Index
Abstract
Dedication
Preface
Definition of EMS for this Document
Federal Agencies Can Help Advance EMS Research
Executive Summary
Introduction
History of EMS Research
The Present State of EMS Research
Overcoming the Barriers to EMS Research

Summary
Appendix A: The National EMS Research Agenda Writing Team
Appendix B: Organizations Invited to Participate in the National Review Team
Appendix C: Ethical Standards and IRB Requirements
Appendix D Inclusion Of Women And Minorities In Research Study Populations Involving Human Subjects
Inclusion Of Children As Participants In Research Involving Human Subjects
Appendix E: Bibliographic List of Internet Links
Appendix F: Published EMS Randomized Clinical Trials
References

The Public and Policy Makers

Public policy makers must also participate in the cultural changes necessary to establish an evidence base for EMS practices. State lead EMS agencies should support statutory changes that encourage evidence based prehospital care. They should promote public health services research and facilitate the development of relationships and resources necessary for such studies.1 States need to adopt standardized data collection strategies and use technology to link prehospital patient care information with outcome data.

State lead agencies must move away from a role focused on regulating the processes of delivering care and evolve into agencies providing insightful leadership and technical assistance. One way to accomplish this is by participating in the evaluation of patient and system outcomes. One example of how a regulatory body can evolve is the Joint Commission on Accreditation of Healthcare Organizations. That organization is changing its focus from process regulation to outcomes measurement. These changes are controversial, and they are not easy to implement. However, they ought to lead to significant improvements in patient outcomes.82

Finally, as competition for health care dollars increases, individual, corporate, or governmental purchasers of health care services are interested in documentation of the effectiveness of the system and the impact of EMS on public health. The public’s knowledge of EMS-related issues, including funding, level of care provided, equipment, system expectations and standards must be increased. These issues should become key factors driving EMS research.