new research or thinking about new possibilities.

How I would introduce myself at a cocktail party? I’m the Medical Director for LA County EMS and an academic physician. I love to create new ideas and to study them to create a knowledge base that can be used to drive change in practice for the betterment of our patients.

Andy Gienapp, MS, NRP

Manager, Wyoming Office of EMS, Wyoming Department of Health, Cheyenne, Wyo.

Andy’s career in EMS began as a volunteer first responder at the age of 17, and he hasn’t looked back since. Though the majority of his career has been spent in a fairly urbanized area, today he works as the Manager of the Wyoming Office of EMS. He serves as a board member of the National Association of State EMS Officials and vice-chairman of its Rural EMS Committee. Andy also has three decades of military experience and currently serves as a medical operations officer in the Wyoming Army National Guard.

How I would introduce myself at a cocktail party? I’m a paramedic. Always have been, and always will be.

Alexander Isakov, MD, MPH, FACEP, FAEMS

Professor of Emergency Medicine, Emory University School of Medicine, Atlanta, Ga.

Living in Atlanta for nearly the last two decades, Dr. Isakov has worked with local, state and federal partners to plan for large-scale emergencies, with a focus on ensuring the health and safety of those affected.

He and his team of EMS physicians serve as medical directors for several first-response, ground and air ambulance services. He developed and leads a team dedicated to the safe management and transport of individuals with confirmed or suspected serious contagious diseases. At Emory University, he leads a center dedicated to disaster preparedness and response and overall community disaster resilience.

How I would introduce myself at a cocktail party? I ‘m an EMS and emergency medicine physician dedicated to compassionate, patient-centered care.  I ‘m privileged to lead a team at Emory that is dedicated to the improved health and welfare of the community by promoting excellence in out-of-hospital care, injury prevention and disaster resilience, through service, education, and discovery.

William Leggio, EdD, NRP

Paramedic Program Coordinator and Assistant Professor, Creighton University, Omaha, Neb.

William has been a lifelong paramedic and educator seasoned with the ability to learn, educate and bring new ideas out of a room full of people. Earlier in his career, he spent four years teaching and developing a university paramedic program in Saudi Arabia where he met his wife, who works as a nurse.

William is now an Assistant Professor and Paramedic Program Coordinator at Creighton University, where he’s dedicated to training and developing future EMS providers and researching leadership development in EMS.

How I would introduce myself at a cocktail party? I’ve been involved in EMS for my entire adult life including scholarship, rural EMS, a level one academic trauma center and serving on a variety of committees.  I enjoy spending time with my wife and our two dogs.

Kevin Munjal, MD, MPH, MSCR

Assistant Professor, Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, N.Y.

Kevin has been involved in national EMS efforts, serving as co-principal investigator for the Promoting Innovation in EMS project and also the lead author of an article published in JAMA calling for changes to reimbursement policy and financial incentives in EMS.

Before he became a board-certified EMS physician, Kevin was an accomplished tennis player in college. He was named an All-American Scholar Athlete and Drew University’s men’s tennis team’s MVP; in 2011, Kevin’s alma mater inducted him into the school’s Athletics’ Hall of Fame.

How I would introduce myself at a cocktail party? I’m an EMS physician, a researcher, and a health policy wonk. I play basketball and tennis for fun and try to stay healthy.

Kyra Neeley, M.Ed., EMT-P

Lieutenant, Fire Commissioner Liaison, Fire Department of New York EMS, Islip, N.Y.

Though you may not see it on her birth certificate, Kyra happily claims her middle name to be “optimism.” She learned this was an important trait early in her career as a new public school teacher in New York City only a few days before 9/11. She learned humility in the face of tragedy and what it took to succeed against unreasonable odds.

Now as an FDNY Fire Commissioner Liaison, Kyra—a paramedic and lieutenant with the department—is responsible for maintaining communication between scenes, the fire commissioner’s office and other key officials during incidents likely to have an impact on New York City residents and visitors. 

How I would introduce myself at a cocktail party? Goethe wrote that ‘Knowing is not enough; we must apply.  Willing is not enough we must do.’ Words to live by – through the lessons garnered from our past, careful analysis of our present and the education & technology-rich vision for the future, we are enabled to dream of an EMS in 2050 of limitless possibilities.

Ernesto Rodriguez, MA, EMT-P

Chief, Austin-Travis County Emergency Medical Services, Austin, Texas

Ernesto was first drawn to the field of EMS by watching Johnny and Roy on the hit TV show Emergency! A natural listener and peacemaker, Ernesto enjoys hearing different views, finding commonalities and encouraging people to share their passions.

As chief of his agency, he’s charged with cultivating partnerships with community healthcare providers to improve patient care while ensuring that the agency remains efficient and innovative and produces positive results.  Ernesto is especially passionate about the wellness of EMS professionals, from their health and fitness to their emotional wellbeing.

How I would introduce myself at a cocktail party? I’m a paramedic and I have the amazing privilege to work in emergency medical services leadership.  I still believe the reason that most people join EMS is because they genuinely want to help people. As a leader, I enjoy caring for the people who serve in EMS. I believe that if I take great care of them, they’ll take great care of our patients. I think some of the most important skills for leaders are listening, inspiring, gaining trust, sharing their vision, and leading with love and respect. In my free time, I play guitar, love my family, and stay involved in my church.

YiDing Yu, MD

Founder and CEO, Twiage; Instructor, Department of Population Medicine, Harvard Medical School, Boston, Mass.

YiDing possesses a wealth of global experience in entrepreneurship, technology and population health. In middle school, she played piano and studied at the Moscow Conservatory in Russia. In high school, she built websites for fun. She speaks fluent Mandarin and spent a year working abroad in Myanmar focusing on delivering care to internally displaced persons inside war-torn areas.

How I would introduce myself at a cocktail party? I’m so lucky to be a primary care physician and I’m passionate about leveraging technology to improve patient care and population health.  When I was a resident, I founded Twiage, which helps EMS and hospitals share real-time data to accelerate life-saving care for patients with medical emergencies.