The air ambulance industry has often cited the Airline Deregulation Act whenever questions have been raised against its billing practices. It is obvious that most people are curious about this act that precludes the states from interfering in the matters of the medical flight industry.
The law was originally passed in the year 1978 with the intent of keeping the prices of commercial flights low and to promote a healthy capitalistic competition. Prior to that, the commercial airline industry was seeing a lot of monopolistic moves and the prices were quite high. The Act was quite successful and the primary reason why we see highly competitive prices in the commercial airline market even today.
How did it Affect Air Ambulance Industry?
The credit goes to the air ambulance industry that has successfully argued they too are in the business of commercial flights and, therefore, the states cannot interfere in the matters of their pricing. However, like all industries, there are bad players in the air ambulance industry too. They have leveraged this act to charge incredibly high amounts to the customers. The issue has now catapulted to the extent that it has caught national attention. Some experts believe that strong lobbying of the industry is even influencing federal decision makers.
The Argument against the Air Ambulance Industry
Many believe that air ambulance industry must not be treated as commercial airlines. Instead, medical flights must be treated as public health utilities. Part of the argument is also that the congress – while formulating the act – would not have imagined that the air ambulance industry would interpret it the way it has been at this point. Also, the main intent was to keep the prices competitive and not soaring as is the case today. The air ambulance industry too, on the other hand, has a valid point. It points fingers at the insurance industry, which is known to deny out-of-network coverage.
Air ambulance evacuations can throw situations at crew members that they are not always prepared for. It is simply the nature of the job. It is impossible to imagine all kinds of situations one might encounter. It is therefore necessary to have a coordination mechanism in place where help can be sought with minimum wastage of time. The coordination could be between ground ambulances, treating or receiving facilities and even cross-nation institutions. At times, it becomes necessary to coordinate between legal teams when the evacuation involves getting a patient from overseas locations. It is vital that one chooses an air ambulance company that is well experienced, in the interest of fluidity in evacuation.
International Air Ambulance Repatriations are Especially Hard
Rules and legislations differ from country to country. You never know what bureaucratic red tape is flung at the crew without forewarning. In cases like these, it is vital that the air ambulance company has a lawyer handy. You would need someone who is well versed in local laws as well as international ones. Failure to procure help in time can lead to legal troubles and unnecessary delay which can prove to be detrimental t the health of the patient.
Coordination with Ground and Hospital Crews
The ground crew does not always belong to the same organization as the air ambulance. Also, the crew usually has to deal with a different ground ambulance organization with each evacuation. Many times, it is their first time dealing with a ground ambulance crew and their organizational rules might be different. The medical fight crew needs to understand their functioning well in advance for smooth transition.
The same goes with the hospital teams too. It is therefore advisable to establish common grounds in advance. It is because of situations like these that most well-organized medical flight companies employ a separate team to take care of these eventualities.
A medical flight paramedic is a part of the support team that acquires immense importance every time there is a medical emergency. They work in conjunction with physicians and nurses. Medical flight paramedics almost invariably fly to the scene of medical team in the air ambulance. It is a frenzy of activities once they reach the spot, where they are expected to diagnose the patient, evaluate the situation and deliver the best life-saving care possible so that the patient can be transported safely to the appropriate treating facility. The job demands keeping a cool head under pressure.
The Career Prospects of a Medical Flight Paramedic
It is believed that in 2011, there were about 2,000 flight paramedics in the United States. However, the numbers have steadily grown since then. The growth is expected to be at a rate of about 23% until 2022. According to statistics that date back to 2012, the median salary of a flight paramedic was slightly over $31,000 but it is safe to assume that the amount has gone up drastically owing to increased demand. Industry experts believe that the demand will go up further as rural American hospitals are closing down rapidly, in turn fuelling the need for air ambulances.
Requirements to become a Flight Paramedic
The candidate must be at least 18 years of age and be certified as an EMT or emergency medical technician. The course must be approved by NREMT. The person should have worked as a paramedic for at least three years already and have CPR as well as paddle training. Other factors such as physical fitness are also important.
Here is a list of certifications needed:
- Prehospital trauma life support
- Advanced pediatric life support
- Advanced cardiac life support
- Basic life support
- NREMT, ATLS-Audit, TNACT, and CCEMTP
Once these certifications are acquired, the candidate must pass FP-C exam to ultimately start career as a medical flight paramedic.
The Right Questions to Ask a Medical Flight Company
Medical flights become a necessity when ground ambulances are not a choice. However, when the need for transport is not urgent, you have the time to make a sound choice, but first, you must know what questions you must pose to the medical flight company. Here, we discuss a few pertinent ones.
Does the Medical Flight Service Come Under My Insurance Network?
Health is important but cost is a factor too. Medical flight services can be quite expensive. When given a choice, you must exercise it to know what you are getting into. Air ambulance transport bills can run into the tens of thousands and in the hundreds of thousands, if the destination is across borders.
What Mode of Medical Flight is Right for Me?
Fixed-wing air ambulances are slightly more expensive than helicopters. However, they are quick and much more comfortable. In fact, preference must be given to fixed-wing flights if the journey is long. One major limitation, however, is its ability to land. Unlike helicopters, they need extended landing grounds.
Is the Air Ambulance Equipped Enough?
Today, one can hire air ambulances that suit the prevailing medical condition of a patient. For instance, you can hire one that is a flying neonatal care unit, if the patient is a newborn. Mission critical equipment like ECG monitors and the like must be available if the situation demands it.
Will the Organization Coordinate Care Beyond the Flight?
Most medical flight companies will offer you services that go beyond simply taking you from one place to another. They coordinate care with the receiving facility and keep in touch with ground ambulances if their services are required. If it is a cross-border transfer, the service provider may help you with the necessary formalities too.
These are some of the vital questions that one must ask before opting for a medical flight service to avoid any nasty surprises later.
Air ambulance services are usually viewed from a narrow lens. In other words, we associate medical flights with emergencies at a very granular level where individuals are rescued. We tend to ignore that they are a huge part of relief and rescue efforts at a government level across the globe. When natural calamities and manmade disasters are epic in proportion, air ambulances are the last hope for survival sometimes. Of course, they do not work in isolation and are a part of the bigger emergency response ecosystem. However, sharing of data, managing them securely and keeping the entire picture transparent and tamper-proof can be a challenge. This is something that blockchain technology can get right.
Blockchain Technology is More than Bitcoins
What most people fail to understand is that Bitcons or cryptocurrencies are just one application of blockchain technology. The real benefit is enablement of a system in which data flow is seamless, transparent and unchangeable. For large government organizations across the world, this is a huge plus because emergency situations are often soft targets for unscrupulous exploitation. Blockchain can keep make it virtually impossible for anyone to tamper with data and consequently the relief funds.
What is Blockchain Technology and How Can it Help Air Ambulance Services
We already know that blockchain brings to picture an immutable record of transactions. For air ambulance services, the biggest benefit is the trustworthy connection it brings to the emergency response ecosystem.
The answer to what the technology is all about: Blockchain is essentially a network that brings a large group together into a system where no change can be made in the dark. The only way to make a change is to make it apparent to the rest of the stakeholders in the network. Also, there is no going back to modify data. In all, this brings transparency to a group where the flow of information is truthful at all times.
Well this might not come to you as a surprise because you might have witnessed this yourself. According to one survey conducted by Kaiser Family Foundation, about 40% of US citizens have revealed that their families have received a medical bill despite being covered by medical insurance. This is a growing problem for the country as insurance companies are seen restricting the number of providers in their networks. Of course, out of network providers are not covered by insurance companies. In this context, the question arises, is it the same logic behind huge medical flight bills that people across the country are witnessing?
Medical Flight Bills and Insurance Network
A majority of industry experts believe medical flight service providers willingly stay out of insurance networks. The reason is simple, they lose the freedom to charge what they feel is fair for their services. It is also felt that there is a huge disparity between what the medical flight industry believes is a fair payout and what the insurance industry pays. The middle ground, it seems, is something that has not been achieved so far. The issue has not gone unnoticed by the lawmakers. However, the opinion is divided as to who is responsible for the huge bills.
Efforts by Lawmakers to Bring Down the Bills
Several attempts have been made to limit the amount that can be charged for medical flight services. From trying to ban balance billing to compelling air ambulance companies to come under insurance networks, several innovative efforts have failed. The reason behind this is the Airline Deregulation Act of 1978. Designed to create a competitive environment to keep the price of this essential service down, it precludes the state governments from intervening in the matters of air ambulances. Only the Federal Government is authorized to make changes.
Air ambulance operations are always critical. Among the critical operational aspects of a medical flight is handing off of the patient between medical flights and ground ambulances. If not done properly, it can lead to increased cost, loss of time and unnecessary lock down of valuable human resources. The efficiency at this juncture is all the more important because, usually, people from two different organizations have to come together to ensure a seamless transfer of the patient. In the event that each company has its own set of guidelines and procedures, things can get a bit complicated. It is for this reason that the Centers for Disease Control suggests a common methodology. Here we take a brief look at it.
The Planning of Hand Off between Ground and Air Ambulance
- Plan is the first thing that is to be put in place. It covers notifying each other of all developments. Beyond the ambulance companies, other organizations such as public health authority and law enforcement agency too might need to be notified.
- Communication of important aspects is another issue that must be taken care of – Does the patient have an infection? Is he or she ambulatory? Is there any special medical need? These are some of the questions, the answers to which both parties must have for communication to be effective.
- Location should be carefully chosen. It is not always about the nearest one. The patient may be a carrier of a highly infective virus. In a situation like this, the landing location should be such that the people in general can be easily isolated. The staff too must be aware that proper care should be taken to keep them from harm’s way. Adverse weather conditions are also important determinants of location. Media too can be an issue when it is a matter of national concern and can lead to a panic-like situation if information flow is not controlled.
There are several other aspects that must be taken care of. We will continue to focus on this subject in the coming days.
It is hard to believe that the future will see more efficient emergency transportation than air ambulances. However, it is true and that future is not very far. The advent of smart vehicles, autonomous driving technology, drones, electric power and the like are transforming emergency transportation today. In the age of patient centricity, the technology that suits the patients’ requirements will rule the industry. While vehicles capable of landing vertically will make a huge difference in treacherous plains, swiftly moving vehicles will be in demand when time is vital. Here, we take a brief look at the different technologies that are making waves today.
Flying Cars and Air Ambulances
Flying cars have been testing human imagination since the 1980s. Their biggest advantage is their ability to take off and land vertically, as well as the fact that they are highly compact. Now, with technology enabling efficient ground support, it will come as no surprise if we see flying cars being used as air ambulances. The other major advantage from the air ambulance service providers’ point of view is the ability to store or park these vehicles without much expense. The current system where they are expected to hire spaces in large hangars can be done away with if flying cars become a reality and can in turn bring down the cost of availing the service too.
Drones and Autonomous Vehicles
A lot of innovation and research has gone into autonomous vehicles and drones. In fact, a combination of these technologies can be quite exciting. Imagine a scenario where an air ambulance company dispatches an autonomous drone capable of handling heavy loads while controlling it remotely. There would not be a need for pilot. This will also make more space for the patient in the compact vehicle, where he or she gets all the life support required.
The technology that guides air ambulances will further improve as artificial intelligence, internet of things, big data and the like progress.
Medical flights are nothing to look forward to but preparing for them does take the stress off somewhat. Let’s look at different aspects of medical air transport and see how you can be prepared for them.
Here are a few details that the flight coordinator will ask you. Keep them handy when you go on a call with one.
- The name of the patient
- Date of birth of the patient
- Weight as well as height of the patient
- The mobility status of the patient: can he walk, sit, stand, etc.
- Contact information of the patient and/or the caregivers
- Specify the need for special equipments such as oxygen, intravenous lines, etc.
- Health insurance details
If the patient is being transferred from one treating facility to another, you must have the following records handy:
- Copy of the health insurance documents
- Copy of the discharge summary as well as the most recent copy of history and physical exam
Before Boarding Medical Flights
There are specifications that medical flights lay down when it comes to luggage that the person accompanying the patient can carry. Know about that well in advance. Also, there are usually limitations on the number of people who can accompany the patient. Usually, it’s just one person. The person accompanying must bring along an identification document.
If You Make Receiving Arrangements
There are instances where people make bookings well in advance so that the patient is admitted to the hospital that his or her family desires. If that’s the case with you too, inform the care coordinator in advance so that a land ambulance can be arranged to take the patient to the treating facility. If the receiving facility has a helipad, then the coordinator will keep the hospital informed of your arrival so that appropriate arrangements can be made.
Traumatic brain injuries can be fatal and demand urgent medical attention that airambulance services can provide. According to a statistic by the Centers for Disease Control and Prevention, traumatic brain injuries are among the leading causes of disability and even death in the United States of America. To put a number to the extent of its dangerousness, traumatic brain injuries account for about 30% of all deaths associated with injuries. The leading causes of brain injuries in the country are assaults, motor vehicle accidents, sports related mishaps, and falls. While the risk of falls is considered high among senior citizens, sports are a major cause for traumatic brain injuries among the younger population.
Ambulance Sometimes Becomes a Necessity in Traumatic Brain Injuries
The survival rate of a patient increases drastically if he or she receives treatment right on time. This is where airambulance services come into play. If the injury occurs in remote or rural areas where access to adequate neurological care is next to impossible, the only recourse that remains is transportation by airambulance. Among the advantages of using airambulance services apart from the speed is the comfort and facilities that they offer. They are usually better equipped. Also, the chances of secondary trauma owing to transport are almost zero when the airambulance is used for transport.
The Immediate Symptoms of a Traumatic Brain Injury
It must be noted that the symptoms related to traumatic brain injury vary based on the severity of the injury. Patients are usually seen experiencing mild-to-severe changes in personality or behaviour, loss of sensation in any or several parts of the body, muddled or impaired thought process, loss of memory, impairment in vision, slurring of speech, inability to move one or more parts of the body. Airambulance services usually employ specific protocols when traumatic brain injuries are involved and utmost care is taken to keep the patient safe so that the chances of long-term consequences are minimum to none.