Rep. Miller highlights EMS services in Ways and Means Committee Hearing

Washington D.C. – Yesterday, Congresswoman Carol Miller (R-WV) brought attention to the critical need for Emergency Medical Services (EMS) for patients in rural America.

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Congresswoman Miller began by highlightinghow critical EMS isin West Virginiawhere patients often face barriers to transportation.

"I represent rural West Virginia and a third of our committee represents rural areas.We care a lot about access to care and one of the major barriers patients face in accessing healthcare, particularly where I am, is transportation. It's important that we get to our providers and this is what makes medical emergency services crucial to patients in my home."

Congresswoman Miller asked Dr. Edward Racht, Chief Medical Officer of Global Medical Response, on what specific challenges he and his team face when dealing with medical transportation in remote areas of the United States.
 
“Dr. Racht, you’ve been around rural emergency medical response for over 30 years. Can you speak to some of the unique challenges your team faces in triaging medical responses in remote areas of the country?” asked Congresswoman Miller.

"It sounds counterintuitive, but those critically ill and injured patients often need to go a little bit further to get the specialized care that will give them the outcome that's most important. Often the longest journeys you will ever have with a critically ill or injured patient without additional help, where you’re maintaining them to definitive care. The challenge of access, the patient's physiology and anatomy still going through the sameprocesses. So, based on where you are, what's the most appropriate facility to take that patient to? It’s not the closest facility,” responded Dr. Racht. 
 
Congresswoman Miller proceeded to explain how the Treat-in-place model would not only help save time, but also impact patients' health.She asked Matt Zavadsky, Chief Transformation Officer, Medstar Mobile Healthcare, why he believed that the treat-in-place model would be beneficial for EMS services in rural areas. 

"One model that I really think can help in some of these rural EMS challenges is the treat-in-place model. The treat-in-place model allows EMS providers to triage and treat patients when an ambulance does arrive on the scene, or to bring them to the lower-acuity facilities outside of hospitals and emergency rooms for treatment.”
 
“Mr. Zavadsky, I understand from your testimony that you are a longtime advocate for treat-in-place. Can you explain why this model of care for EMS services is so impactful in rural communities?” asked Congresswoman Miller. 

In many cases when a rural hospital or a critical access hospital is not available, EMS becomes the default healthcare provider and they're doing everything to transport patients to the most appropriate clinical care facility, and that takes the ambulance out of service. Often times that patient can be very effectively treated in place with perhaps a telemedicine connection, so the ambulance doesn't have to take the patient three or four hours away. It's more convenient for the patient, and it saves a ton of money and getting that patient not having to go to that high, expensive medical care facility. West Virginia state legislature passed a law that allows the EMS to be reimbursed for treatment in place services, and that has revolutionized the protocols and procedures that can be put in place with those providers in West Virginia, like Jan-Care and others to really improve, not only the medical care but the availability of resources in those communities,” responded Mr. Zavadsky. 
 
Congresswoman Miller concluded by asking Mr. Zavadsky about howmountainous terrainandweather playa role in medical response time. 
 
“Could you talk about the mountainous terrain exception? Congresswoman Miller asked. 

“Because of the geography, we need to make sure that legislation and reimbursement policy takes into account those nuances that you’ve heard all of us talk about because healthcare and specifically emergency services are very unpredictable and very fragile right now,” responded Mr. Zavadsky.