Several countries around the world have progressed much further than the United States when it comes to drones. Take for instance, the East African Nation, Rwanda. The country has been using drones in lieu of air ambulances to transport medical necessities during emergencies. Of course, these might not be as efficient as air ambulances yet, but the day is not far when drones would be much more useful. Rwanda is a country where roads are far from being ideal and drone technology is seen as a respite. Come to think of it, rural America too can benefit from this concept.
The Prevalence Gap between Air Ambulances and Drones in the US
The US skies are dotted with a lot of airplanes, which of course include air ambulances. The drones on the other hand can be a hindrance. In fact, there have been several instances where drones have proven to be a nuisance for air ambulances and commercial flights. The necessity, therefore, is for a regulation that strikes the right balance. Also, general drone enthusiasts should also proactively show more responsibility. The other area that needs a closer look is innovation in the field of medical drones where they can at least play the part of supplementing efforts of air ambulances.
The Government Encouragement for Medical Drones
The congress, at the present time, is in the process of considering a bipartisan legislature called Drone Backlog Reduction Act. The intent of this legislation is to encourage innovation and ensure safety of medical drones. Once that is achieved, it will become easier to get the approval of the Federal Aviation Administration to use medical drones more extensively. At the current time, the use of drone is also severely limited by the norms laid down by the Federal Aviation Administration. If all goes well, the people will benefit from innovations in medical drones immensely.
Well this might not come to you as a surprise because you might have witnessed this yourself. According to one survey conducted by Kaiser Family Foundation, about 40% of US citizens have revealed that their families have received a medical bill despite being covered by medical insurance. This is a growing problem for the country as insurance companies are seen restricting the number of providers in their networks. Of course, out of network providers are not covered by insurance companies. In this context, the question arises, is it the same logic behind huge medical flight bills that people across the country are witnessing?
Medical Flight Bills and Insurance Network
A majority of industry experts believe medical flight service providers willingly stay out of insurance networks. The reason is simple, they lose the freedom to charge what they feel is fair for their services. It is also felt that there is a huge disparity between what the medical flight industry believes is a fair payout and what the insurance industry pays. The middle ground, it seems, is something that has not been achieved so far. The issue has not gone unnoticed by the lawmakers. However, the opinion is divided as to who is responsible for the huge bills.
Efforts by Lawmakers to Bring Down the Bills
Several attempts have been made to limit the amount that can be charged for medical flight services. From trying to ban balance billing to compelling air ambulance companies to come under insurance networks, several innovative efforts have failed. The reason behind this is the Airline Deregulation Act of 1978. Designed to create a competitive environment to keep the price of this essential service down, it precludes the state governments from intervening in the matters of air ambulances. Only the Federal Government is authorized to make changes.
Bystanders are often left wondering how to handle emergency situations. If the medical necessity is grave enough to warrant a medical flight, live streaming the emergency situation to the first responders through video streaming can be quite helpful. With the connectivity and mobile enablement that the world enjoys today, making this possible is not a tough ask. All it would take is an app that covers privacy, consent and similar concerns. The chances of the injured or ill getting immediate help becomes easy. Bystanders can get instructions from qualified first responders.
Addressing the Privacy Concern
The app will certainly help the patients immensely; however, there can be privacy concerns. The solution – treatment, if needed, can be delivered after an expressed consent from the patient. Moreover, the video need not be recorded or stored on either ends, both the patient and first responders. In fact, the kind of application is already being used in United Kingdom. A dedicated solution like this to emergency response centers, can do a lot of good. Since every medical flight covers a huge amount of distance, people, especially in rural America, can benefit significantly.
The Need for Medical Flight Can be Gauged
In situations where there is no qualified medical professional to make a decision whether the patient needs emergency medical flight services, the mobile app can be of immense help. The ‘medical necessity’, which plays a huge part in insurance approvals, can be determined quickly and effectively so that the patient is free of such worries from the word go and where applicable, an informed decision can be made.
Integration of such an app widely is important. If each player in the medical flight industry comes up with a unique platform to execute this, it would be a disaster. What the industry needs is a common platform so that execution becomes easy.
The Airline Deregulation Act of 1978 has found mention far too many times recently. Every attempt by insurance commissioners and insurance industry has been successfully countered by the air ambulance transport industry, thanks to this act. At the outset, the act itself seems arbitrary considering it takes away the power to control prices by the democratically elected state governments. Then why was this bill introduced in the first place? This is the question that comes to mind often. It was originally passed so that competition can be encouraged. However, it is questionable whether this intent is still being served in the current industry context as prices are simply shooting up. In an ideal competitive world, the prices must be well controlled.
FAA Reauthorization Act of 2018
It must be noted that only the Federal Government can make changes to the existing ADA of 1978. Considering the growing voices against the act, the government enacted FAA Reauthorization 2018. While some were hopeful that it will make drastic changes to the exiting act, it was not to be. The new act limited itself to making provisions to appoint an advisory committee to take a closer look at the air ambulance transport industry and the financial burden on the patients. It has no powers to implement any changes and is limited to offering advice only.
Balance Billing and Air Ambulance Transport Industry
Balance billing continues to be a problem. The healthcare insurance industry, it looks like, refuses to change its reimbursement model for the air ambulance transport industry. It has remained unchanged for over two decades now. On the other hand, medical flight companies are refusing to conform to the prevailing reimbursement rates and adamant against going under insurance networks. The result: balance bills that are not covered by insurance are being thrust upon the patients and they are being compelled to foot bills that amount to thousands of dollars. A solution does not seem at sight, at least at this juncture.
Air ambulance services are dispatched only when the emergency is dire and time is of critical nature. Many a times, the only contact with a patient or a victim is over the phone. As a consequence response professionals in emergency call centers are forced to rely entirely on their experience to determine the condition of the patient. Most times, the patient himself is unaware what is wrong with him. For instance, a person having a cardiac attack might not even realize that he is having one. The response professionals are forced to rely on qualified guess work. All this can change with the introduction of artificial intelligence technology.
Offering Better Air Ambulance Services with Artificial Intelligence
Imagine a situation where analyzing patient condition is done by an algorithm that continuously learns by analyzing patterns in data. It eventually becomes capable enough of offering diagnostic suggestions based on the description of symptoms, speech pattern, breathing frequency, etc. It would go further prompting the response professional to ask the right kind of questions to aid in understanding what the patient is going through. Wouldn’t that be amazing? It is no longer a science fiction; this is now a possibility, thanks to artificial intelligence. If implemented, it can take air ambulance services to a whole new level.
How Does Artificial Intelligence Learn
As mentioned earlier, it is all about forming patters through a combination of cases. All that an artificial intelligence algorithm would need is call recordings made by patients to air ambulance services over a period of time. It would have been pre-programmed to find patterns of symptoms to come up with a diagnosis.
It is all about data and analyzing it. The added advantage is that this data becomes a ready base to study populations, injury patterns (especially in road accidents) so that safety measures can be bolstered to increase safety. The applications are several and are only limited by one’s imagination.
Air ambulance operations are always critical. Among the critical operational aspects of a medical flight is handing off of the patient between medical flights and ground ambulances. If not done properly, it can lead to increased cost, loss of time and unnecessary lock down of valuable human resources. The efficiency at this juncture is all the more important because, usually, people from two different organizations have to come together to ensure a seamless transfer of the patient. In the event that each company has its own set of guidelines and procedures, things can get a bit complicated. It is for this reason that the Centers for Disease Control suggests a common methodology. Here we take a brief look at it.
The Planning of Hand Off between Ground and Air Ambulance
- Plan is the first thing that is to be put in place. It covers notifying each other of all developments. Beyond the ambulance companies, other organizations such as public health authority and law enforcement agency too might need to be notified.
- Communication of important aspects is another issue that must be taken care of – Does the patient have an infection? Is he or she ambulatory? Is there any special medical need? These are some of the questions, the answers to which both parties must have for communication to be effective.
- Location should be carefully chosen. It is not always about the nearest one. The patient may be a carrier of a highly infective virus. In a situation like this, the landing location should be such that the people in general can be easily isolated. The staff too must be aware that proper care should be taken to keep them from harm’s way. Adverse weather conditions are also important determinants of location. Media too can be an issue when it is a matter of national concern and can lead to a panic-like situation if information flow is not controlled.
There are several other aspects that must be taken care of. We will continue to focus on this subject in the coming days.
The soundest advice that can be given to someone who wants to pursue any career is this, “Do not rush into it.” The same goes for the career choice of being an airambulance paramedic. It is always wise to test waters before getting deep into it.
Most airambulance paramedics will tell you that there is no life experience that can prepare you for what will come your way on a given day. What matters most is the willingness to go beyond the call of duty to serve those who are in need. This is the most important prerequisite of being an airambulance paramedic.
The Right Airambulance Paramedic Training is Essential
It is not necessary to hold a degree to become an airambulance paramedic but it can lay the foundation for a fruitful career. You might come across as a more viable prospect to potential employers.
Look at the Programs Closely
Course material matters a lot. A quick glance through the syllabus will give you a brief idea of what you will learn. Don’t forget the human factor training as you do this. For instance, a good course will prepare you to handle a patient psychologically when the situation is critical.
Experience versus Books
A good course will place you in a real airambulance setup even when you are a student. This gives you an insight into the life that awaits you. Usually, good schools offer about a week’s experience on the field. It is, therefore, vital to know how well they are connected in the airambulance industry.
Prepare to Work Under Pressure
It is one thing to romanticize a critical situation and another to be in the midst of it. You cannot afford a panic when lives are at stake. You need to stand firm and do all that it takes to save the patient. If you think you have a personality trait like this then, the life of an airambulance paramedic will suit you.
Air ambulance services play a critical part in providing medical care on time for stroke victims. The Centers for Disease Control estimates that about 795 thousand people suffer strokes every year in the United States of America. Up to 140 thousand of these people die of stroke. Approximately 610 thousand people have never experienced stroke before. To put these numbers into perspective, one person has a stroke every 40 seconds on average in the country. All these people need air ambulance services to receive care on time. If not, they are at risk of suffering disability for the rest of their life.
Air Ambulance Services are Time Critical in Stroke
It is said that the chances of survival and complete recovery improve drastically if the patient receives care within the first three hours of the stroke. Air ambulance services play a major role in ensuring that this. The fact that rural doctors are moving towards urban areas and the reality that rural hospitals are closing at a rapid rate makes air ambulance services for such regions critical and life-saving. These patients are in need of high-level care facilities equipped to handle this medical condition.
The Economics of Stroke
In the US, cost of stroke treatment is approximately USD 34 billion annually. This includes the cost of care, medicines and loss of work revenue due to medical absence. Despite this, insurances only cover about 30 to 40% of the cost related to air ambulance services. Why? Because the reimbursement rates have not been revised for over 20 years, which puts a lot of financial strain on air ambulance services. The result – medical flight service providers are closing at a rapid rate, especially in rural America. If something is not done about this by the congress, it could turn out to be a grave situation for the people in the near future.
Working in the air ambulance industry can bring to fore those hidden emotions that people tend to burry up and no person is impervious to such emotional shakeup. Take for instance Prince Williams. The Duke has been quite vocal lately about mental health issues. However, he has hardly spoken about the loss of his mother out in public, apart from one time when he was about 15 years old. He lately opened up about it in the context of his stint as an air ambulance pilot for the East Anglian Air Ambulance company. He had been a part of it for about two years.
Prince William, Air Ambulance and His Emotions
The Prince had previously been a part of the nation’s defense forces and had ever served in Afghanistan. However, what churned up his hidden emotions related to his mother, Princess Diana, was his job as an air ambulance pilot. He said, finding himself in situations where death was always a possibility was hard to take on a daily basis. He added that the job as medical flight pilot made him depressed and the memories of having lost his mother at a young age surfaced quite often. He made his revelation as part of a documentary.
William Sharing His Feelings Sheds Light on the Mental Status of Air Ambulance Personnel
Air ambulance services are availed for life-threatening emergencies most of the time. The suffering patients who are under a lot of distress and struggling to stay alive can be quite impactful on the minds of the personnel. All this, while the crew cannot let their emotions get the better of them. Suppressing emotions becomes a norm and this pent up feeling can eventually lead to anxiety, depression and other mental health issues. The industry needs to tackle this very seriously and focus towards having a mechanism that takes care of the mental wellbeing of the crew.
It is hard to believe that the future will see more efficient emergency transportation than air ambulances. However, it is true and that future is not very far. The advent of smart vehicles, autonomous driving technology, drones, electric power and the like are transforming emergency transportation today. In the age of patient centricity, the technology that suits the patients’ requirements will rule the industry. While vehicles capable of landing vertically will make a huge difference in treacherous plains, swiftly moving vehicles will be in demand when time is vital. Here, we take a brief look at the different technologies that are making waves today.
Flying Cars and Air Ambulances
Flying cars have been testing human imagination since the 1980s. Their biggest advantage is their ability to take off and land vertically, as well as the fact that they are highly compact. Now, with technology enabling efficient ground support, it will come as no surprise if we see flying cars being used as air ambulances. The other major advantage from the air ambulance service providers’ point of view is the ability to store or park these vehicles without much expense. The current system where they are expected to hire spaces in large hangars can be done away with if flying cars become a reality and can in turn bring down the cost of availing the service too.
Drones and Autonomous Vehicles
A lot of innovation and research has gone into autonomous vehicles and drones. In fact, a combination of these technologies can be quite exciting. Imagine a scenario where an air ambulance company dispatches an autonomous drone capable of handling heavy loads while controlling it remotely. There would not be a need for pilot. This will also make more space for the patient in the compact vehicle, where he or she gets all the life support required.
The technology that guides air ambulances will further improve as artificial intelligence, internet of things, big data and the like progress.