Good afternoon, everybody. It’s Stephen Hartz with another session, the H and H Impact, our podcast that talks about health care. And today we’re going to dive into a new topic.

We’re going to talk about ems. I have a couple guests with us today, Todd Sheridan and Fred Wurster. We’re going to get an opportunity to meet them and, and learn about their expertise.

And our goal today is to kind of talk a little bit about some things that we have going on. You know, H and H Leadership Solutions has always been about health care and a rural health care environment. And recently we started a new company called H and H EMS Solutions.

And within that, the big thing is that we’ve taken over. Taken over is a very strong word, but we’re the managing partner for nemsma, the National EMS Management Association. And just recently we’re proud to announce that we are taking over as the managing firm for NEMsqua, which is National EMS Quality Assurance.

Great to be a part of those organizations. But before we get too far down the path, I’m going to go ahead and I’m going to have Fred and Todd introduce themselves. I’ll go ahead and start with you, Todd, Go ahead and introduce yourself.

Thanks, Stephen. Great for you bringing us on this, this podcast today and we really appreciate everything y’ all are doing. So, Todd Sheridan, been in EMS now for almost 25 years, I think here recently I had to check that box at the my naemsp, right.

Or in, in the emtp, right. The checkbox there to say, hey, look, you’ve been here this long, but been in the industry in a variety of different roles, everything from consulting management to even working in high performance EMS such as Richmond Ambulance Authority. So great to be here, Steven.

Look forward to the conversation today. Thanks, Todd. We’re looking forward to talking to you.

And we’ll pass it over to Fred. Fred, go ahead and introduce yourself. Hey, good morning everybody.

Thanks Stephen, for again the invite. Super excited to be here and just talk ems, something I’m truly passionate about. But much like Todd grew up in the fire service and transitioned over to ems.

Served with Todd actually as his EMS chief for a large health system in Southeastern Pennsylvania and did some consulting work as well, but really have spent a lot of my time in the education space and clinical as well. So super excited to be here. Thanks, Steven.

Awesome. Thank you guys. You know what’s interesting is we’re going to level set first with just ems.

What is emergency medical services. I think there’s confusion with some people about ems. They Think it’s a right.

And in some locations it is. You know, it’s a tax based, paid for service. In some locations they have paid for service.

Some locations it’s part of a hospital system and there’s just so many different systems. If I asked you, Todd, to kind of give me an overview of just EMS in the United States, can you give me a quick understanding of what EMS in the United States looks like? I’ll tell you. EMS in United States is to just say, frankly, isn’t evolving, is an evolving industry.

That’s the best way to describe it. I’ll, I’ll start it there. I think the evolution or how it’s evolving is really becoming fascinating if you just think of the history of us, right? You know, everything back to funeral homes, picking people up, then evolving into oxygen, then going into, you know, all of a sudden becoming a transport, transporting entity, you know, and now being that we’ve gone from just being a transporting service to doesn’t matter if you’re public, private, a part of health
care, part of, you know, a fire department, you’re going from just this transport mode to also treating folks at home, you know, your mobile integrated health community, paramedicine.

You look beyond our borders and you see paramedics actually doing more advanced, more advanced treatments outside of just what we would call the emergency, emergency services, emergency industry. So EMS in short, right now is, is predominantly transport again across all the different Factors. Health care, EMS or healthcare, 911 emergency, public, private, fire department based, all of them essentially doing the same thing with a little bit of twist depending on where you’re at.

However, that evolution is coming quick into really being that health practitioner in the community. Yeah, that’s kind of where I would, I would describe it at in its in itself, in this totality today. That’s really good.

You know, when I look at it, I remember when I became an EMT back in 92 in the Fairfax county system, right. You came in and you were not only an emt, you were typically also a firefighter. You go to Firefighter 1 and 2, you go to EMT and you’re able to do both.

We go to other locations. I think of our partners up in Connecticut that we’re working with and you know, they have a very defined EMS agency within the city of New Britain that covers 13 square miles. And then they have their own separate entity which is the fire department.

One is a not for profit, that pays for itself and the other is a city run, a municipality run agency, the fire department and it is, it can get really confusing because states are all different. Requirements are all different based on the state you go to. And I think that’s unique.

You know, Fred, what is your experience and your thoughts on EMS in the United States? You know, I think one thing and Steven, just with you talking about New Britain for a second, really I go to the point of. And it’s, it’s, it’s really becoming big. Is the essential service piece of EMS and is EMS throughout, you know, the United States, is it an essential service? And the numbers vary a little bit, but about 17 ish of the states in the United States have, have deemed EMS an essential service.

Much like the postal service, the police department, fire department. Many of those other states have not have failed legislation. We just saw New York just had that not too long ago, attempted to pass EMS’s essential service.

Did not get through. We’re seeing that out in the, the Midwest as well. Where now, counties, Iowa for example, they’re actually allowing the counties to decide whether or not EMS is an essential service so that they can figure out how to best provide.

Because the flip side of that is that we’re seeing now this new term called ambulance deserts. So we’re seeing areas that are just significantly impacted from a lapse of funding, inability to provide, a decrease in staffing, recruitment, retention, all those things. So now we’re seeing agencies not being able to survive.

And we’re seeing, you know, sometimes hour, two hours, three hours till people can, can get access to ems. Todd and I worked in the far south and there was a area that we worked in where days for an ambulance to show up and sometime ambulances didn’t show up at all. And then you, you know, you’ve got ambulances posted on street corners all over the place.

So it’s, it’s very diverse, you know, just geographically, socioeconomically, financially. We just see this, this really interesting conglomeration of, of EMS and, and how it, how it functions and it’s, it’s different everywhere you go. I, you know, in my experience with it as well, you know, with as when H and H kind of got into the healthcare aspect of it, we started getting in majority in the rural environments.

And you would see most rural hospitals had an EMS agency assigned to them or they owned it and you know, they were struggling to figure out how they’d pay for EMS1 as an essential service. Some of them get tax living money. They have an EMS levy that’ll go out to the organizations I think of like Leavenworth, Washington is an Example of that the hospital owns the EMS agency and then they get a tax levy to help subsidize to a degree.

And then you look at like Fairfax county where everything’s paid for by taxes. It’s definitely considered an essential service in like Fairfax, Arlington, Alexandria where I’m living. But those challenges are real.

You find like a community that can’t find a paramedic. So they go from advanced life support ALS to a BLS system. And then the BLS really just becomes a transport trying to do their very best.

You know, a lot of the rural communities are trying to do tele ems. So hey, we are a BLS agency, but we’ve gotten a higher level of authority because now we can tell in a doc who can tell us check for this, check for this, check for this and be able to provide a higher level of care. But you know, I think the same issues that you’re seeing on EMS are similar to what we see in hospitals.

There’s staffing challenges, there’s resource challenges and then there’s a little bit of parochialism. You know what I noticed in some of the places that we go to, you’ll have fire wants to take over EMS because they want to have the whole nugget of resources, the dollars. You’ll find that kind of going back and forth if you have the for profit systems or other transport systems within a community that are trying to take the business while they also have their municipalities.

And so it’s just a lot of uniqueness, I would say in the ems. And it’s not, I can’t say it’s standardized. I can’t say that I’ve been to one organization that is just like everywhere else.

But I think that’s really unique. You know, when I think about some of the biggest challenges that you guys see facing EMS coming in the coming years, know. I’ll start with you Fred.

What would you think are some of the biggest challenges facing EMS? You know, 26, let’s say 26 through 2030. You know, if you had a, a Project 2030 EMS model, right. I think there’s probably three big things and I think it all comes down to, to capital, right? It comes down to your human capital, those being right, the individuals in your organization, how can you retain them? Are you doing a good job at, at keeping them engaged, paying them adequately, allowing them to have good work, life
balance, employee wealth and our health and wellness and those, those items.

Then I think it comes down to, right, the financial capital of, is the money. There are you are you being good stewards of the money, Are you recuperating the money that, that you need to. Are you doing a good job of recuperating? That revenue cycle management is absolutely huge in today’s EMS industry.

And I mean, you know, if you think about leaving a couple pennies on the table for every, every, you know, billable call that’s done, that insurance could be paying, those couple pennies add up pretty quickly. I think, you know, the last capital piece really comes down to investing in the, the capital around you, right, of your municipal leaders, your elected officials and having, I think the word partnership really comes to mind that, right? Being good partners, being good strategic partners,
being good operational partners, being good financial partners, but really partnering, walking alongside of. Shoulder to shoulder with your, with your, you know, your local municipal elected officials, your state elected officials and, you know, hospital officials, those things.

I think those three capital items really, really come into play for me. And looking at like a Project 2030, that’s awesome. That’s a great recap, Fred.

I appreciate that. Todd, I’m going to ask you the same question, man. What do you think biggest challenges over the next four or five years for ems? So I’m just going to say this.

There are a couple of things that Fred said I would piggyback on. One, he talked about partnerships. I’m going to say partnerships and transparency.

And the reason why I’m going to say partnerships and transparency is I think one of the things that, that just inherently happened when we started with a lot of private entities that were working in municipal spaces, that the idea of sharing information, sharing data in real time was tough. So I think that that evolution of being able to only share data then to everyone, so it’s all transparent, but leaning into educating the community we’re in. What I’ll talk about in a minute is, as my third
point is, we’re in a change between clinical and quality and what we’re looked at and what we’re expected.

I think there’s gonna be an educating moment of just not you call, we hall. I think there’s gonna be a real big moment here of you call and we may get you a telemedicine appointment. You may through, through different levers, may go to an urgent care clinic.

You may, we may help you with an appointment, or we may refer you to a mobile integrated health nurse or paramedic, or we work you through the process over a said period of time. If it’s getting your medicine, getting food, helping you get connected like through patient navigation and let’s even say some not for profits to help you with some, you know, in home care that in home care or social economic challenges that you may be having. So I think that transparency and partnership is really going
to be an evolution because it’s going to stretch us past our normal work that we do.

I think that evolution point number two is, is going to be an evolution of workforce. And here’s what I mean by that. We Fred, Fred alluded to the fact of paying people, right.

Helping with the retention. I think he’s even coined a phrase here previously stay interviews, right? Those things that help people in the workforce want to stay a part of, want to help develop that culture is going to be key. Learning how to leverage each other like going through some assessment tools, right where we as a group start to come together, we understand how to partner with each other.

But the workforce changes are going to evolve in two different ways. I see as the evolution of understanding our workforce, meaning volunteerism into career municipalities and what they can do. Maybe you need to emerge as two municipalities or two different districts into one just to better service the community or deal with tax bases or revenue sources to just stay functioning.

I think that part of it from a, from a lead, from a, from that piece is going to be key. And then again I go back to the legislation that could be your local legislation getting involved in national legislations, initiatives, state, state initiatives. Because if we’re not at the table pushing that, then we’re not going to really be able to make any change.

And then third piece, I think what’s going to stretch a lot of leaders that have maybe had operational and financial lenses for so many years are going to be stretched. As we start to expand clinical services, really focus in on quality. There’s going to start being a key push as we start getting dabbling into and getting into these, these hospital at home, getting into some of this mobile integrated health.

What are those initiatives? How are they really servicing and then what are those KPIs associated? We look at hospitals today, they focus a lot on quality. We’d see, you know, nursing homes. I listened to a variety of different conversations on what, what their care, what their care quality metrics are.

And it’s pretty, it’s pretty extensive. And I think as we start to evolve into that side, we’re going to see that in the next four to five years. I, you know, you bring up some really good points.

I think a lot of this challenges are going to have to be addressed by legislation because you think about the home care products you mobile integrated health community paramedicine, you have to have a way to reimburse for that aspect of it. And not every insurance agency is willing to do it or knows how to do it. How do you have the data to support that? And I think that’s a huge piece of it.

I think of like we have a client up in Washington state is a great example. You know, they’ve been pushing hard on the mobile integrated health community paramedicine. You know, they have, on any given day they have two full time ambulance crews going.

So that’s typically four to six people, but they only average 2.1 calls a day. Right.

And so that’s a lot of sit time that they’re there. And so trying to figure out how can we maximize that time. Does that mean EMTs and paramedics working in the ED? You know, hey, enhancing your skills, maintaining that efficiency to leverage that because it’s hospital based.

The, the mobile integrated health community paramedicine. And you brought up a great point, is that integration with your partners. You know, when you go out there and we all have the frequent flyers, we’re all familiar with that, right? People that call you all the time.

I was actually telling my wife last night, we used to have this frequent flyer who would call us every Friday and Saturday night between the hours of 8 and 10 with chest pains. And we would go out there every Friday and Saturday night that I worked and the guys would tell me it would be like four times a month. And it was a 72 year old woman.

And my chief one time went on the call with us and he said, you know, I gotta ask, you know, you seem to always be fine once we get here. She’s like, well, you’re the only people that have come talk to me, you know, and you guys are coming and spending. And so that’s a very expensive use of it.

Validate, you need it. I mean that’s important. But that’s where that partnership could come in.

By helping to find those outside resources or when we go on site and we’ve been into organizations where there’s habitable space is not there, you know, issues with children. It’s. It is that whole partnership.

But those were some great points. I think one of the interesting one, and Fred talked about being a chief and I working together previously, we kind of naturally inherited a situation where there was a, I’m going to say a mobile integrated and community paramedic program wasn’t quite a formal. And back then when we were doing it wasn’t it wasn’t a formalized program per se, but what I found interesting was this was a hospital, hospital based EMS and they were partnering with some of their outside,
outside and surrounding community ambulance companies and they would, you know, have a couple paramedics and whatever and through the patient navigation process when they were discharged from the hospital, they were looking at fall risk, they were looking at some cardiac services, some stroke services and then these paramedics would go out into the community and maybe give lasings to somebody or maybe go help them and then they had a whole graduating process.

But one of my biggest learnings and partnerships there, and I never even thought about it previously, was what’s actually in the community that can support these people outside of ems. These are patients that have real risk, real problems, real bills they can’t pay. And there I had no idea that once we started getting connected into the hospital world, listening to patient navigation, talking to some of the case managers, they had a laundry list of here’s some not for profits that can help them
outside of these walls of the hospital or outside us ems.

So it was really interesting to learn from others and watch that program evolve for support. So you just talk about that Steven. There’s things we don’t know, but you talk about that one individual there.

Great that you all going out there and being able to be, you know, a shoulder for this person to lean on is wonderful. What happens if we could have four or five other people in the community that could really help bolster this person or keep them going or help really identify those deep seated interests. So I, I just tell you that story because I think there’s, there’s validity to we touch so many different people’s lives if it’s in their most emergent, critical setting, all the way to them
needing a shoulder and helping navigate through.

We have to help them navigate that continuing health care. And the more we get involved, the more we understand, the more we leverage our partners. I think is going to be key as we evolve through the next 5, 5 ish, 10 years or so now.

I absolutely agree and you know, it’s, it’s one of those challenges that you see in, in EMS is you know, the desire to do the right thing. But then how do you have the finances or resources to pay for it? You know, and it’s always that push and pull aspect of it because I, I will tell you, I’ve been to other countries, as I’m sure you guys have, you know that you go there and 91 1’s not an option or, you know, my wife is from Colombia and she had told me back in the day and even today you could
call for an ambulance, it could be an hour, two hours, three hours. They don’t have a ton of them.

There’s no design program that you would be faster going to the hospital by ordering a taxi than you would by ordering an ambulance, you know, and people I think oftentimes overlook the need or the value of it because it’s like, hey, I haven’t needed, I’ve never used it. But whenever there’s an emergency, whenever there’s a hurricane, a fire, you know, those things occur. And in rural America, where we do a lot of our business, I have a friend out in Oklahoma in the panhandle, and they pay for
insurance for life flight and they actually used it.

Their son had an issue where his arm got caught in a machine and ended up losing his arm. But they were able to call and they had a helicopter on site within 30 minutes and you know, quite frankly saved his life. But that’s not an option for everybody, you know.

But you know, I think, I think those are some great points. Ted or Todd? Ted. Todd.

You know, I wanted to talk a little bit about on the consulting side, you know, is H and H has transitioned to our new company, H and H EMS Solutions. And we opened up that service line and you know, a big reason we kind of got into that was a lot of our clients in the hospitals started asking for support with ems and it was cost based reimbursement, it’s training and education, it’s recruitment, all the same things that we see in healthcare. And then by getting into nemsma, which really focuses
on leadership, and then now nemsqa, which is really quality, I found that to be a huge piece of EMS that also is kind of disjointed.

You know, everybody has their versions of leadership or you know, what levels does leadership need to be taught at? And I thought that as we were getting into this it kind of just aligned and I’d love to hear your guys thoughts on it because I know a lot of consultants really focus on operations, right? They’re focused on operations and finance. And I think it all ties in. I think our approach is slightly different as we look at leadership and quality as the foundation.

And then from there you can build better operations, you can build financial. I’d love to hear your guys take on that. And I’ll start with you, Parade.

You know, interesting. I don’t know that I had previously thought about that until you just Kind of said that. But, you know, I think just like there’s.

Right. However many 25 different car manufacturers in the world. Right.

I think that if you apply that same mentality to EMS consulting, some may be great at data work and data validation. Right. Some may be great at operational assessments.

Right. Coming in and saying, you know, you average a call every 1.1 hours, you need 37.

265ambulances on shift. You know, you need all of these things. Then there’s, you know, some that really focus on being a solution for a leadership problem.

Right. Or providing coaching, executive level. I think that that’s one area that, you know, not to sidebar.

But one area that I don’t feel has really made its way well into EMS is executive coaching. Right. We do it.

It happens in the healthcare space all the time. I mean, I know my, my wife is a, you know, senior hospital executive and she had a leader, an executive coach for years. Not that she was bad at what she did, but it was there to help her, help her to be better and to find her strengths and weaknesses and be able to do all of those things.

And I think when you look at. I think that’s an untapped resource when it comes to consulting really is being that really helping leaders to be better leaders. Right.

And that comes through that, whether it’s the inverted triangle support system or whatever that that works out to be. But I think that’s. That’s a space that, that definitely has a need.

But I think again, there’s that opportunity to create a collaborative approach to what is needed when it comes to consulting. You brought up a great point, Fred. I think when you think about leadership, one of the things that we really liked about nismsmile when we were learning about them and partnering with them, is they developed their seven pillars of leadership.

And some of the great minds in ems, I think, really were involved in helping to develop that process. And it’s becoming standardized. Right.

It’s no longer just a theory, but, you know, people actually talk about it on a regular basis. So I appreciate your perspective. Todd, what are your thoughts? So I’m actually going to lean just a little bit differently.

And that is, I think I’d almost pose it as a question and answer the question is, listen to you say that it’s almost like, what is quality? And I’m going to pause there to say we always think about quality. Think about this widget does this, this treatment does this for the patient. Right.

So we, we typically lean into that side of the quality. But what we don’t think about sometimes is the quality of the culture we’re designing for, the quality of the individual that we’re training or the leadership quality in it amongst each person. You know, I. I think that’s interesting you bring up about coaching.

Right. I had that the first time, and I’ll never forget, I was as skeptical as sometimes when I’ve had maybe my own personal dog trainer on how we’re going to do something, right? I was so skeptical right out the gate. I mean, you’re thinking, hey, I’ve been in these positions before, I’ve done this and been successful.

And which didn’t realize is sometimes you just needed somebody to challenge you, help you think differently. And I think that part of the coaching aspect for me, the other part that I really, I really have to say for the coaching, I didn’t realize I didn’t know myself. And this is the other piece that got me was when you start talking about some of those assessment scores you go through, if it’s your strength score.

I mean, anybody who knows me knows that I feel like I’m probably the most extroverted person that you ever known. Okay, thanks, Fred. You had to actually laugh out loud there.

I appreciate that. Okay. But here you would think I’m the most extroverted person.

Well, when my scores came back, I was actually on the line of introvert and extrovert. And I found out that I actually, some people, they recharge going and sitting around others. Some people recharge in silence.

And I didn’t realize I recharged in silence just like an introvert does. I had no idea, I had no idea that these certain strengths that I had and certain weaknesses that I had, or you can say challenges, whatever, were actually some of my partner’s strengths. And then I started to realize how I could lean on my team members.

So I think it allowed me to grow from a quality aspect in what I do, what I produce, and as an individual to also be able to help build teams better. I think what you know, from a leadership aspect, looking at it as, hey, we’re going to bring this team together, great, but is it the right team? Do they have the ability to leverage each other in that leveraging of each other? Do we have. Does this allow for us to create the best culture for our organization? Are we going to know, hey, I need to
lean on Fred or lean on Steven or lean on somebody else during these situations? Because this may not be my.

My best moment. I give you my advice, but somebody else may this may be something that they’re stronger in because that leads into a couple different things. You know, Stephen, you’re talking about.

We were having our introductory call about doing this podcast, and one of the things you talked about was helping boards. And in that, in talking about helping, you know, board management, we talk about, you know, the culture at the executive level, but we also have to talk about the organizational level and some of the boards and being a part of them, helping set that strategic direction, doing some of those assessment and assessments, personal assessments, whatever it is, to help give them
guidance. So I think it all leans back to the simple idea of quality, quality and culture, quality in people and quality in organizations.

You know, great perspectives. And I’ll, I’ll dive in on two aspects of this one. Assessments.

I know assessments, right? I, I give a lot of assessments. We do assessments on people we recruit, on leadership development, on advisory. You know, the thing that I found interesting when I took my assessment is I always had an idea of who I was.

Like, I knew I was an extrovert. You know, I’m a, a high D type personality. My hair is always on fire.

You know, when they, when I went and took my, my Navy test and they’re like, hey, if you’re taking this pilot exam, think like, maverick. I’m like, well, that’s not hard because that’s what I’m going to be like, right? But what I, what I failed to recognize is how other people perceive me, right? So, like, not everybody’s my style, and people that aren’t may not perceive me in the great way that I perceive myself. You know, that I could come across as a little bit cocky, a little bit too, too
Chatty Cathy and, you know, too focused on getting from A to Z, but not thinking about all the empathy and the, the people side of it.

And all, I found that to be very interesting. And then the other was how our actions may change under stress, right? So we always are our best selves when we’re in a good mindset, but under varying degrees of stress, like, the worst sides of us will come out. And I, when I give this example in coaching, I say, for those of us who’ve ever been married, you know, know that that stress quotient can go up and, you know, we can be nasty, we say things we don’t mean or whatever it is, but most people
who’ve ever been married have been at that point.

You know, part of it is also because we know that hopefully the spouse will always forgive us and we can always get back to zero. But it’s. That’s the case that you deal with when you’re talking about those assessments and learning about yourself.

I thought that was a great point. The other side of it, you know, when you talk about quality, you know, what I found in EMS and many of the agencies that we’ve gone into in varying degrees, where in healthcare we’re really good at collecting data, right? We have dashboards, we have. Our EMRs are really good at collecting it.

I find a lot of EMS agencies, especially the rural facilities, don’t do a great job of collecting data. They don’t talk about what’s their time to get on station. You know, how many times did they do X, Y or Z? It’s just kind of like, yeah, we got called, we went and we came back, you know, and that aspect of the data, to be able to provide that understanding of quality is a huge deal, you know, because people, I feel, in, in my experience, often overlook the quality aspects when that’s your only
option.

Right. You know, if that’s your only option, then I, I really don’t care and I just need somebody. And that’s, that’s a thing that I think can help.

You know, raising rising tide raises all boats is an aspect that can really help EMS get to be better as we start to focus on those things. And so that leads me into my. My next topic.

You know, we have coming forward the NEMSMA conference. They’re having their inaugural conference in March. The conference focuses on leadership.

Great people coming to speak. We have General Neller, who I had the opportunity to speak when he was the commandant of the Marine Corps. Just a phenomenal speaker.

I mean, to. Nothing will get you wanting to get out of your seat and go jump into a war like talking to the commandant of the Marine Corps. You know, you have Asbel Montez coming.

You know, Ray Baron Shansky’s coming. Lots of great leaders coming to speak at this. And so my first question for both of you, are both of you registered for the conference? I am, actually, yes.

Excellent. I’m looking forward to it. It’ll be great to get you guys up here.

The other nice thing about coming here to D.C. during that time of year, it’s the Cherry Blossom festival.

So if you’ve never been here to see the cherry blossoms in the Washington, D.C. area and that time of year, it’ll be great.

Hopefully there won’t be any snow on the ground. Although this weekend we are having our Snowmageddon. You know, they’re expecting a whopping 13 inches of snow in D.

C. in the last. My parents, my parents just left here and showed me.

So it was 19 to 23 and where they’re going to be at in Virginia. And I said good luck or you could just stay here for another week and watch my dog. But you know, they chose the latter.

I felt, I felt insulted. It’s okay. Yeah, but, yeah, no, it’s, it is, it’s going to be cold up here and everything.

But you know, when you think about the conferences, and I know that’s one thing EMS has is man, we have, we have more conferences in EMS than probably any, any industry out there. But when you think about conferences, whether it’s an EMS conference, NAEP conference, an AEMT conference, any of them, EMS world, what do you guys look for when you go to conferences? What are the things that kind of get your peak, your interest and get you excited about the industry? I’ll start with you, Todd. So I’ll
say the first thing that actually piques my interest is.

Well, I’m going to have to go back to is some of the speakers, right? Because some of the speakers have, have extreme knowledge in the industry and some of them are really pushing the limits. But I also like the fact that you’re bringing the general in, right. So I think it’s what you said and one of the interesting sides is I got a chance to listen to a two star general speak one time and I. There was so much I learned that you could take away from what they told us both on working with people,
how to, how to deal with people in situations in which they’ve never been in.

And I’ve taken that and implemented that, you know, years in past. So really looking at the speaker schedule. But the other thing I really look at is the networking opportunities.

I think one of the pieces, we have so many good people that are not just speaking but are, that are attending the conferences and being able to have moments to where people can get together, really share experiences, you know, they can tell war stories, they can do whatever. But we learn, you know, as you say, iron sharpens iron, all of those moments, right. I think a lot of that networking.

So I look forward in both the speakers seeing what’s next, seeing what’s pushing, pushing what’s in my brain and pushing what I’ve always thought is good or where we’re going, learning to what may be that next, the next big thing as well as being able to network with folks there that are attending the conferences. You brought up a great point. So the networking is probably my favorite aspect of attending conferences, but a lot of that goes to understanding what they’re doing.

I find in conferences that somebody’s got a new widget or they have a new vendor for a new innovation or something like that, and being able to learn that in a conference and then be able to validate that, like, hey, so and so has already done or utilized this system system or this, this product, this innovation. And you know, it makes you more confident to try because a lot of us have the same challenges or problems. It doesn’t matter whether you’re big or small, north or southeast or west, we
still face the same challenges.

And you know, back to your conference speakers point. You know, it’s funny, one of the things I’ve taken with me, I also have listened to many admirals and generals in my day, but the one I heard, a three star admiral was telling me the other day when we were talking about cultural change, he brought up a great point. He’s like, you’re not doing cultural change.

Cultural change takes three to five years. He’s like, what you’re really doing is you’re changing behaviors. And by changing those little behaviors day in and day out, you will affect culture over time.

And I stopped in my shoes and had to think about that because I always tout we help cultural transformation, but the reality, it’s a behavioral transformation. To get a culture to go down a path, you have to change your behavior, whether it’s accountability, whether it’s effectiveness, it’s the way you look at data and things like that. And I hadn’t thought about that.

But to your point, it came from a great speaker that I heard and it really got my mind going. So Fred, same question to you. What are your thoughts on what you like about conferences and what are you looking forward to? My path is a little bit different.

I was that guy, I was the guy who was the, the street level paramedic and fireman who, who went to the conference to have a good time, right? To, to, to enjoy the whole experience. And as I kind of progressed, I, I actually focused on conferences where I felt like I could meet individuals that, that would be beneficial to me as I, you know, moved through the, the career pathway. And you know, I specifically looked at some of the, not mainstream conferences because I found that a lot of times that
filled a different bucket for me.

Like, you know, we all travel in the work that we do and I can, you know, go to a hotel and, and sit at a restaurant and make conversation with somebody, right? You, you do That a hundred times on the airplane, all of those things. Right. But when you go to a conference of like minded individuals and you know, you see what different people do, I actually found that to be really bucket filling for me.

And it wasn’t necessarily XYZ speaker, but it was those attendees or those product developers, Stephen, like you were just talking about, I was very fortunate. I, I was able to navigate. I worked for Gems magazine for years and that was all because of attending a conference and meeting certain individuals.

A past employer I sat, you know, sat on a, on a committee with and said I’m going to work for you someday. And you know, we worked through that together. But just I think that one of the, one of the really exciting things that I was so pumped about being, getting to attend the inaugural conference for, for NEMSMA is number one.

I’m a huge believer in nemsma. I, Mike Touchstone was a, was a mentor of mine for years and years and just a truly genius leader in a, in, you know, urban EMS setting and was very influential in those seven pillars. But when you look at bringing that group of like minded individuals and they’re not all the same leader, right? But the like mindedness of trying to better EMs from the leadership aspect, that really excites me to kind of all be housed in the same hotel and just be able to have
conversations with, you know, people that I’ve always wanted to or somebody that I don’t even know, you know, maybe coming from Hawaii or maybe, you know, across the pond, you know, or something like that, just being able to have those conversations.

And it’s just real day things, right? Like hey, how do you, how do you recruit and retain? What are you doing for Billy? You know, kind of these big ticket items that we spend a lot of time talking about. Sometimes you can just have an easy conversation. Somebody says, oh yeah, I’ve done that.

Here, let me send, send you something. Right? That’s, that’s what I really like when it comes to the whole conference mentality. No, absolutely.

Now, I mean the three of us go to conferences all the time and so, you know, we go in there with a very focused mind on what we’re going to do for our conferences. I find it interesting. Like you’ll see other leaders who go to conference and it’s like spring break for them.

It’s like the first time they’ve gotten out of the house in like six months, you know, and they go, go wild. But I think that, you know, the thing is, to your point, it’s if you sum it all up, it’s the networking, it’s the meeting with people, learning about new products, new innovations, new technologies, new ways to do everything. And then it’s what you get, an opportunity to learn.

That aspect is awesome. Speaking of innovations, I’m going to throw out one. I know that Todd is working with the company and really well with the company, a company called Ride Central.

And I thought, you know, when I first, he was telling me about it, I thought that was just a phenomenal program for organizations. And so, you know, Todd, I would love for you to just tell us as an example real quick about Ride Central and like, how does that help EMS agencies? Because the problem to me is evident everywhere I go and the solution to me seems easy. Kind of like, man, I wish I was the guy invented the paperclip.

But you know, I, I love you to talk about it a little bit as, as an example. You know, Stephen, it has been, it’s been a pleasure actually working with Ride Central. They have, they’re, they’re really being innovated, especially in the non emergency transport setting.

When you talk about hospital transfers, nursing home transports, all of that setting, what I mean by that, which, what I don’t think many people know is case managers, nurses, they have to do 30 minutes, 45 minutes, an hour’s worth of work just to get ready to schedule a transport. And on the flip side, when they do want to call our schedule transport, they have to call and they’re on the phone five, seven minutes at the first company, can’t do it, then maybe they have to go to a second and a
third and this timeframe just keeps getting extended with all the work that they have to do. And then after the, and then on the flip side, let’s go with the ambulance company, they have to staff for all those phone calls, then they have to manage everything.

Then the employee has to get paper. If the paper is not signed right, the form’s not done right, medical necessity doesn’t match it. Then there’s this whole paperwork back and forth.

All of that takes time. The hospital loses money, loses time. The caregivers are already being asked to do more with less.

And now they have to go through this process. And even those caregivers may not know who to call society. Ambulance companies have to deal with all that staffing.

What Ride Central has done is they have integrated directly into the hospital EHRs, directly into these CAD softwares and, or even directly into Uber and Lyft and where the hospital can push a button. And when they push a button, it extracts all that demographic information a provider needs to do transporting. They fill out exactly what’s wrong with the patient, establishing medical necessity, hit submit.

And when it’s submit, it generates all the payer forms that are electronically signed or connected to the credentialing system. So if they know by CNS rules an OIG they can actually sign, it’s a legal document. And all that information goes directly to the ambulance company based on the tiers, the right providers, what’s wrong with the patient, then they can accept a deny it right at the CAD system and then the hospital system will get notified.

Last but not least, and all the data is transparent. Everybody can see performance, can see standard C processes and some of the biggest KPIs that we’ve had is through our invoicing process where we reduced cost to the hospital by about 25 to 30% increase in performance. When they’re late, they’re reduced from being late from like 30 minutes late on average down to single digits.

And everyone is on the same page. You’re able to develop contracts that are win win and you create this stickiness and partnership that, that works well for everybody. So I say it’s the last transactional thing that goes on in our industry that we can automate.

That saves a lot of money on the hospital time, a lot of work on the caregivers as well as for the ambulance companies in their workflow. So for the non emergency transport, let me throw one more thing out there. One non emergency transport was, because of this automated process, was able to extend, you know, 3,000 trips a month and not even have to add an fte.

So it’s been one of those moments that’s really where this value of has really come into play. You know, the other thing I would add to that is that accountability piece. You know, when you’re looking at your ambulance agencies and I know one of the clients we’re working with had had a lot of trouble because they’re no showing, no calling after certain hours and everything.

And you know, a program like this would set the tone. You know, you can no longer deny it because we know where you’re at, what you’re doing and if you don’t want to do it, then we’ll pass it on to the next person. And so that accountability to it kind of helps keep, you know, full transparency on where everybody’s at.

I think that’s, that’s awesome. You know, just that kind of technology, I think that’s where it’s going. You look at, you know, technology in general and EMS and the advent of AI, the advent of telemed and those type of things I think are going to be game changers for EMS as we move forward for the industry.

You know, Fred, I’d throw out to you any, any awesome things you’re working on right now or technologies or clients, without giving any names, any clients or things that you’re doing right now that you think will really make a big impact or benefit to the ems. I think it goes back to a phrase and something Todd and I have had the privilege to present together several times on the national speaking circuit and we kind of put this equation together and when I look at what’s coming up and it’s not
necessarily, it’s not AI based, right, but it really, it’s not technology based, but all of these things lead to it, right? And we’ve used each one of these words today in our conversation, just which just made it pop into my mind of you know, we talk about what is, what is collaboration, right? We’ve talked about partnerships a little bit, we’ve talked about all of these pieces. We’ve talked, you know, Todd just shared about Ride Central, which is like, you know, the staples easy button for, for
you know, non emergency transport stuff.

And you know, what, what does true collaboration look like? And I think, you know, when it comes down to it, we can have all of this awesome technology, we can have AI, we can have the, the Ride Central easy button, we can, we can again have all these things. But there needs to be a willingness aspect and there needs to be a transparency aspect. And you know, Todd and I have done again some, some presentations on this, but we have regularly used the word transparency plus willingness equals
collaboration.

And I think it absolutely makes sense. Maybe because you know, Todd and I kind of coined it, but I think it absolutely makes sense when you really break it down that you know, each one of those items individually are important, but each piece of that is vitally important for success as an, as an EMS leader, as an EMS organization. You know, I’ve had the pleasure of, of helping many EMS organizations across the United States and had hard conversations, had easy conversations and everything in
between.

And you know, when you look at those words and then you leverage what’s out there today, right? How many times did we send emails or do lit reviews or research trying to find out some piece of information that we needed? Right now we’ve got chat GPT, we’ve got, you know, Microsoft Copilot. We’ve got these items that can easily help us. And it’s not that you’re, you know, I don’t feel that you should be using it to do the work for you, but you should be using it to stimulate the work that you need
to do.

And I don’t know, maybe that’s not as. As spicy as you were looking for, Stephen, but I just think that that’s really important when we talk about technology, is that there are those come, you know, few human element factors that really we can have all the technology in the world. You know, I remember switching from flying in a BK to switching in a Eurocopter and all of the, all of the pretty screens, right? And I was like, wow, this is pretty cool.

And you know, you still had to push the stick and do those things to make it go up and down, right? That’s called a cyclic and a collective. Just saying. But, you know, again, that, that piece of adding those, those elements together with technology I think will really be the next step in, in really seeing how EMS progresses in the future.

Well, I, you bring up a great point. You know, technology and innovation is only as good as the people who know how to implement it and use it. And so, you know, all the greatest technology out there.

I go back in my mind when you were saying that, it popped into my head. You know, we all saw Star Trek where they, they like scan a body with the, with the device and all of a sudden they could tell you everything that’s wrong, but somebody still has to agree to it, understand what it is, and then dispense the medication or the treatment, you know, and I think that aspect will never go away. Innovation can help you do a lot of things, and I think, but it’s also getting people to buy into the
system.

And it’s. EMS is no different than any other organization or any other industry. You know, we’ve been in EMS agencies where you talk to them about mobile integrated health or community paramedicine.

And you’re like, well, that, that sounds like work. I mean, that’s really going to affect my John Madden, you know, 2024 season, because I won’t be able to play as much. And it’s like, well, but, you know, this is, this is practicing at the higher level of your license.

And so you get all types and everything. But I think, you know, I think EMS has got a lot of going on. I think, Todd, you brought it up earlier.

The legislative pieces at the state and the federal level are going to be huge. And how all that integrates, I think, as, as agencies, figure out how to get paid, how to become more self sufficient, ways to grow and do revenue, all those different aspects that’ll tie into it. And, you know, as we wrap up, I just want to appreciate or tell you both, I appreciate you taking the time to come on and talk to us and talking to our listeners about EMS and helping to understand that.

I know big things in the future. I can’t wait to open up big things in the future in the coming months for more to come, but it’ll be exciting. So, again, thank you guys both for coming on the H and H Impact today and looking forward to seeing you guys at the conference in about a month.

Well, thank you so much for having us. We really appreciate the time here today. And actually, it was really insightful conversation, so I really appreciate it. Sam.