Interview with Jonathan Sell of Booker EMS

Jonathan Sell of Booker EMS and Fire Department was elected to TEMSA’s Board of Directors in August 2015. He has been involved with his EMS and Fire for the last 11 years. Jonathan began as a volunteer in his hometown with Booker EMS and Fire Department in 2004 as an EMT. In 2010 Booker EMS was separated from the City of Booker/BFD and became part of the Booker Hospital District. BHD hired Jonathan to be the first paid staff member/EMS Director, and has been in that role ever since. Booker EMS is currently staffed by 18 EMTs and Paramedics and operates 3 MICU ambulances providing 911 and interfacility transport. It also operates both auto extrication and off road rescue units.

Jonathan holds a Bachelors Degree in Business Administration majoring in Accounting from Oklahoma Panhandle State University and is a Licensed Paramedic and Advanced Coordinator in Texas. He is Nationally Registered and holds additional certificates in Critical Care Transport and Tactical Medicine. In December of 2014, Jonathan started a consulting company called Innovative Solutions Management (ISM) which has both EMS and non-EMS clients. He resigned from the Booker Fire Department in March of 2015 with the rank of Captain and Training Officer in order to focus more of his time on ISM and its clients. He is currently a member of the Board of Directors for RAC A and serves as a member of the National EMS Management Association (NEMSMA), which is where he is participating in the NEMSMA Program & Education Committee. It is focused on creating guidelines for the education of EMS management (supervisors, managers, and executives) prior to credentialing of those levels).

The following is a Q&A that TEMSA recently conducted with Jonathan Sell.

TEMSA: Why did you want to get involved with TEMSA as a board member?

Jonathan Sell: I wanted to get involved with TEMSA because I believe TEMSA provides an excellent opportunity for EMS services in Texas to have a better standing in multiple areas including legislative lobby and information dissemination, networking, and sharing of ideas relevant to EMS in our state. I think it is critical that small rural services have a voice in this organization, and that is why I wanted to be involved.

TEMSA: We have witnessed a rapid transformation of the entire health care industry over the past few years due to a number of reasons, including the Affordable Care Act, industry consolidation, and declining commercial insurance reimbursement rates. How do you see the Texas EMS industry fitting into this changing environment?

JS: My system has gone through a complete transformation over the last 5 years from an all volunteer service, to a paid service. Our goals, challenges, and oppertunities have drastically changed, and I believe they will continue change in the future. Changes in the healthcare industry create both challenges and opportunities.

The Affordable Care Act and its design shifting away from fee for service has and will create a major void in EMS services and our funding model. The ongoing shrinking of medical technology also provides drastic new opportunities and challenges for us.

TEMSA: You operate an EMS system in a rural community. What types of challenges are you witnessing in the rural area?

JS: My service is not experiencing most of the rural struggles that I see most of our neighbors facing because of our vision over the last five years and our support from our community. The services around us are facing a waning support from their communities, lack of volunteers, lack of educational opportunities, which results in staffing shortages and other issues.

My service’s main challenges stem from our desire to provide additional access to healthcare that is not restricted to transport to an emergency department. This is our goal for a community paramedicine program over the next two years. Additional technology and the training/education it requires is the second major area of challenge for our service. We implemented I Stats into our units last year to provide blood labs (Chem panel, ABG, and Troponin) in order to better serve our patients, and we plan to add ultrasound in the upcoming year.

TEMSA: What do you think your EMS program will look like in five years?

JS: I don’t think we will be called an EMS. I think we will be a Paramedical Service that has an Emergency Medicine and Transport service (EMS Model) and a primary health care model in conjunction with a clinic or a primary care physician providing house calls and clinic care.

I think the addition of technology such as the I Stat and portable Ultrasound machines combined with the continuing shortage of primary care physicians and mid level practitioners will provide ample opportunity for this conversion of our service and will allow us to provide better health care to our community all in a value based system.