Guest Editorial: What I Expect to See

The opinions and commentary expressed in “Perspectives” are the sole property of the author and do not necessarily reflect those held by EMS World, its staff members or affiliated organizations.

Emergency care is still a relatively new field, but EMS has transformed enormously since the 1970s. Particularly in the past decade, its broadened scope and outreach have created something prior generations could scarcely distinguish. Augmenting rapid response times with more invasive ALS interventions and robust technological advances has helped us bolster patient outcomes. 

Significant change will continue to occur with our prehospital care systems. Acknowledging this gives us the chance to have pragmatic conversations that can perhaps steer the direction of these changes in a positive way, toward the efficient and effective care of patients. As such, I would like to outline three predictions I have about EMS care in the coming 10–20 years. I encourage you to respond with thoughts, comments, concerns, and questions as we look ahead to the decades to come.

Telemedicine will become far more prevalent—Healthcare delivered remotely through telehealth platforms has grown rapidly in recent years. Though EMS telehealth has yet to spread to the same extent, we will undoubtedly see its increased integration in coming decades. 

How can remote consultations provide a means of emergency care? Devices both under development and already on the market can securely and reliably connect first responders and patients to physicians, nurses, and specialists. They’re often compatible with tools like otoscopes and other specialty cameras, and a host of other add-on functions can be integrated to allow the remote physician to examine and perform tests directly.  

It is with near certainty that I foresee such remote interfaces representing a larger portion of EMS care. Consider the banking industry: In 2018 almost 80% of banking was done with the use of a mobile phone. This remarkable percentage was less than 5% only one decade ago.

This analogy shows not only the power of rapid technological progress but also how an entire culture can shift its perspective. We don’t hear people refer to banking done on their smartphones as “e-banking”; rather, it’s become so common that it’s an accepted part of the practice and definition, rather than an extension. 

By 2050 ambulances will largely be operated by autopilot technology—And it will build dramatically on the already-progressive auto-safety technologies we’ve seen to date. Not only will it further protect lives and property, but it will further maximize efficiency and quality of care by allowing responders to prepare en route for upcoming scenes. Advances will allow crews to be briefed prearrival on patients’ histories and tailor their care accordingly. 

Our prehospital care system will begin to more closely resemble Europe’s—That is, its integrative prehospital care modalities. To clarify, I foresee the U.S. increasing the involvement of physicians in the field—currently a practice far more common in Europe than in the U.S. This shift will largely occur before we successfully integrate telemedicine into the EMS field, and so physicians or PAs will begin to ride on ambulances and provide expanded care on scene.

While we can’t know what the future will bring, talking about the evolution of EMS care now will help us be better equipped and stronger advocates for one another as change unfolds. If you’re interested, let’s continue the conversation in the online comments or on social media with the hashtag #EMSin2050. 

Christopher Gaeta is a student at Swarthmore College.