The EMS Department serves an important role inside the healthcare community as a “Safety Net” organization. What was envisioned originally as a system to respond to acute life-threatening emergencies has evolved so that it not only fills that original role but has also become an integral part of the U.S. healthcare system.
EMS represents the intersection of public safety, public health, and health care systems. A combination of the principles and resources of each are employed and practiced by modern EMS systems. During the past 30 years EMS professionals have driven dramatic changes in technology and prehospital medicine, professional education and the way emergency medical services are managed to improve public health and emergency medical care.
The 1996 EMS Agenda for the Future established the vision for Emergency Medical Services nationwide:
Emergency medical services (EMS) of the future will be community-based health management that is fully integrated with the overall health care system. It will have the ability to identify and modify illness and injury risks, provide acute illness and injury care and follow-up, and contribute to treatment of chronic conditions and community health monitoring. This new entity will be developed from redistribution of existing health care resources and will be integrated with other health care providers and public health and public safety agencies. It will improve community health and result in more appropriate use of acute health care resources. EMS will remain the public’s emergency medical safety net.
In Austin, EMS already plays a larger role in improving health beyond the tradition of resuscitation and delivering patients to the emergency department. Over the past decade we’ve expanded our programs and services to include comprehensive solutions to further integrate public health and EMS in an effort to help build community resilience and reduce dependency on emergency services. For example, the ATCEMS Community Health Paramedic Program works daily to improve access to healthcare for persons experiencing homelessness and those with limited access to healthcare resources. Proactive programs like this offer tangible benefits for patients and communities to bridge gaps between emergency services and primary care.
Texas law contained in the Health and Safety Code governs EMS. The Texas Department of State Health Services provides administrative oversight for EMS throughout the state. EMS personnel must acquire and maintain licenses that allow them to deliver healthcare interventions for medical conditions caused by acute, chronic, and traumatic conditions. Training and education focuses medical assessments, and clinical interventions. Studies include topics such as anatomy, physiology, pharmacology, cardiology, and endocrinology.
The City of Austin EMS Department is a direct reflection of the vision set out over twenty years ago for the EMS industry. The department responds to over 110,000 requests for assistance each year including conditions such as difficulty breathing, chest pain, altered consciousness, drug overdoses, and many conditions affected by social determinants of health and barriers to healthcare. The department monitors performance on various clinical and public safety measures and physicians provide clinical practice oversight.
Distribution of Work
Examining the work of the EMS Department indicates that most of the time, EMS personnel are engaged in providing medical care for patients (71%) and a small portion of time responding (14%). Personnel also spend time disinfecting medical equipment and replacing used medical supplies after every response (14%). The chart below shows the distribution of work on the process that occurs over 110,000 times a year.