EMS One-Stop

EMS research has grown rapidly, but finding the studies that truly matter to everyday clinical practice remains a challenge. In this edition of EMS One-Stop, Rob Lawrence is joined by Dr. Christopher Richards, EMS and emergency physician at the University of Cincinnati; and Dr. Christian Martin-Gill, chief of the Division of EMS at the University of Pittsburgh and former president of the Prehospital Guidelines Consortium, to discuss the recently published EMS research reading list and the effort to identify the most important evidence EMS clinicians and medical directors should know about.

The discussion explores how the reading list was created; why a significant gap remains between publication and implementation; and how EMS can better translate research into education, protocols and patient care.

Richards and Martin-Gill explain the mix of evidence-based guidelines, position statements, systematic reviews and original research included in the project, while highlighting major gaps in behavioral emergencies, pediatrics, obstetrics, workforce wellness and EMS operations.

The message is clear: EMS practitioners should not wait for new research to appear in their protocols. They should read it, discuss it, question current practice and, where evidence is lacking, consider contributing to research that closes the gap.

Additional resources:

Richards CT, Cash RE, Crowe RP, et al. 2026. “Developing an emergency medical services research reading list for emergency medical services practitioners.” Prehospital Emergency Care, 1-6. https://doi.org/10.1080/10903127.2026.2693158

EMS1 Research Center. A central access point for critical research that can help drive operational and policy changes

Understanding research and its impact on patient care. David Page, MS; Hezedean Smith, DM; and Ayanna Walker, MD, share best practices for evaluating and interpreting prehospital research 

Key quotes

“With EMS research, there's always something missing. There's always more that we can do.” — Dr. Christian Martin-Gill

“What we're seeing here, particularly over the last decade, is these organizations working less as silos and moving more towards working together when it makes sense to do that.” — Dr. Christian Martin-Gill

“We didn't go in actually feeling like we needed to identify 10 primary research or professional statements that complemented the guidelines that were already identified through the systematic review. But there was just a natural break point there.” — Dr. Christopher Richards

“There are a number of position statements that are published by national and international organizations that are key scientific literature out there that people need to be paying attention to.” — Dr. Christian Martin-Gill

“Still there is research lacking in what the EMS clinicians themselves experience as part of the workforce — safety on scene, wellness, these sort of questions.” — Dr. Christopher Richards

“The behavioral emergency space I think is really important right now.” — Dr. Christian Martin-Gill

Episode timeline

01:09 – Rob introduces the episode and welcomes Drs. Christopher Richards and Christian Martin-Gill

02:16 – Dr. Richards introduces his EMS, emergency medicine and research background

03:18 – Dr. Martin-Gill discusses his role at the University of Pittsburgh, UPMC and the Prehospital Guidelines Consortium

04:15 – Why does EMS need a dedicated research reading list?

07:11 – Where can EMS practitioners currently go to identify the research that really matters?

09:13 – Moving research into protocols, practice and clinical care

11:15 – Can the Prehospital Guidelines Consortium help align the many organizations producing EMS clinical guidance?

13:41 – Breaking down the different categories of publications on the reading list

14:47 – Evidence-based guidelines included in the broader reading list

15:49 – Position statements covering hemorrhage, restraint, air medical utilization and workforce issues

16:26 – Systematic reviews addressing airway management and prehospital evidence-based guidelines

16:51 – Four original research papers, including refractory VF, pain disparities, evidence integration and midazolam use

18:58 – How the research reading list was actually developed

19:32 – The open call for EMS research submissions

20:10 – The project is ongoing, with submissions continuing for the next iteration

20:42 – Expert panel review, scoring and the natural cutoff that produced the final 10

23:18 – What important EMS research is still missing?

24:37 – Gaps in airway, pediatric and behavioral emergency evidence

26:08 – Dr. Richards highlights workforce, safety, wellness and operational research gaps

28:18 – Which areas should future EMS researchers investigate?

28:31 – Martin-Gill highlights behavioral, obstetric and pediatric emergencies as priorities

30:12 – Richards explains how everyday frustrations in EMS can become important research questions

32:12 – Final thoughts on the paper and the breadth of the reading list

33:37 – Martin-Gill discusses access to research and why highlighting important publications matters

35:05 – Turning reading into discussion, protocol review and further research

35:58 – Rob closes with a challenge to read, question, discuss and contribute to EMS research

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In this episode of EMS One-Stop, Rob Lawrence speaks with Wesley Brookshear, critical care paramedic and FTO program supervisor with AMR in Knoxville, Tennessee, about a community-led effort that is changing how EMS responds to the city’s Mission District. What began as an attempt to understand unusually high 911 utilization has evolved into a multidisciplinary outreach program bringing EMS, public health, addiction services, shelter providers, clinicians and other community organizations directly to Knoxville’s unhoused population. By concentrating on relationships, consistency and basic human needs, the initiative has produced a reported 32% reduction in traditional EMS call volume while dramatically expanding access to wound care, food, addiction treatment, mental health support, nurse navigation and other services.

Wesley explains why the program’s success is less about creating another specialized EMS unit and more about connecting people to the resources that already exist. The team initially arrived without uniforms, handed out fruit, listened and built trust before attempting to provide care. Two years later, the program has recorded thousands of encounters, helped more than 140 people enter treatment or sober living and generated remarkably few ambulance transports from its outreach activity. The conversation explores how other EMS systems can identify high-utilization areas, develop community partnerships, protect the mental health of outreach staff and start small—even with a single motivated employee.

Above all, Wesley argues that EMS has an opportunity to move beyond simply transporting patients and instead become the connector that gets people to the care and resources they actually need.

Additional resources:

Global Medical Response - AMR Mission District Medical Team Program Sees 32 Percent Decline in 911 Calls

eBook: How to fund community paramedicine

Very high EMS utilizers: 7 strategies for local action

From sirens to solutions: Guiding paramedics to a patient-centered mindset

Public health at the front door: An MIH model to emulate

Key quotes

“We did go down without our EMS uniforms on. We went in black t-shirts, blue jeans and started making connections.” — Wesley Brookshear

“We have noticed a 32% reduction in our normal call volume down at the mission since we started this program 2 years ago.” — Wesley Brookshear

“MIH, mobile integrated healthcare, isn't a title; it's actually a list. It's mobile, it's integrated and it's healthcare.” — Rob Lawrence

“This is not Wesley Brookshear, this is not AMR, this is an entire community of Knox County citizens that are coming together to support.” — Wesley Brookshear

“We talk about the homeless or the unhoused, and I do use both terms, but the unhoused, and we act like it's those individuals; it's never those individuals, those are humans within your community.” — Wesley Brookshear

“My mission wasn't admission avoidance, it was arrival avoidance.” — Rob Lawrence

“Our folks are wrapping their own wounds now. We are providing supplies. We are giving education.” — Wesley Brookshear

“Do not go down with the idea that you're going to cure this idea that homelessness is going to go away.” — Wesley Brookshear

Episode timeline
00:49 – Rob introduces the episode and the concept of specialist teams focused on populations at risk

01:52 – Wesley introduces himself, AMR Knoxville and the multidisciplinary Mission District outreach team

03:25 – Identifying concentrated 911 utilization around the North Broadway area

04:22 – The headline result: a 32% reduction in normal call volume after 2 years

05:08 – Building services around Maslow’s hierarchy of needs: food, water, shelter and safety

06:10 – How the project began with surveys asking community members what they actually needed

06:50 – Wesley emphasizes that homelessness should be understood as a human and community issue

08:05 – Building partnerships and establishing a consistent Tuesday outreach presence

08:28 – Why the team initially attended in jeans and black t-shirts rather than EMS uniforms

10:10 – Rotating team members to manage emotional and mental-health pressures

11:27 – Training new outreach personnel and protecting the culture of the program

12:10 – The practical work: washing wounds, basic dressings and human contact

13:02 – Patients begin managing and dressing their own wounds with education and supplies

13:26 – Taking CPR and Stop the Bleed education directly into the Mission District

14:00 – Using GMR nurse navigation to expand access to alternative care and follow-up

16:09 – Nurse navigation, mental-health pathways and bypassing the emergency department when appropriate

18:28 – Discussion resumes: community paramedicine versus mobile integrated healthcare

19:23 – Rob defines MIH as “mobile, integrated and healthcare”

20:01 – Building relationships with partner organizations beyond the street-level outreach work

21:23 – Program numbers: approximately 4,800 encounters, 515-plus people served, 140-plus entering treatment or sober living, and only nine outreach encounters requiring ambulance transport

22:14 – A frostbite patient whose feet were saved through coordinated community intervention

24:23 – Wesley reflects on severe wounds, winter outreach and the impact of simple acts of care

25:18 – Where another EMS chief should start: find the hot spots and find someone who cares

26:39 – Starting small and expanding services gradually through community partnerships

27:08 – Why handing someone a resource list is not enough

27:36 – EMS as clinicians and navigators rather than simply a transport service

28:50 – Rob discusses “arrival avoidance” and directing patients into appropriate pathways of care

29:51 – The minimum viable program: one person who builds connections and physically links patients to resources

30:42 – Costs, donated supplies and the operational value of reducing unnecessary 911 demand

31:55 – The broader return: increased ambulance availability and potentially improved workforce engagement

33:14 – What not to do: don't approach outreach expecting to “solve homelessness”

33:43 – Managing compassion fatigue and rotating team members

34:58 – Food, coffee and small gestures as tools for relationship-building

35:26 – Challenging assumptions about who becomes unhoused

36:51 – Wesley's closing message: seek opportunities for EMS to grow and approach vulnerable populations with compassion

38:38 – Rob closes the episode with a challenge to EMS leaders: start something, even if it is small

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Finding grant funding can feel overwhelming, particularly for smaller EMS and fire agencies where one person often wears multiple hats.

In this episode of the EMS One-Stop podcast, host Rob Lawrence is joined by Lexipol Grant Writer and Colorado Firefighter-Paramedic Anya Otterson to demystify the grant-writing process.

From identifying funding priorities and locating grant opportunities, to building a compelling case backed by data, Anya provides a practical roadmap for agencies looking to secure funding for equipment, staffing and operational improvements. She explains why success starts with clearly defining organizational needs, understanding grant priorities, and assembling evidence that demonstrates both community impact and operational necessity.

The discussion explores the complete grant lifecycle, from preparing competitive applications, through to post-award reporting and compliance. Anya emphasizes that strong grant applications combine hard data with real patient stories, while Rob shares lessons learned from managing successful Assistance to Firefighters Grants (AFG) and transportation safety grants.

They also discuss how AI tools such as ChatGPT can accelerate research when used appropriately — but caution against relying on AI to write narratives outright. The episode concludes with encouragement for agencies to not be discouraged by unsuccessful applications, reminding listeners that grant writing is an iterative process where persistence and continual improvement often lead to success.

Additional resources

EMS1 GrantFinder: Our suite of solutions gives agencies direct access to seasoned grant professionals—backed by over 500 years of combined experience—along with a comprehensive tailored grant database

Assistance to Firefighters Grants: Meeting firefighting and emergency response needs

On-demand webinar: Grants Day — Your funding playbook. Get the insights, expert advice and tools to help your agency score big on grants

Key quotes

"The data and statistics are incredibly important when writing grants, but to try to set yourself apart, I do like to have a little bit more of a personal touch." — Anya Otterson

"Figure out what kinds of things you want funding for and prioritize it." — Anya Otterson

"You've got to be in it to win it." — Rob Lawrence

"Give yourself enough time. This is not a day-before kind of thing." — Anya Otterson

"Making sure that everybody's on the same page is critical because this is not something you can really do in a silo." — Anya Otterson

"Never be afraid to reach out to the funding agency with questions. Their job is to help you through the process." — Anya Otterson

"ChatGPT should not be writing your narratives for you." — Anya Otterson

"If you don't get funded the first time, keep trying." — Anya Otterson

"The juice is worth the squeeze." — Rob Lawrence

Episode timeline

00:00 – Introduction and why so many EMS leaders struggle to know where to begin with grants

01:30 – Meet Firefighter-Paramedic and Lexipol Grant Writer Anya Otterson

03:00 – The first step: identifying and prioritizing organizational funding needs

04:00 – Where to find grants, including GrantFinder, ChatGPT, state resources and direct outreach

05:45 – Overview of FEMA's Assistance to Firefighters Grant (AFG) program

07:00 – Understanding funding priorities and why high-priority requests have the greatest chance of success

09:00 – Building a compelling grant narrative using statistics, research and patient stories

12:30 – Grant writing best practices: answer the questions, proofread thoroughly and involve leadership early

15:50 – Importance of organizational buy-in and internal communication

17:20 – Understanding grant requirements, matching funds and funding conditions before applying

18:40 – Post-award responsibilities, reporting requirements and maintaining compliance

20:40 – Rob shares practical lessons from administering successful federal grants

23:20 – Lexipol's GrantFinder platform and professional grant writing services

25:45 – Using ChatGPT responsibly to support grant research while avoiding AI-generated narratives

29:35 – Final advice: persistence, continual improvement and learning from unsuccessful applications

Enjoying the show? Email editor@ems1.com to share feedback.

Matt Zavadsky explains how a commercial insurer’s reimbursement proposal — and looming Medicaid changes — could reshape EMS funding

In this week’s episode of EMS One-Stop, we examine two major financial threats facing EMS reimbursement.

Host Rob Lawrence is joined by Matt Zavadsky to analyze the recent Elevance (Anthem) Health Public Policy Institute paper, which argues that commercial insurers should reimburse ambulance services at approximately 160% of the Medicare fee schedule.

Zavadsky, EMS/mobile healthcare consultant with PWW | Advisory Group, explains why this paper is significant, noting that Medicare already reimburses below the actual cost of providing ambulance services. If policymakers adopt or even believe Elevance's recommendations, commercial reimbursement could fall dramatically, removing one of the few revenue sources that currently offsets chronic underpayments from Medicare and Medicaid. The discussion highlights the growing influence of commercial insurers in state legislatures and stresses the need for EMS leaders to counter policy proposals with credible cost and operational data rather than anecdotal arguments.

The conversation then shifts to CMS's proposed Medicaid supplemental payment rule (GEMT), where Matt predicts that most of the proposed changes are likely to survive into the final rule despite industry opposition. Both hosts discuss their review of the public comments, noting differing impressions of stakeholder sentiment but agreeing that agencies should begin financial planning now for a potential reduction in supplemental Medicaid revenue beginning in 2029.

Throughout the episode, the recurring theme is that EMS must become far more effective at explaining both the cost of readiness and the consequences of underfunding. The episode concludes on a more positive note by highlighting the newly released What Paramedics Want in 2026 report as a practical roadmap for improving workforce satisfaction while the industry continues addressing long-term reimbursement challenges.

Additional resources

The 160% mirage: Why every EMS leader should read the Elevance Ambulance Report

When the spreadsheet meets the siren: How CMS’s Proposed GEMT Rule could reshape EMS funding

What Paramedics Want in 2026

Key quotes

"The commercial insurance industry is creating a story that elected officials may perceive as reasonable. We need to combat that story with facts." — Matt Zavadsky

"Medicare reimbursement is already below cost, so using it as the benchmark automatically discounts ambulance services." — Matt Zavadsky

"We do a great job telling stories about the lives we save. We do a poor job telling the story of what it costs to provide that service." — Matt Zavadsky

"The balance billing issue is going to be the No. 1 issue in the next 12 months." — Matt Zavadsky

"The first time local elected officials hear there's a problem is usually when the sky is already falling. We need to tell the story before the sky falls." — Matt Zavadsky

"Know your costs; know your costs at different service levels, and begin educating your local community." — Matt Zavadsky

"This isn't necessarily good news, but it's something we need to understand and all work together to deal with." — Rob Lawrence

Episode timeline

00:00 – Introduction and the Elevance Health Public Policy Institute report

02:00 – Matt explains who Elevance Health is and why the report should be viewed as a commercial insurer's policy position

03:30 – Discussion of state balance billing legislation and how commercial insurers are successfully pushing lower reimbursement benchmarks

06:15 – Breakdown of what percentages of Medicare actually mean using national EMS financial data

08:30 – Why using Medicare as the reimbursement benchmark is fundamentally flawed because Medicare itself pays below cost

10:30 – Discussion on the political influence of insurers and why EMS must counter with data-driven messaging

12:30 – Why EMS has historically struggled to tell its financial story despite being effective at telling patient care stories

14:20 – Matt predicts balance billing legislation will become the industry's No. 1 policy issue over the next year

16:10 – Potential consequences if commercial reimbursement falls to 160% of Medicare

17:30 – Discussion on community funding, essential service models and matching service expectations with available revenue

22:20 – Transition to CMS's proposed Medicaid supplemental payment (GEMT) rule

22:45 – Review of public comments submitted on the CMS proposal and differing observations about stakeholder support

25:00 – Matt predicts the CMS rule will largely move forward and agencies should prepare accordingly

27:45 – California and other states discussed as examples of systems likely to experience significant reductions in supplemental Medicaid funding

30:45 – Closing on a positive note with discussion of the What Paramedics Want workforce survey

The 2026 AIMHI Excellence in Public Information or Education Award recognizes organizations that create innovative programs which improve health, educate communities and demonstrate measurable outcomes. This year’s recipient, the Medic Keep the Beat Foundation, earned national recognition for a groundbreaking fall-prevention initiative that is helping older adults remain independent, reducing repeat 911 calls and preventing avoidable hospital admissions. The award celebrates programs that move EMS beyond emergency response into proactive, community-based healthcare.

In this episode of EMS One-Stop, Rob Lawrence sits down with Jimmy Pierson, president and COO of Medic Ambulance; and Angeline Pierson, occupational therapist with the Medic Keep the Beat Foundation, to explore the award-winning program in depth. The discussion covers everything from home safety assessments and occupational therapy interventions, to public-private partnerships, sustainable funding, EMS workforce innovation and why prevention may be one of the greatest opportunities facing EMS today.

Key quotes
“You’ve taken the frequency out of a faller.” — Rob Lawrence

“We don’t want healthier transports; we want a healthier community.” — Jimmy Pierson

“This isn’t a business model; it’s a community model.” — Jimmy Pierson

“We want to keep people safe and independent in their own homes.” — Angeline Pierson

“With this program they can stay at home instead of moving into a skilled nursing facility.” — Angeline Pierson

“The key is finding partners who see you as a partner; not as a subcontractor.” — Jimmy Pierson

“The Australian paramedics became part of our family; they weren’t temporary staff.” — Jimmy Pierson

Additional resources

Awards – AIMHI

Medic Keep the Beat Foundation

Fall prevention: EMS patient education tips after the lift assist

Fall hazard reduction and emergency alerting

Geriatric slips, trips and falls: 3 assessment considerations

9 fall prevention tips for EMS providers to share

Episode timeline
01:00 – Meet Jimmy and Angeline Pierson

02:00 – Inside the award-winning fall prevention program

06:45 – How patients enter the program

08:30 – Why preventing falls starts inside the home

12:30 – Measuring outcomes and demonstrating return on investment

15:00 – Funding, grants and building community partnerships

17:00 – Public-private partnerships with California fire departments

22:00 – Sonoma County Fire and collaborative EMS delivery

28:00 – Workforce rebuilding after COVID-19

31:30 – Recruiting Australian paramedics and creating a sustainable workforce

34:30 – Final reflections on prevention, partnerships and the future of EMS

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