How can technology help to address the paramedic shortage?

Author: Rachel Engel

The U.S. is facing a paramedic shortage, as agencies nationwide report low EMS recruitment and retention, with a 100% turnover rate in EMS providers every four years, according to a survey by the American Ambulance Association (AAA), an EMS advocacy group.

In 2021, the AAA sent a letter addressed to congressional leaders describing the current paramedic shortage as "crippling" and outlining its impact on communities. The advocacy group acknowledged that EMS recruitment challenges go back longer than a decade and pointed to the recent COVID-19 pandemic as having exacerbated the issue.

"The challenge is to make sure that the paramedics and EMTs of the future know that EMS is a rewarding destination," the letter read.

As agencies grapple with the EMS shortage and attempt to limit the impact on their communities, technology advancements offer a way to help public safety organizations across the country.

Aggravating factors to EMS recruitment and retention

The paramedic shortage and downturn in EMS recruitment in the U.S. is a widespread problem. According to JEMs, “Across the country, local emergency medical services operations are increasingly challenged to staff ambulances, leading to excessive wait times for patients in potentially life-threatening situations.”

On-time response rates are declining as agencies find it more and more difficult to adequately staff ambulances across shifts. Identifying the factors that are contributing to the EMS shortage is key to rectifying the problem.

EMS pay

The mean salary for paramedics and EMTs in the U.S. was $49,500 in 2021, according to the most recent figures from the Bureau of Labor Statistics, though the amount can vary greatly depending on location. This is below the national average wage index, which for 2021 was $60,575.07 according to the Social Security Administration.

Mental health considerations

First responders are 10% more likely than the average population to be diagnosed with acute stress disorder or post-traumatic stress disorder (PTSD).  EMS providers are typically the first to arrive on scene, which can mean dangerous, high-pressure and exhausting conditions which puts EMTs or paramedics at a high risk of developing depression and anxiety or PTSD. In addition, EMS providers will likely be exposed to traumatic incidents multiple times over the course of a single 24-hour shift, with little time in between to reflect on what they witnessed.

According to the 2022 EMS Trend Report, 37% of survey respondents report symptoms of burnout, with 69% of respondents saying they plan to leave their current employer within the next four years.

Offloading times

Long offload times at hospitals have further exacerbated the paramedic shortage, with 67% of NAEMT survey respondents reporting increased offloading times at hospital emergency departments in April 2021, reducing the number of ambulances and personnel available to answer subsequent 911 calls.

Non-emergency workload

Another major challenge for paramedics is the large number of non-emergency calls they receive. According to the Centers for Disease Control and Prevention, there are more than 130 million annual patient visits to emergency departments nationwide, yet only 14.2% result in hospital admission. Responding to non-emergent calls places increased burdens on the EMS system.

Per CBSnews.com, “AMR, the nation's largest private ambulance provider, announced its ending non-emergency transport in Los Angeles County. The company cites low Medicaid reimbursement as a major reason for a $3.5 million budget deficit in that market alone.”

Per the announcement on AMR’s website, “California has not increased Medi-Cal reimbursement for private ambulance operators since the late 1990s. The current Medi-Cal base rate for private ambulance services sits just above $100, which is far below our cost of providing the transport.”

Leveraging technology amid the paramedic shortage

 

1. Enhancing situational awareness

Improving situational awareness can be a force mulitplier for first responders - helping EMS better deploy and prepare with more accurate and timely information. This can help teams achieve better results with fewer staff and resources. For example, reducing 911 response times by one minute could save as manas as 10,000 lives every year. 

Mounted cameras and drones can provide useful information to first responders. However, hundreds of video feeds and data points can be time-consuming to view.  Artificial intelligence (AI) can help by providing the tools to effectively integrate and analyze the data, and bring it into a unified view that can be shared across agencies. Interoperability is critical to ensure data silos on disparate systems don't hinder responses by limiting access to mission-critical information. A real-time response system can help provide paramedics and other public safety agencies with an accurate, consolidated, near-real-time view of not only emergencies but day-to-day operations.  This can help with inter-agency collaboration, enhancing situational awareness and helping to improve decision-making.


2. Improving operpations and data analysis

Another way to help counter limited resources amidst the paramedic shortage is to enhance the effectiveness of existing operations. According to EMS World, “New cloud-based systems can take in data and make it available to scheduling supervisors instantly.”  Additionally, expanding data-analysis capabilities can help teams recognize potential issues, provide better coordination and schedule responders more effectively.  

According to JEMs, “Patient movement data is central to this strategy. When EMS administrators have the data necessary to analyze and predict patient volumes, acuity, location, and demand peaks, they will be better equipped to appropriately match resources to service area needs.”

Integrating large amounts of data from multiple sources, including video sensors, wearable devices, record management systems, computer-aided dispatch and third-party databases can be enhanced by the power of 5G. 

According to EMS1, updated pre-hospital solutions are needed as software can be outdated, can lack customization or fail to meet the specific needs of individual teams and their available resources. More advanced, adaptable, and user-friendly tools are critical to reducing the burden on existing team members and making onboarding new ones an easier process, the article continues to explain. 

Traditional EMS workflows often follow standardized protocols. Pre-hospital solutions can help to automate some of this process, helping to improve both patient and paramedic experience.

Cloud-based technology and managed services from a trusted provider can allow agencies to scale up and down based on their current resourcing requirements. This can help to reduce costs by ensuring organizations only pay for what they need while also giving staff access to updated technology. These types of solutions can help both EMS teams and patients.


3. Improve training

A 2022 American Ambulance Association study of employee turnover found that 39% of part-time EMT and 55% of part-time paramedic positions went unfilled because of a lack of qualified candidates. Technology can help to train new recruits faster and provide existing staff with access to a greater range of training.  Reducing the need to travel can lower costs, expand the pool of who can attend and reduce the need for understaffed teams to have to find coverage while EMTs attend training, and encourages a better work/life balance.

The higher speed and lower latency of 5G allows for multi-participant online interactive training, including video and simulations, which can be accessed whether paramedics are at home, at an office or even on their rig between calls. 5G also powers virtual reality (VR) and augmented reality (AR).

AR and VR can provide realistic immersive training, preparing first responders for high-stress emergency situations. This training can track the progress of individual participants, allowing trainees to access extra help when needed. VR systems can replace costly simulators and help paramedics upskill—which can improve both their personal earning potential and the quality of healthcare provided in their community.


4. Enable alternatives for non-emergency care

Another option is to invest in technology that can help to reduce the need for paramedics to respond in person to non-emergency situations. 

One example is to treat patients in place through the use of mobile healthcare options as part of a community paramedicine (CP) program. Agencies with CP programs can save money and improve health outcomes for community members. One CP pilot program in Massachusetts reportedly saved $6 million in one year by leveraging treat-in-place procedures. Other at-home services use technology to provide a virtual triage, followed by treatment for common and complex injuries and illnesses directly in the patient’s home.

Telehealth solutions can assist with reducing the burden of non-emergency calls. An easy-to-use, healthcare-centric platform combined with tools such as AI-enhanced chatbots can make it easier for patients to be assessed remotely and instructed on the most appropriate setting to receive care.

Addressing the EMS shortage with enterprise intelligence

Finding a long-term solution for the paramedic shortage will require more than technology, yet the benefits for EMS agencies of an enhanced, data-driven view of their operations can help them to identify how to do more with fewer resources. Verizon can help to make your organization smarter and more connected, giving you the Enterprise Intelligence needed to adapt in near-real time and respond with agility.  With the power and bandwidth that 5G can provide, first responders can have near real-time situational awareness and be better equipped for crisis response.

Learn how Verizon Frontline, the advanced network for first responders on the front lines, is prioritizing reliable connectivity for public safety operations across the country.

The author of this content is a paid contributor for Verizon.