NEMSAC Tackles Care Inequities, EMS Bill of Rights, and Cybersecurity

Efforts to achieve equitable EMS service across all income groups, the need for an “EMS Bill of Rights,” and coping with cybersecurity threats were discussed during the National EMS Advisory Council (NEMSAC) meeting held May 11–12, 2022.

In a report from NEMSAC’s Equitable Patient Care Committee, Richard Bradley, MD, chief of emergency medical services and disaster medicine at the University of Texas Health Science Center, noted that “individuals who experience an out-of-hospital cardiac arrest in areas with a lower socioeconomic status and in communities with higher proportions of people of color have worse outcomes than their comparative groups.”

To find out precisely why this is the case, “researchers from across the country need to have a strong understanding of all the factors that impact upon out-of-hospital cardiac arrest,” Bradley said. “Right now we do not have any good resources for data that cover across the country to help us understand this.”

One possible solution to this lack of data would be the creation of a national registry for out-of-hospital cardiac arrest, he noted. Such a registry would include access to matched outcome data from hospitals.

“From this registry, state, local, tribal, and federal agencies and authorities can better understand the causal factors in these disparities and outcomes and then design and evaluate interventions to help target these disparities,” Bradley said. “The advisory we’re working on makes recommendations that seek ways to implement this registry and also makes a recommendation…to enlist the support of the National Committee on Vital and Health Statistics to better understand barriers in linking EMS and hospital records to better understand outcomes.

A second advisory will focus on equitable access to EMS, regardless of population data, Bradley said. “We have good evidence that shows there are inequities in outcomes and inequities in patient care based upon population density… Clearly individuals who need EMS in urban and suburban areas have easier access to resources than those in rural and frontier areas.” The subcommittee expects to have a draft of this advisory ready for the next NEMSAC meeting, scheduled for August 11–12, 2022.

EMS Bill of Rights

Appearing on behalf of NEMSAC’s Sustainability and Efficiency Subcommittee, Jonathan Washko, assistant vice president of operations for the Northwell Health Center for EMS and SkyHealth in New York, spoke about their drafting of an advisory covering a proposed EMS Bill of Rights. Such a bill would include EMS being recognized as an essential service by governments and funded through various sources, rather than relying on health care reimbursements, he said.

Washko noted that EMS fulfills many functions in the community, including supporting disaster response and mitigation, public health, and public safety, in addition to its primary health care mission. “There should be funding sources for each of these things,” he said. As well, “we want to make EMS desirable for our practitioners again, (by becoming) a violence-free workplace.”

Cybersecurity

The Integration and Technology Subcommittee’s Cherie Bartram, a PSAP subject-matter expert with Michigan-based Equature, covered the topic “Cybersecurity: What to Do When Technology Fails and How to Mediate in a Proactive Way.”

According to Bartram, there have been 93 cyberattacks on public safety agencies in the last 24 months. To mitigate future attacks, her subcommittee is preparing an advisory that can guide policy development on EMS cyberprotection.

“Our advisory is addressing the risk of cybersecurity incidents as they impact the whole chain of survival from 9-1-1 to EMS responders to the hospitals,” Bartram said. “We recognize EMS is in a unique position as it relates to cyberincidents because they are right between dispatch and the hospital, and if either of those entities experiences a cyberincident, it could very well impact EMS response in patient care.”

Meanwhile, when it comes to protecting 9-1-1 services against hackers and malware, Bartram advised these agencies to base their policies on best practices to ensure the prompt detection of such attacks and the most appropriate responses to them. She also urged “all the agencies involved to have a plan for recovery in place.”

To learn more about NEMSAC’s work in the field of EMS advocacy and upcoming meetings, go to www.ems.gov/nemsac.html.

James Careless is a freelance writer and frequent contributor to EMS World.