James Campbell of Montgomery County Hospital District

James Campbell speaking at EMS EVOLUTION 2019.

James Campbell is the Chief of EMS for the Montgomery County Hospital District. TEMSA recently sat down with James to get his thoughts on the future of EMS in Texas.

Click here for the video interview.

TEMSA: How have you witnessed the EMS industry evolve over the past few years?   

James Campbell: Clinical innovation has continued to be impressive over the past few years.  In our state specifically, with delegated practices, EMS agencies can implement new treatments and measure their impact outside of the hospital. Some of the clinical innovations that have been impactful include: blood products, simple thoracostomy, increased ketamine use, video laryngoscopes, IV nitrates for CHF, hyperkalemia management,  cardiac monitor transmission capabilities, Pit-Crew CPR, better data capturing and reporting capabilities, community paramedic programs, and the use of tourniquets, to name a few.

Ambulance safety has evolved over the past few years as well.  Ambulance safety standards are improving, which has improved patient and provider safety.

Active shooter situations have increased, and more agencies have implemented ballistic vests to protect their providers.

Smart911 and other advancements in technology have improved our abilities to locate 9-1-1 callers.  Also, hands-only CPR and early bystander CPR have been strong public initiatives that have impacted EMS.

Reimbursement continues to be a focus at the national level.  Our current reimbursement rates versus what future reimbursement will look like as it incorporates quality and alternative models (i.e., Medicare’s ET3 program).

Provider safety is continuing to evolve.  I think about three things for EMS providers: physical health, mental health, and our equipment.  Conversations are continuing to gain momentum regarding fatigue, health, mental health, safer equipment, and career longevity.  When looking at the people-centered model of the EMS Agenda 2050 project, ensuring our providers are cared for so that they can adequately be prepared to care for patients will continue to be the focus.

The standards for paramedic education have been discussed at state and national levels.  What will be the standard for paramedic education as we move forward, and how will that impact staffing, scope of practice, and wages?

TEMSA: Where do you see EMS in Texas in 10 years? 

James Campbell: I believe the next ten years in EMS will help shape the long-term future of EMS.  I think we will have creative plans to mitigate fatigue, manage short term and long-term provider health (physically and mentally), and perhaps have a different model for how we operate as a profession.  Medicare’s ET3 project has the potential to have long-term clinical, operational, and financial impacts on how EMS operates in our communities.

From an emergency management standpoint, Texas has worked to develop a model that has had a proven track record for success. As our model continues to be refined, this could become a template that other state emergency management programs duplicate.

With the amount of data and data sharing that is taking place, regionalizing out-of-hospital care in conjunction with our hospital partners will improve the healthcare system.

I’m not certain how it is going to happen, but in the next ten years, I’m optimistic that we will have viable solutions for EMS care in the rural parts of Texas (i.e., west Texas).

I’m hopeful that we will have long term viable solutions for transporting patients with mental illness to destinations that are specialized for their healthcare needs.  As the population in Texas continues to increase, EMS call volume will rise. Therefore, alternative transportation destination will be important for specialized care.

Community paramedic programs will be further integrated into the communities they serve and will hopefully become strong stakeholders in transitional care.

I do think in the next ten years EMS education, especially at the paramedic level, will transition into an associate degree.  This will result in two years to obtain the paramedic licensure, and upon completion of the program, students will have earned an associate degree.

TEMSA: Tell us about your lightning round topic at EMS EVOLUTION 2019. (Click here for a link to the PowerPoint.)

James Campbell: At the Montgomery County Hospital District we wanted to improve our overall customer service abilities, which led us to improving our internal Service Inquiry process.  As with many organizations, we receive phone calls about missing items (i.e., driver’s licenses, keys, etc.), potential negative patient interactions, and questions from other stakeholders regarding the services that we provide.

We improved our process with better tracking and reporting tools so that we could evaluate the amount of effort we are putting into investigating these inquiries.  With a defined workflow procedure we could ensure we were communicating with our customers regularly and providing confident feedback regarding their inquiries.  Our abilities to track and report our findings have allowed for quality process improvement procedures to be implemented internally.

TEMSA: Why do you think it’s important to have an organization like the Texas EMS Alliance?

James Campbell: In one word: unity.  The old saying, “If you’ve seen one EMS agency, you’ve seen one EMS agency” is something that we are all familiar with.  The Texas EMS Alliance is working to create unity between our agencies in the state.  EMS can be fragmented and individualized, which can make change and advocacy difficult at the state and national level.  This organization provides an avenue for our profession to collaborate while simultaneously building a unified voice for EMS in the state of Texas and beyond.  Change (or even maintaining) can be challenging, but doing it alone is much more difficult.  The Texas EMS Alliance is working to build a network that provides EMS leaders with the ability to be informed and the strength to have a voice.