EMS: In the Year 2050 …

Back in 1969, when I was just a youngster, two musicians by the name of Zager and Evans penned a song called, “In the Year 2525.” The song hit number one on the Billboard Hot 100 six weeks in a row. The lyrics start with, “In the year 2525, if man is still alive, if woman can survive, they may find ….” The song then escalates and theorizes about the years 3535, 4545, 5555, all the way up to what the year 10,000 will look like. Each stanza, including the first, is nothing but a theory of what the future holds.

Hard to imagine                 

I could not help but think about this song when I started reading the draft document of the EMS Agenda for 2050. For two years, an expert panel has been working on the document that will set the agenda for how EMS delivery should look by 2050.       

I don’t envy the panel. Sometimes I cannot even tell you what I may have for dinner tonight, let alone what something will be like 32 years from now. Things change so rapidly, and there are things that we can’t possibly know now that will exist in the future. After all, if you look back 20 years ago, we did not have social media sites, like Facebook and Twitter; iPhones, iPods and the other “i” products; drones; shared ride vehicles, like Uber and Lyft.     

Since I started my career, I’ve seen all kinds of advances, including hands-free defibrillation, pacing, nebulizers, stairchairs, mechanical CPR devices, motorized stretchers, CPAP, pulse oximetry, and intraosseous infusion, to name a few. Who knows what technology will be available to EMS in the next 10, 20 or 30 years.

The panel—which is funded by the National Highway Traffic Safety Administration (NHTSA) Office of EMS and a variety of other federal agencies—is an attempt to mimic a similar program in 1996 called the “EMS Agenda for the Future.” The “EMS Agenda for the Future” and the “EMS Agenda 2050” are guiding principles for what EMS should look like in the future.

In the case of the “EMS Agenda 2050,” there are some very generic statements that everyone can agree on. Some of those include that EMS systems should be people-centered, inherently safe and effective, reliable and prepared, socially equitable, adaptable and innovative, sustainable and efficient, and integrated and seamless.

In the draft document, each one of these guiding principles has further explanation. Some seem pretty straight-forward while others raise concerns for me. For example, the document describes providing the same level of EMS in a “socially equitable system regardless of age, socioeconomic status, gender, ethnicity, whether they will in a rural or urban community or other social determinants.” I am not sure how a system like this will be paid for when you clearly cannot provide the same level of care in a rural community versus an urban community. Money will always drive a system. As they say, you can have your EMS system fast, cheap or good—pick two.

There is no doubt that we already provide care to anyone who calls 9-1-1 without asking them for a credit card or bank account number. You can’t get more socially equitable than that. The question is, how do we continue to fund EMS systems when most EMS systems do not have the money or the reimbursement they need now to operate?

Another area of concern is that the word “education” appears repeatedly throughout the document. If the goal is to raise the education level to a four-year degree for anyone providing EMS, this will have a negative impact on the fire service, particularly considering all the specialized training already required to be a firefighter, such as hazmat and technical rescue. Of course, there are some in EMS who think that four-year degrees will mean more pay and respect for the EMS profession.

Time will tell

In the year 2050, I will be 92 years old. If I am blessed to still be around, I will enjoy reading my copy of Firehouse Magazine to see whether the future EMS columnist thinks the EMS Agenda 2050 hit its mark.