In April of 2021, New Zealand Health Minister Andrew Little announced plans to abolish the 20 district health boards (DHBs) and replace them instead with a single organization called Health New Zealand, which will be responsible for hospitals across the country. 

The unexpected announcement was a major indicator of changes to come in New Zealand's health system. As the system reforms its organizational and decision-making structure, they are also looking for a solution to a fragmented data system in health IT. 

New Zealand has struggled with a fragmented process for transmitting patient data for many years. Current processes don't allow for the seamless, secure transmission of patient data between facilities.

It has been a rough eighteen months for all disciplines within healthcare. Since the start of the pandemic, call volumes have increased. More people need help. And yet, as the pandemic drags on, there are fewer and fewer providers still on the job. Emergency services agencies around the world are experiencing staffing shortages. Headline after headline after headline has demonstrated that the problem is both severe and widespread.

Many factors have contributed to staffing shortages in EMS across the United States, as well as ambulance services in the UK and Australia. These factors will need to be addressed soon. In the meantime, however, those still on the job are left looking for ways to continue providing care for their patients. Staffing shortages are hard enough but are made even worse for those left behind when the lack of providers starts to impact the level of care they can provide. 

Over the past year, telehealth became a favored tool in non-emergent care for helping clinicians treat patients from a distance. However, many EMS agencies are now discovering that leveraging telehealth as a part of normal practice can actually help save time, preserve resources, and increase the output of smaller crews. 

If you're struggling with staffing shortages, here are a few ways telehealth may be able to help you work with the resources you have. 

As a tertiary care center and Level I trauma facility in Colorado Springs, Colorado, the trauma team at UCHealth Memorial Hospital Central had their patient care process dialed in. However, there was one part of their process they weren’t satisfied with: their communication system.

The team was receiving notifications through an alarm dispatch system, which ran through the hospital operators and was then manually managed by each individual service line. UCHealth’s Associate Nurse Manager, Nikki Schroeder, BSN, RN, CEN, TCRN, described their process: “Prehospital providers would call in to our ED charge nurse, relay pertinent information, and then the ED charge nurse would determine what level of activation was required. To notify our hospital team, the charge nurse would give the information to our unit clerk, and our unit clerk would page our 811 paging system. That’s how the trauma surgeon, the ICU, and the whole trauma team got notified.”

The COVID-19 pandemic has impacted the world in innumerable ways, but it's growing increasingly apparent that it's contributed to a worldwide crisis of another kind: mental health.

The need for mental health resources in the UK is on a sharp incline. Dr Adrian James, the president of the Royal College of Psychiatrists, recently stated that the pandemic has posed a great threat to mental health, and threatens to undo years of progress without a new injection of funds into the system. 

While mental health has been a growing need for a number of years, the demand has increased exponentially since the start of the COVID-19 pandemic. In June of 2021, a record 1.5 million people across the UK received mental health treatment from the National Health Service (NHS). According to Dr James, many more desperately need that treatment. After a year of lockdowns, an estimated 1.6 million more people have come forward looking for help, and are waiting for treatment.

PART 2 of 2

Editor’s Note — This is Part 2 on the events that took place on September 11, 2001, through the personal account of Chief John Peruggia, retired Chief of FDNY EMS. If you haven’t yet, please read Part 1 — Remembering 9/11 Through the Lens of FDNY’s Chief of EMS.

Planes hit. 

Buildings collapse. 

Lives are lost. 

Loved ones are lost. 

Grief. Fear. Anger. Mourning. 

Tragedies shape everything that comes after them, separating time into two distinct frames: Before, and After. 

The dust settles, and those left behind in its wake are left to pick up the pieces. 

Through the loss, through the darkness, come sparks of innovation. 

PART 1 of 2

Editor’s Note — I recently had the privilege of spending time with Chief John Peruggia, retired Chief of FDNY EMS. He shared his vivid memories of September 11, 2001, and how the world has (and hasn’t) changed over the past 20 years. Chief, thank you for your time and sacrifice to the EMS community.

Where were you on September 11, 2001? Instantly, each of us can vividly remember what we were doing when two planes collided with the World Trade Center. The stories that came from that day continue to echo down through the years, as we approach the 20th anniversary of the event.

But few people quite know the story like those who were there. 

Chief John Peruggia was one of those people. 

When COVID-19 struck Texas in early 2020, Montgomery County Hospital District suddenly faced a whole host of new problems. Patients were still calling 911 and needed emergent care, but not all of them needed—or wanted—to be transported to the hospital. Paramedics were daily putting themselves at risk as they entered environments that could expose them to COVID-19. 

“Early on, we didn't know what was going to happen,” said Rob Dickson, MD, FAAEM, FACEP, FACEM, and EMS Medical Director at MCHD. “And we were all—across the nation, across the world—struggling with procedures and PPE and how we could best look after our employees.”

MCHD had a brief window to come up with innovative solutions. They had been using Pulsara to streamline care team communication around stroke and STEMI patients. But in response to the crisis, they began using Pulsara for a completely different purpose: regularly checking in with their employees who had contracted or had been exposed to COVID-19.

When the COVID-19 pandemic flared in the state of Texas in early 2020, the state struggled to load balance their COVID-19 patients. Some areas of the state experienced overwhelming waves of surge, while other areas had available beds and resources. Matching the particular needs of complex patients with available beds and other resources necessary for each patient was difficult.

They sought out a solution that would help create a virtual placement center for smooth patient transfers—supporting effective COVID-19 management and surge mitigation and a 75% reduction in excessive phone calls.

Time is everything in time-sensitive emergencies. But you don’t need us to tell you that. 

You know that time is tissue. You know that every minute counts, and every minute impacts your patient’s outcome. It’s your job: care for the patient, stabilize them, and transport them to the next stage in their care journey as quickly as possible. 

So why does it sometimes feel like the system isn’t built to support that? 

Delays in care happen for many, many reasons, but they all boil down to one thing: communication. 

We have a lot of different communication technologies that do the job they were meant to do: radios, pagers, phones, and fax machines. But they don’t talk to each other. With every middleman a message travels through, it’s another delay for your patient. And when time is of the essence, it’s essential to make sure that the right information gets to the right person at the right time.

As a medic, you matter to your patients’ care. 

You are the first person on the scene. You are the first to see the patient, to assess them, and to decide what kind of treatment they need. You decide whether they need transport to the ED, or whether they are safe to stay at home. 

Your decisions guide and influence the rest of their care journey. 

For most medics, involvement with a patient’s case ends when they drop the patient off at the hospital. Most don’t receive any feedback on the patient’s case, how their treatment went, or what their outcome was. Only one in three EMS agencies reports having any access to electronic, patient-specific medical information.

But...you need this kind of feedback. (What gets tracked gets improved.)

Do you ever get tired of repeating yourself as you tell the same patient story multiple different times, to multiple different audiences?

You write on the back of your glove to keep track of what’s happening with your patient on scene and during transport. You deliver your report to the hospital via radio, to let them know what to expect when you arrive. You give an in-person inpatient report when you hand off the patient at the bedside, and you may also have to complete a leave-behind hand-written “short form.” And finally, you’ve got the patient care report that you complete afterward, within 24 hours of the case. 

That’s at least five different times you have to repeat the same basic information to update everyone who needs to be in the know. 

What if there was a better way? (Hint: there is!)

In time-sensitive emergencies, it’s easy to see how each passing minute impacts a patient’s outcome, for better or worse. The faster a patient receives treatment, the better chances they have at a good outcome. When you’re performing a time-sensitive intervention for a stroke or trauma patient, you know that every minute matters. 

But what happens after the patient is admitted to the hospital? What about the minutes slipping past that aren’t quite as noticeable: the time while a patient recovers, waiting to be discharged? 

How does the length of a patient’s stay in the hospital impact their outcome?

New technology is often an exciting prospect. It's fun to experiment with, especially when it promises to help streamline a cumbersome process. But ultimately, the true test of technology is whether it actually improves the way you do things...and when it comes to technology in healthcare, how it helps you provide better care for your patients.  

So when a group of leading experts and clinicians in Victoria, Australia implemented Pulsara to improve communication between their care teams, they were curious about what the innovative new technology could do for them. But more importantly, they wanted to see what it could do for their patients.

Over the past few years, they have successfully developed a streamlined system for making sure everyone on the team has the right information at the right time. And, they're happy to report, their new system has helped them provide stellar care for their patients.

Change management is hard. Adopting new technology and new workflows can be an exciting process, but that process may also bring hesitance, skepticism, fear, and doubt. It's not easy to change the way you've always done things. 

So when a group of leading experts and clinicians in Victoria, Australia implemented new technology to improve communication between their care teams, they worked hard to make sure that everyone was on the same page. And it worked. They've seen a great deal of success with their strategies, and have successfully developed a streamlined system for making sure everyone on the team has the right information at the right time—a system that their teams now love. 

Becker's Hospital Review recently reported that as of April, 354 rural hospitals in the U.S. are still at a high risk of closing, unless their finances immediately improve. Those 354 hospitals account for almost exactly 25% of all 1,430 rural hospitals in the United States. Every state has at least one hospital with a high risk of closure, though, in states like Oklahoma, that number is as high as 28. 

As rural hospitals look for solutions, some are turning to technology to come up with new and innovative ways to find the funds to keep their doors open. Among the most surprising? Telehealth. 

Patient care involves many moving parts, several teams, and a lot of people. How do you get everybody on the same page, especially when messages have to travel through multiple communication methods before they reach their intended recipient? How do you unite all the disparate teams involved in a patient's healthcare journey—from ambulance to emergency department to specialty teams—into one region-wide system of care? 

Over the last few years, a group of leading experts and clinicians in Victoria, Australia have implemented cutting-edge technology to improve communication between their care teams. They've seen a great deal of success with their strategies, and have developed a streamlined system for making sure everyone on the team has the right information at the right time.  

In this three-part series, you'll hear directly from them on their search for a solution, the results they've seen, and the advice they would offer other systems that want to build their own regional system of care. 

View the full webinar video discussion below, or read on for Part 1 of the full roundtable! (Part 2 and Part 3 can be accessed here.)

While it’s critical that EMS providers stay on top of the latest clinical skills for saving lives, it’s also important to look for ways to improve overall operations, especially as ongoing changes brought about by the COVID-19 pandemic continue to change the way EMS providers deliver care.

From our free eBook, learn 10 things you need to know about four key operational issues, including interagency cooperation, the expanding role of telehealth in EMS, and lessons learned from the COVID-19 pandemic. We also explore how new innovations in your EMS station can help prepare providers to deliver the best patient care possible, as well as promote the safety and well-being of EMS providers themselves.