The “Promoting Innovations in Emergency Medical Services” Project was administered by the Mount Sinai Health System in collaboration with the University of California, San Diego Health System. It was funded and supported by the United States National Highway Traffic Safety Administration, Office of Health Affairs, the Department of Homeland Security and the Department of Health & Human Services.

This project was intended to respond to the call from a variety of stakeholders for the federal government to support the implementation and dissemination of innovative Emergency Medical Services (EMS) delivery models. Regulatory, financial, technological, and other barriers have posed challenges to innovation in EMS. The project involved broad stakeholder involvement over a multi-year period to develop a national framework document providing guidance to overcome commonly faced barriers to innovation at the local or state level, and foster the development of new innovative models of healthcare delivery within EMS.

The Co-Project Directors of this award were Dr. Kevin Munjal, of Mount Sinai Health System in New York, and Dr. James Dunford, of University of California, San Diego Health System. According to Dr. Munjal the award “engaged a diverse group of stakeholders in creating a pathway toward the widespread implementation of best practices and delivery system reforms in EMS across the nation.”  Dr. Dunford described this moment in healthcare history as, “a fantastic opportunity for EMS to merge imagination, sound medicine and health information technology to improve care and lower cost.” Tomorrow’s innovations will likely improve domestic preparedness, increase patient access to care, decrease healthcare costs, and improve community resilience.

As EMS agencies strive to innovate within the current infrastructure, they face challenges from existing laws, regulations and even mind-sets. The project team is aware of the delicate balance between enabling innovation while still protecting public health and safety through regulatory oversight and maintaining a statewide systems approach to the provision of emergency medical care. State Offices of EMS play a vital role in fostering innovation and will be vital stakeholders in this project which seeks to develop model legal, regulatory, and financial frameworks to assist and encourage state and local health systems to test new EMS delivery models.

Key aspects of the project included:

• Collection of input from key EMS and community healthcare stakeholders from around the country via surveys and interviews.
  Regional stakeholder meetings held in San Diego and New York in May of 2015, with a focus on incorporating national input into overcoming local barriers to EMS innovation.
  A national steering committee meeting held in Washington, D.C. on September, 2015.
•  An iterative approach to drafting materials and soliciting feedback through in person, telephonic, and online encounters with stakeholder groups.
• Multiple drafts released to the public with opportunities for public feedback (January 2016, and July 2016).
• Finally, the National Framework Document was completed and submitted for review in May 2018 with formal release planned for February 2019.  The document hopes to serve as a broadly representative, thoroughly vetted tool that will offer a useful pathway to harness the full potential of EMS.