In a number of emails I have been asked for an outline or “thesis” about what EMS 2.0 is. There was talk awhile back about a national EMS 2.0 organization to begin lobbying for the changes we all want to see. Others asked me for my suggested education requirements and how I expected a volunteer Paramedic already working two jobs to go back to school to keep doing what they want to do.

I have no answers to those questions.

Sometimes when asked I reply that I have all the answers, I just haven’t sorted out what questions they go to yet.

I used the phrase EMS 2.0, and I think Mr Chris Kaiser did as well, because it brings up the image of a reboot, or upgrade.
Many of the Windows 7 features I got are neat, but most of it is based on the same things I liked about Windows 3.1, sure it is full of random errors and can be frustrating, but the system is slowly updating itself.

A few years ago I had had it with my operating system and all the limitations I saw in it and jumped into Linux.
I was under the impression I was savvy enough to make code changes to effect the entire operating capacity of the system. And since I had only a basic understanding of the features I so desperately wanted, I was unable to have the comfortable computing experience I expected. The adventure ended months later with a partitioned hard drive and having to choose an operating system each time it started. Drove me nuts. But those who know how to make it work love it and it works fine.

So when I speak of EMS 2.0, I am indeed aware of the pros and cons of an “upgrade.”

Another list of questions I get is about the comparison to Web 2.0, the movement that led to the communities and user submitted content we call the internet today. I recall the early days of FTP file searching by tree late into the night in college, having the entire internet text based as a few html sites began to sprout up. I compare searching roots and file trees then and the “Web 2.0″ experience we have now and realize that it is the inter-activity of the internet that has made it a community rather than just a marketplace.

There is an element there I can identify with when it comes to EMS. One of the Medical Directors who came by the booth in Baltimore asked me how he could use blogs to get his Paramedics to accept changing their protocols. I told him he should listen to what the patients his Paramedics encounter need and let that guide protocol changes. Then I asked if his medics had any way of approaching him about changes and he looked as if no one had ever suggested a medic could ever suggest a policy change, let alone present evidence in support.
“An open door and an honest opinion goes a long way in folks feeling like you care about what they’re doing,” I told him.
“No, I need them to do what I say.” he replied and I couldn’t speak against that because I am not an MD, nor in his system, understanding his troubles and challenges.

So where does this all fit into the EMS 2.0 landscape?

I dunno.

We need change, we need a new re-thinking of EMS, what it is, what we’re doing and why, how, where, everything needs to be re-examined and reformed based on new research, response models, patient presentations and care taker abilities.
How that can happen on a National level all at once is something I would love to see happen, but we all know here are far too many feifdoms, unions, politicians, companies and providers who will fight tooth and nail to maintain the status quo, regardless of the benefits.
There are those who will not move forward no matter what they are shown or told. And not all of them are the old salt medics. Some of the new kids on the EMS block feel they have made it and will just sleep through their refresher every two years and keep drawing the pay check.
Departments will fight to keep licensing requirements low so as not to have to pay their people to seek out education, possibly because the higher educated can draw a premium at the next service over.

From my lofty perch here with my education and high paying EMS job you may think me a dreamer with all this CoEMS and EMS 2.0 talk and you’d be right.
But the Chronicles was a dream a year ago and now we’re set to travel the world doing exactly what we want to do, explore what EMS means.
So I’m going to keep dreaming about EMS 2.0 and hope one day I can meet a crew from a department somewhere who both have an advanced education and operate under protocols or guidelines that give them the flexibility to treat, transport or transfer citizens, clients and patients based on what they need, not what they or some future lawsuit want.
I think we can all agree on that.

But how do we get there? We all get there in different ways at different times, hence the trouble in explaining EMS 2.0 to people at different levels of different systems.

There can’t really be an EMS 2.0 “thesis” or guide, but more of a mission statement, and that I am thinking about.
So far three main principles come to mind and how to expand on them will be up to you. They will certainly mean different things to different people, and that is one of the things I love about it.

My EMS 2.0 is based on three main concepts.
Technology
Teaching
Trust

Using technology to improve our ability to assess and treat,
Advancing our educational levels to not only learn more about our patients and communities, but teach them what we can and can’t do.
We have to earn the trust of those who give us the power to do what we do in order to do more.

In short I need some expensive gear, a pricey college education and then let me go do what I’ve learned and proven competent to do. Exactly what that is will depend on your community.

The future is coming and we as a Profession have a chance to not only make ourselves a respected part of the health care system, but excel in providing care in an innovative manner that can release the burdens the current system is collapsing under.

It is a dream. But it had to start somewhere and if that is all it is for now, I’ll take it, but something is happening out there and I want to be ready if my Chief asks my, “What do you think we should do?”

What are the three concepts your EMS 2.0 platform would fight for? Let me know.

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