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  • 23 Aug 2016 12:00 PM | AIMHI Admin (Administrator)

    A little lengthy, but valuable insight to the reasons some healthcare systems have been able to successful become integrated care networks…  Love the Dell analogy!

    ————————

    8 Ways to Chart A Savvy Course to Integrated Care

    Dan Beckham looks at eight health systems that have followed consistent strategies particularly well to create value

    August 15, 2016

    Dan Beckham

    http://www.hhnmag.com/articles/7531-charting-a-path-to-integrated-care

    Strategic decisions have positioned some health systems particularly well in the past and promise to do so in the future.

    Respected industry leaders helped me identify eight of them: Advocate Health Care (Illinois), Banner Health (Arizona), Baylor Scott & White Health (Texas), the Cleveland Clinic (Ohio), Geisinger Health System (Pennsylvania), Intermountain Healthcare (Utah), the Mayo Clinic (Minnesota) and Sentara Healthcare (Virginia).

    In studying them anew, I have relied on personal interviews as well as an extensive review of existing literature and data. And I drew on my own experiences working with a number of health systems to develop their strategic plans over the past 30 years. My key areas of study have included reputation, geographic influence, strategic coherence over time and demonstrated performance, particularly as it has related to quality.

    Pursuing integration

    For at least three decades, these eight health systems have shared a single value proposition — the delivery of integrated care.

    Integration is the antidote to fragmentation. And fragmentation remains the greatest threat to value in health care. Autopsy just about any medical accident, misdiagnosis, failure to provide timely care, disaffected patient or unsustainable cost, and you’ll find fragmentation as a cause.

    For these eight organizations, integration has been about creating a connected and coordinated system that delivers care distinguished by markedly enhanced value, including quality, safety, accessibility, satisfaction and affordability. (For an in-depth overview of each organization’s strategic commitments, visit www.hcstrategyinnovation.com.)

    Each of these health systems has faced tough competitors. But the real competition has been between fragmentation and integration.

    Fragmentation is well-entrenched, has strong champions, pushes back and evolves. It is a slippery foe. Strategy is about moving from a place in the present to a better place in the face of resistance and uncertainty. Fragmentation offers plenty of resistance and uncertainty.

    Harvard Business School professor Clayton Christensen, author of The Innovator’s Dilemma, is well-known for his concept of disruptive competition. He applied his thinking to health care in a later book titled The Innovator’s Prescription.

    Christensen uses a metaphor to describe fragmentation in health care and the proper role of size:

    “If you take the cover off of your Dell computer, every component [is] made by a different company. … Intel can give you faster processors, Microsoft can give you Vista, Seagate more gigabytes on the drive. But none of them [has] the technical or commercial scope to wrap [its] arms around the whole system and rethink what it is.

    “Most of America’s health care system is structured like a Dell computer. … But there are only a few institutions that have the scope to rethink it all … that can wrap [their] arms around all of the pieces of the system to just re‑architect it.”

    These eight health systems, among others, have demonstrated the kind of scope Christensen describes:

    1. Advocate Health Care: Advocate grew out of the merger of two health systems with flagship hospitals already recognized for quality and advanced capabilities. It was an early mover on physician employment and group practice formation, and it turned its physician-hospital organizations into a super-PHO, becoming the national benchmark for clinically integrated networks.
    2. Banner Health: Built around a flagship hospital and a strong operating company model, Banner centralized leadership and governance, and standardized care and management processes. Banner grew aggressively through acquisitions and new hospital construction.
    3. Baylor Scott & White Health: Two respected but distinctive organizations came together to form a delivery system serving a wide swath of north and central Texas (including Dallas and Temple). Scott & White brought its highly integrated multispecialty group practice model and its health plan to the merger, while Baylor brought a robust network of hospitals, surgery centers and entrepreneurial partnerships.
    4. Cleveland Clinic: Few organizations have been as clinically innovative and tenacious as the Cleveland Clinic has been from its founding. Once focused intently on the heart, it has leveraged its worldwide reputation into other services and diseases. A pioneer in transparency related to demonstrated value and bundled contracts, Cleveland Clinic has combined one of America’s premier multispecialty group practices with community hospitals and independent physicians to produce a powerful economic engine.
    5. Geisinger Health System: A large, sophisticated medical center in a small town serving a big chunk of rural Pennsylvania, Geisinger has focused on building deep intellectual capital related to care management. It is internationally recognized for innovating at the interface between health insurance, inpatient care, outpatient care and physician practice. Few organizations have positioned themselves as purposefully as Geisinger for the transition from volume- to value-based payment.
    6. Intermountain Healthcare: The late W. Edwards Deming, a quality icon, was a central inspiration for Intermountain’s relentless battle to drive out variation. While many health systems treated total quality management and its variants as a passing fad, Intermountain dug in and made it a way of life. The presence of Intermountain contributes greatly to Utah’s position as one of America’s healthiest places to live.
    7. Mayo Clinic: No organization has built as strong a brand for quality as Mayo. Its strength flows, to a great extent, from the team-based multispecialty group practice model that has been central to its operations since its founding, along with its unwavering focus on putting patient interests first. The “Mayo way” is well-engineered and nonnegotiable. No organization has deeper, better-connected data. Once satisfied to be insular, Mayo is stirring.
    8. Sentara Healthcare: When other systems experimented with ownership of health plans, then exited in the face of losses, Sentara persevered. When physician employment became too big a financial burden for others, Sentara doubled down. Because it persisted when others folded, it was able to put more than two decades of experience into its intellectual bank vault. It learned to meld a managed care enterprise, a hospital enterprise and a physician enterprise into a formidable integrated delivery system.

    Four paths

    These eight health systems didn’t wait for health care reform to move them down the path toward integration and value. Indeed, their initiatives provided models that the Centers for Medicare & Medicaid Services and other government agencies have attempted to emulate. These health systems positioned themselves to manage care by moving down one of four integration pathways.

    For Mayo and the Cleveland Clinic, the integration path was paved by their century-old multispecialty group practice model in which team‑based delivery of coordinated care wasn’t an option but a requirement. Intermountain, Baylor Scott & White and Sentara’s path toward integration involved owning a health plan, while Geisinger had the benefit of an already well-developed multispecialty group practice model when it stepped into health plan ownership. Advocate’s path ran through development of its physician-hospital organization and clinically integrated network. For Banner, the path involved creating a tight operating company model for every piece of the system, including hospitals and physician practices. These four paths have coalesced as they’ve converged on the same destination – integrated care.

    Two shared characteristics stood out in all eight systems. First, each had a well-established reputation for delivering high-quality care. This reputation often had been resident in star physicians and flagship hospitals before the systems were built out.

    The second common point of differentiation was wide geographic distribution, usually developed as a result of acquisition and mergers. Such wide distribution expanded access, created leverage with insurers and pushed the health systems’ brand identity into new markets. Wide geographic distribution also diversified the systems’ portfolio of markets, so a slowdown or setback in one could be averaged out among the others.

    Strategic choices

    Focus is an essential characteristic of any truly strategic organization. These health systems demonstrated an ability to home in on those strategic commitments that made the greatest contribution to their value proposition of integrated care.

    Ten driving strategies can be seen at the eight health systems over the past decade. The emphasis on each strategy has varied over time and by organization. They are interrelated and not in any particular order:

    Offer advanced capabilities to sustain consumer awareness and preference. Advanced clinical capabilities in the form of physician expertise and technology were legacy commitments emphasized from the onset at Mayo, Cleveland Clinic and Geisinger and were embedded in the flagship hospitals of the other five health systems.

    Fortify a quality brand. Advanced clinical capability carried with it an expectation of higher quality outcomes. But to be sustained, differentiation on the basis of quality had to be demonstrated with data showing superior outcomes. Because of their higher levels of integration, these systems have been able to provide such evidence.

    Standardize care processes and management. Key to quality and affordability is driving out variation wherever possible. And moving beyond variation requires standardization. Quality of care, quality of leadership and quality of management all rely on a degree of standardization. It is impossible to deliver a high-quality service without the reliability and consistency that standardization delivers.

    Require teamworkAddressing the U.S. tradition of independence in medicine is fundamental to delivering coordinated care. Teamwork is essential to bringing to bear multiple sources of expertise and experience. To have an impact, teamwork can’t be optional, and it must be facilitated by structure and technology.

    Develop partnerships of trust with physicians. There is absolutely no way to effectively manage the quality, access and cost of care without physicians’ active and committed involvement. And there’s no way to foster productive physician involvement without including physicians as trusted partners in the system’s most important work.

    Create proximity and productivity through electronic connections. It’s not practical to move all physicians and patient care into close physical proximity. The benefits of proximity and connection have to be created electronically. Providing the right information at the right time to the right people in the right place is the highest use of information technology in health care.

    Manage risk. It’s never a good idea to turn your back on risk. Risk invariably has two traveling partners: danger and opportunity. These health systems embraced and managed risk in its many forms — in new ventures, in innovation and in business arrangements. When they began their pursuit of integration, there were few maps to guide them.

    Pursue growth that expands access and influence. The best use of size is to make expertise and services more broadly available. For a health system, market influence arises from the number of individuals served. More patients and enrollees mean more influence. Access is obviously critical to market share. And suitable market share growth is the surest way to improved financial performance and deeper experience.

    Restructure to enhance integration. Strategy drives structure, or at least it should. These health systems either designed themselves from the onset for integration or fundamentally restructured themselves to enhance connections, communication and coordination systemwide.

    Cultivate network effects. The most recent phase in integrating these health systems has been their investment in extending themselves beyond their core campuses and facilities through networks of affiliation. Bricks and mortar are notoriously immobile, expensive and difficult to merge. Knowledge, on the other hand, is inherently portable and malleable. Through arrangements that resemble franchising of intellectual property, these health systems are leveraging their deep investments in expertise and innovation.

    More commonalities

    It’s often suggested that strategic success depends not only on the quality of the strategy but also on the quality of execution. There have been a consistent set of behaviors that have characterized the execution of strategic commitments by each of the eight health systems:

    Continuity and consistency over extended periods of time. These organizations stuck to their commitments, even through periods of significant uncertainty and disruption. They also extended their strategies throughout their systems, along with the operational activities needed to support them. Longevity in leadership was key. CEO tenures ranged from seven to 21 years, with an average of about 14. Ultimately, an organization’s strategic mindset must emanate from its leaders.

    Flexible persistence gave rise to purposeful agility and opportunism. Mayo Clinic was born out of a storm — an F5 tornado hit Rochester, Minn., in 1883. That disaster precipitated the formation of the clinic and solidified the core beliefs of its founders. The Cleveland Clinic burned to the ground about the same time as the nationwide bank collapse in 1929. Instead of walking away, the founders rebuilt the clinic and added two floors. None of the systems progressed in quick, bold strokes. Instead, they experimented their way forward. They gradually invented their own paths toward integration.

    Nonnegotiable commitments were essential to fighting fragmentation. Each of these organizations demonstrated tightness not found in most other health systems. Some things were beyond negotiation. Driving out variation was not optional. Executives, physicians and staff were required to adhere to standards that yielded integration and value.

    Focused accountability in pursuit of value ran through each of the health systems. Constructive competitiveness drove them to demonstrate superior performance against a worthy standard: value. Because of the clarity of their intentions, including their establishment of measurable goals, accountability for value became a reality rather than a nebulous and unfocused aspiration.

    It’s taken at least 30 years for these eight health systems to deliver on their value proposition of integrated care. I believe that many other health systems can accelerate and strengthen their commitment to value by emulating the lessons these eight embody. No commitment will serve U.S. health care better.

    Dan Beckham is the president of The Beckham Co., a strategic consulting firm based in Bluffton, S.C. He is also a regular contributor to H&HN Daily.

  • 23 Aug 2016 9:00 AM | AIMHI Admin (Administrator)

    3 alternative payment models that may work in the ER

    by Paige Minemyer

    Aug 19, 2016

    http://www.fiercehealthcare.com/population-health/how-emergency-departments-can-transition-to-alternative-payment-models

    As more hospitals and healthcare facilities move away from a fee-for-service model, they may find it difficult to apply alternative payment models to the emergency department, frequently a safety net for patients who may be uninsured or unable to pay for care.

    The ED also presents challenges because emergency care isn’t set up to follow patients after discharge, which makes it difficult for organizations to obtain a full grasp on care costs, according to new study published in the American Journal of Managed Care. Furthermore, ER doctors may order a large number of tests to rule out life-threatening conditions for patients, so payment reform may lead to misdiagnoses as care patterns change, study authors note.

    Despite the unique challenges the ED presents to payment reform, the report’s authors examine how payment models under the Department of Health and Human Services’ four-category framework could work.

    In addition to using the existing fee-for-service model, they suggest that organizations could:

    Connect the fee-for-service model to quality benchmarks. In this model, according to the study, EDs would still operate under a fee-for-service system, but they could earn additional payments by achieving certain goals, like improving patient satisfaction or better care coordination. Being paid directly for coordination of care can lead to better outcomes and lower costs, according to the study.

    Build a new payment model based on fee-for-service. One way this could work is for providers to establish frequent use programs, which cut costs by personalizing plans for patients with more complex medical, psychological and social needs. EDs could also offer bundled payments for more episodic conditions, which may reduce both costs and unnecessary readmissions, according to the study.

    Create a population-based payment system. Under this model, ED providers would be paid a fixed sum based on local population, previous emergency care use or projected costs across a certain window of time. Basing payments around population gives incentives to providers to address inefficient care and to prevent unneeded ER visits for acute care.

    Here’s the link to the AJMC Study:

    http://www.ajmc.com/journals/issue/2016/2016-vol22-n8/aligning-payment-reform-and-delivery-innovation-in-emergency-care

  • 12 Aug 2016 11:30 AM | AIMHI Admin (Administrator)

    EMS1.com, Fitch & Associates and the National EMS Management Association just published their EMS Trend Report.

    Click below to view and download a copy.

    2016_EMS_Trend_Report-1


  • 18 Jul 2016 11:30 AM | AIMHI Admin (Administrator)

    If your organization would like to join AIMHI, the membership application is now available. You can access the application at the “Join Us” tab, or download it here. Please email the completed application to ariordan@ambulance.org.

  • 19 May 2016 11:00 AM | AIMHI Admin (Administrator)

    Tue, May 17, 2016 | By Matt Zavadsky, MS-HSA, EMT

    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.


    High-Performance EMS

    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.


    MIH-CP

    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.

    Written by Matt Zavadsky, MS-HSA, EMT
    Matt Zavadsky, MS-HSA, EMT, is the director of public affairs at MedStar Mobile Heatlhcare, the exclusive emergency and non-emergency ambulance provider for Fort Worth and 14 surrounding cities in North Texas. He holds a master’s degree in Health Service Administration and has 30 years of experience in EMS, including volunteer, fire department, public and private sector EMS agencies. Contact him at mzavadsky@medstar911.org.

    Article from JEMS

  • 27 Apr 2016 10:30 AM | AIMHI Admin (Administrator)

    Dan Fellows is the Fleet Manager for Richmond Ambulance Authority (RAA). We recently chatted with Dan about his time as a Fleet Manager, what makes RAA unique, and much more in our latest interview.


    Dan, first off thank you for taking the time to speak with us. You are currently the Fleet Manager for the Richmond Ambulance Authority (RAA). Tell us how you came to work at RAA and what you did prior.

    DAN FELLOWS: I had worked at heavy truck and light truck shops before attending Nashville Auto Diesel College. After graduating and working for Ford dealers for a few years on ambulances, I came to RAA in the mid 90’s when they were looking for an experienced ambulance technician.

    RAA has a reputation for being a high performing EMS system with response times that remain some of the fastest in the nation. As the Fleet Manager, you are always looking for ways to improve efficiency. What are some of the most important things that the RAA does on a daily basis to remain a high performing EMS system?

    DAN FELLOWS: At RAA, the availability and reliability of the vehicles is paramount. To achieve efficiency in the System Status Management System we consistently want to keep vehicle turnaround time as low as possible. Fleet service technicians are given 15 minutes to determine if a vehicle currently in service can be repaired within the time frame or if the vehicle needs to be changed out. All of the vehicles at RAA are fully stocked and ready for service and thus changing vehicles takes a matter of minutes. Vehicles in for repair not only have the service needed done, but are also checked over for other possible needs along with checks on high potential failure areas, which have been designated from data collected on repair and preventative maintenance.

    You recently received the National EMS10 Award for your innovative approach to using solar energy to supplement the electrical needs of ambulances. Can you give us some background on how this concept came about and how it felt to win the award?

    DAN FELLOWS: The concept came from the need to have a resource vehicle’s battery charged in a location without access to a shore line. The most effective possibility was solar. After installation and testing, it was found the solution worked exceptionally well, and a trial was implemented to test the effect on standard Type III ambulances. Data was collected and the findings were very encouraging so the decision was made to continue installing the solar to the remaining Type III fleet. Receiving the EMS 10 award was very humbling for me as the solution was created out of necessity and to be honored by my peers in EMS is very gratifying.

    An article entitled “How to Develop a Fleet Replacement Strategy” by Rob Lawrence and yourself was recently published on EMS World. The article had stated that fleet selection should be based on environmental, as well as operational, conditions. What are your thoughts on Compressed Natural Gas (CNG) and its potential?

    DAN FELLOWS: As with all vehicle technologies, as each reaches its effective state, CNG has great potential in the EMS industry. Not unlike solar, CNG does have the potential for increasing the effectiveness of fleets while reducing the cost of operation when infrastructure is developed and available for its use.

    The RAA has been a loyal customer of Excellance for many years. What are the most important aspects that you look for in a manufacturer and how does Excellance provide that for RAA?

    DAN FELLOWS: At RAA, I look for the quality of a vehicle, the ability to come up with innovative design, and the ability to remain cost effective with future changes through a rechassis process. Excellance provides an avenue to each of these goals.

    What are some of the biggest challenges you have had as a Fleet Manager and what are you most proud of?

    DAN FELLOWS: I have many of the same challenges as other fleet managers, maintaining budgets, maintaining efficiency, and keeping a consistent product on the road for the service of citizens. I am most proud of seeing the hard work my staff and I have done bearing fruit month after month, year after year in a fast paced, high volume system.

    Do you have any advice for individuals looking to become a Fleet Manager?

    DAN FELLOWS: Be not afraid of data or what it has to tell you. Do not be hesitant to call upon other fleet managers to aid in answering questions you may not currently have the answers to. Always keep the needs of the crews and citizens in mind when designing, maintaining, and replacing vehicles.

    Article source: http://www.excellanceinc.com/2016/04/exclusive-interview-raa-fleet-manager-dan-fellows.html

  • 13 Apr 2016 10:00 AM | AIMHI Admin (Administrator)

    T Samuels AAA1 T Samuels AAA2

    RICHMOND, Va., April 13, 2016 – Richmond Ambulance Authority (RAA) paramedic Tiffany Samuels has received an American Ambulance Association’s (AAA) Star of Life award for her leadership in clinical excellence and exceptional training for new EMS field personnel.   The Stars of Life awards, presented at AAA’s Stars of Life Celebration April 11-13 in Washington, DC, honor remarkable ambulance service professionals from around the nation who truly stand out and represent excellence in their field.  All who receive this award are nominated by their peers.

    Samuels has been with RAA since 2008 where she currently serves as a paramedic field training officer and chair of the RAA Clinical Services Committee.  After graduating high school, Samuels was briefly employed in the banking industry before beginning her EMS career with the Richmond Ambulance Authority.  In 2008, her EMS career started at an entry level position within the Logistics Department as a vehicle service technician.  She has worked very conscientiously, entering each new position with an undeniable passion.  Ms. Samuels’ dedication and focus ensured she was confident and proficient at current certification and skill level before progressing through the organization to her position as a paramedic – field training officer.  In this role she takes great effort and shows immense pride in teaching new employees how to provide world-class EMS.

    “Tiffany is a delight to work with,” said Wayne Harbour, chief clinical officer for the Richmond Ambulance Authority. “She continues to be a valuable asset to RAA not only by the dedication with which she carries out normal day-to-day duties, but also by the many contributions she makes while serving on various committees. She helps shape the clinical direction of the agency by serving as chairperson of Clinical Services Committee”.

    Last year, Samuels received the 2015 RAA Medical Director’s Award.  This prestigious award is presented annually by RAA’s internationally-renowned Medical Director, Dr. Joseph P. Ornato, to a paramedic who has demonstrated superior clinical abilities and has also dedicated personal time and effort to ensure RAA remains clinically on the cutting edge of mobile healthcare, not only in Richmond, but also nationally and internationally.

    “She is an advocate for her fellow EMS providers while participating on the Wellness Committee, and she has presented many creative ideas to the Scheduling Committee promoting a positive work/life balance” said Chip Decker, CEO of the Richmond Ambulance Authority.  “She deserves to be recognized as a Star of Life, and we are proud of her many accomplishments.”

    Samuels commented, “I am very honored to be selected by Richmond Ambulance Authority to represent them at the Stars of Life Assembly. To be considered with such high regard by my fellow coworkers and supervisors is truly humbling. I strive every day to live up to the reputation that this honor represents and will continue to do so with the pride and joy that comes along with truly loving my career.”

  • 1 Mar 2016 7:30 AM | AIMHI Admin (Administrator)

    DAN EMS 10 pic

    RICHMOND, Va., March 1, 2016 – Dan Fellows, fleet manager of the Richmond Ambulance Authority (RAA), has won the national EMS10 Award for his innovative approach to using solar energy to supplement the electrical needs of ambulances.  This award, presented at the 2016 EMS Today Conference by the Journal of Emergency Medical Services (JEMS), recognizes 10 individuals who have contributed to EMS in an exceptional and innovative way.

    As fleet manager for RAA’s 40 ambulances, Fellows is responsible for the design and day-to-day operation of these vehicles, and he is constantly looking to for ways to improve efficiency.   When faced with the problem of finding a reliable energy source for a RAA resource vehicle that did not have access to a shoreline power plug at the back of headquarters, Fellows decided to explore the use of solar panels to charge the unit.

    “The solar panels installed on this unit did an excellent job of charging the battery needed to start the vehicle each morning so we decided to try solar panels on a standard ambulance to see if we would have similarly positive results,” said Fellows.  “There were many factors to work through such as secure mounting and wiring the panels directly to the vehicle’s battery so the solar energy could power the ambulance’s entire electrical system.  Others in the industry had dabbled with solar to charge individual component batteries, not the entire vehicle, and we have come close.”

    RAA’s solar panels don’t generate enough energy to completely power the largest ambulances but do generate enough electricity to offset the energy requirements of the many onboard electronics such as the mobile communications systems, air quality control, mobile gateways, and computer chargers, all of which draw power.  After offsetting the draw of the electronics on board, the solar energy provides about four additional amps of power to trickle charge the batteries.  As a result, ambulances no longer high idle when parked between calls.  While the solar panels don’t generate enough energy to allow the ambulances to be completely turned off between calls, the engine only needs to power the heating and A/C system; the solar panels power all the other electronics within the ambulance.

    Before implementing solar-charging in all of RAA’s ambulances, Fellows tested an ambulance for almost a full year to collect data on its efficiency. The cost savings and positive environmental impact proved a winning combination.

    “Dan is a creative manager who thinks outside the box and is constantly looking for solutions to improve efficiency,” said Chip Decker, CEO of the Richmond Ambulance Authority.  “The use of solar panels on our ambulances has led to noticeable cost reductions.  Battery life is extended, fuel is saved and the solar panels serve as a barrier so the vehicle absorbs less heat which reduces air conditioning demand in the summer.  There is also the added benefit of reduced environmental impact.  We are proud of Dan and happy to see his innovative approach to operational challenges recognized on a national level.”

    “It is a tremendous honor to win an EMS10 Award,” said Fellows.  “I am blessed to work with supervisors and senior staff who encourage experimentation and are willing to explore new ideas and methods.  This culture of innovation at RAA – clinically and operationally – drives us all.”

    This is the third EMS10 Award for the Richmond Ambulance Authority.  COO Rob Lawrence and Operational Medical Director, Dr. Joseph Ornato are also recipients of this prestigious national award.  Only two EMS organizations in the United States have three EMS 10 Awards – RAA and MedStar in Fort Worth, Texas.

    About the Richmond Ambulance Authority
    In 1991, the Richmond City Council and the city manager implemented an Emergency Medical Services (EMS) system that placed the patient first and guaranteed its performance to the City’s residents.  Today, the Richmond Ambulance Authority responds to approximately 200 calls per day and transports, on average, 140 patients per day.  RAA’s emergency response times are among the fastest in the nation with ambulances on the scene of life threatening emergencies in less than 8 minutes and 59 seconds in more than 90% of all responses.  RAA is one of only 24 EMS agencies in North America accredited by both the Commission on the Accreditation of Ambulance Services and the National Academies of Emergency Dispatch.  RAA is also a Commonwealth of Virginia Accredited Dispatch Center.  For more information, see www.raaems.org.

  • 7 Apr 2015 9:00 AM | AIMHI Admin (Administrator)

    Fort Worth, TX — April 7, 2015 – At their meeting on February 19, 2015, the Coalition of Advanced Emergency Medical Systems (CAEMS) Board of Directors took a bold step in support of the industry movement toward being more than simply emergency medical services providers. CAEMS is now the Academy of International Mobile Healthcare Integration, helping the transformation of EMS to mobile integrated healthcare through the development of high performance systems, setting the standard for clinical excellence, accountability, public education, research and economic efficiency.

    AIMHI’s vision is to improve patient health and experience of care by promoting excellence in mobile healthcare integration through evidence-based, out of hospital healthcare system effectiveness and efficiency.

    A major focus for AIMHI will be to help publish peer-reviewed research projects that demonstrate the clinical, experiential and economic impact of sound MIH models. The Academy will also continue to promote the clinical, operational and fiscal benefits of High Performance EMS (HPEMS) models.

    The Founding Members of AIMHI include:

    • Emergency Medical Services Authority, Tulsa and Oklahoma City, OK
    • Mecklenburg EMS Agency (MEDIC), Charlotte, NC
    • Medic EMS, Davenport, IA
    • MedStar Mobile Healthcare, Fort Worth, TX
    • Metropolitan EMS Authority, Little Rock, AR
    • Niagara EMS, Ontario, CA
    • North Shore Univ./LIJ Health System, Syosset, NY
    • Nova Scotia EHS, Nova Scotia, CA
    • Regional EMS Authority, Reno, NV
    • Richmond Ambulance Authority, Richmond, VA
    • Pinellas County EMS Authority/Sunstar Paramedics, Largo, FL
    • Three Rivers Ambulance Authority, Ft. Wayne, IN

     

    Leading the transformation of EMS to mobile integrated healthcare through the development of high performance systems, setting the standard for clinical excellence, accountability, public education, research and economic efficiency.


    Doug Hooten, the President of AIMHI and the Executive Director of MedStar Mobile Healthcare explains:

    “The transformation of EMS into Mobile Integrated Healthcare (MIH) is a patient centered way to help the healthcare system achieve goals articulated in the Institute for Healthcare Improvement’s Triple Aim.

    The members of AIMHI represent many of the thought leaders in MIH delivery and we are in the ideal position to not only promote the model, but conduct peer reviewed research demonstrating the impact of this service delivery model.

    We invite all agencies interested in the effective delivery of MIH services, including the high performance EMS service line, to join us in promoting the evolution of our profession into this expanded service delivery model.”

    To learn more about AIMHI’s members, its mission, vision and activities, and to join AIMHI as a member email info@aimhi.mobi.

    Click here to view or download the official press release.


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