I found out a lot about helicopter emergency medical services (HEMS) during a 30-minute chat with the head of the largest air medical operator in the U.S., Aaron Todd (see Air Methods CEO: Higher Responsibility for HEMS,” page 44, and the full interview at www.rotorandwing.com starting Monday, Oct. 3). The biggest just got bigger—with the recent acquisition of Omniflight Helicopters, the total combined fleet stands at 398 rotorcraft and 22 fixed-wing aircraft. Wow, that’s a lot.
“I don’t know that our objective was ever to become the largest rotary wing operator, it was more just making sure that we remain focused on what we do best, and that’s air medical,” Todd explained. “In some cases, the added size brings operational challenges, but it also brings a lot of opportunities that other smaller operators do not have the advantage of.”
He added that Air Methods doesn’t “consider ourselves a healthcare company that happens to have expertise in aviation, rather an aviation company that happens to have an expertise in healthcare, so it is likely that our focus will continue to maintain a healthcare orientation, but that does not mean that we won’t do other types of aviation rotor wing services.”
One of the more interesting parts of the conversation was talking about safety challenges in the HEMS industry and how to lower the accident rate. Air Methods is leading the way with its safety management system (SMS) program, as the first helicopter operator to exit FAA Level 2 status in January, with sights set on exiting Level 3 in early 2012.
But achieving various levels is “really not why we did it,” Todd explained. “We truly believe that a comprehensive safety management system that incorporates everything from ASAP and MSAP reporting to monthly safety newsletters to safety advisory councils—basically all of the tools that allow us to identify risk on a pro-active basis, and mitigate that risk before something happens in a protected environment so all feel free to communicate these concerns without fear of retribution, is a very powerful mechanism for safety enhancement. Which is really at the heart of what SMS is about—identifying risk, evaluating it and solving it, in an environment that has free flow of communication throughout the organization.”
I asked him about recent comments by Helicopter Association International (HAI) President Matt Zuccaro that safety efforts might be “missing the target” in focusing a lot of attention on the accident rate in the HEMS sector while overlooking lower-profile segments such as personal flying and initial pilot training. (See "Target Practice", July 2011, page 4.)
“In all fairness to that comment, I do think that we have a higher responsibility,” Todd replied. “We’re transporting individuals that did not choose necessarily to fly with us, as you might imagine, and so I do think we have a higher duty to lead in safety and to not be content with perhaps a comparative to another sector of rotary wing services.”
Air Methods—which is now approaching half the total U.S. air medical fleet—and rest of the HEMS industry, he continued, “recognizes its responsibility that to be a leader in size, to also be a leader in safety initiatives on the front edge of some of these new technologies and training techniques that continue to improve safety.”
Perhaps the most interesting thing he said, though, came after working our way through 20 scripted questions, and I asked him if there’s anything he’d like to add. “One of the things that I’ve always tried to communicate is that sometimes air medical is a bit misunderstood,” Todd responded. “I think there’s a belief that the primary benefit to the patients we serve is because of the speed of the helicopters, and the reality is while that is an important aspect of the service, what’s most important about air medical is the ability to take high-end healthcare talent—highly skilled trauma nurses and paramedics—and expand their geographical reach to a broader area without compromising response time.”
In his opinion, “that’s something that is always hard to understand. Sometimes the patient may have gotten there as quickly via ground as with air, but they would not have the benefit of having a highly skilled trauma nurse and paramedic in the back ensuring that the patient is well cared for and complications addressed, if any, while they’re being transported. With the critically ill and injured patients that we serve, those capabilities that are unique to those high-end positions is crucial, and unfortunately there’s not enough of those wonderful medical professionals to go around.”
The helicopter is “a great tool to expand their reach in ensuring that every American has access to these services,” Todd said. “I think sometimes that’s lost on those that would just presume that the reason we utilize a helicopter is just to get the patient there quicker. It’s also to expand the reach of a scarce medical resource.”
With budget cutbacks and service reductions hammering HEMS operators and other public service entities that have a medical function as part of police and rescue work, it’s important to step back and look at the big picture. Helicopter EMS is an essential function for those who need it—the extra few seconds and minutes can be the difference between life and death.