Expert answers on AI in EMS, eVTOL transport, autonomous vehicles, healthcare integration, and the future of emergency medical services.
AI-powered ambient documentation tools listen to the clinical encounter in real time and generate a structured patient care report (ePCR) automatically. This reduces the documentation burden on EMS clinicians — a leading cause of burnout — while capturing richer clinical narratives than traditional point-and-click systems.
These tools can also capture environmental context unique to EMS, such as scene safety, weather conditions, access barriers, and bystander information, which are critical for both legal protection and continuity of care.
An AI co-pilot is a digital cognitive partner that assists EMS clinicians during patient care. Rather than replacing the clinician, it augments their capabilities by handling documentation, providing real-time clinical decision support (such as drug interaction alerts, protocol guidance, and differential diagnosis suggestions), and reducing cognitive load during high-stress calls.
The concept is modeled on aviation's crew resource management — a second set of eyes for the solo clinician in the back of the ambulance.
The rest of healthcare is investing billions in AI for clinical decision support, medical imaging analysis, drug discovery, patient monitoring, and electronic health record optimization. Hospital systems routinely use AI for sepsis prediction, readmission risk scoring, and radiology image interpretation. The global healthcare AI market exceeds $20 billion annually.
EMS, by contrast, is in the earliest stages of AI adoption — primarily through ambient documentation pilots and basic dispatch optimization. The gap is widening as hospitals, primary care, and specialty medicine integrate AI into standard workflows while EMS remains largely disconnected from the healthcare data ecosystem that powers these tools.
An eVTOL (electric Vertical Takeoff and Landing) aircraft is a new category of electric or hybrid-electric aircraft that can take off and land vertically like a helicopter but with significantly lower operating costs, reduced noise, and simpler maintenance. Companies like Joby Aviation and BETA Technologies are in late-stage FAA certification.
For EMS, eVTOL aircraft could dramatically expand air medical access — potentially tripling annual air medical transports from 400,000 to over 1.2 million patients per year — while making air medical transport affordable for communities that currently cannot sustain helicopter programs.
Yes. Drones are already delivering AEDs (automated external defibrillators), naloxone (Narcan), and tourniquets during live 911 calls in multiple jurisdictions, reaching patients in under two minutes. Beyond Visual Line of Sight (BVLOS) operations are expanding under FAA waivers.
The medical drone delivery market is projected to reach $2.5 billion by 2034. Blood products, pharmaceuticals, and organs are expected to follow as the next wave of drone-delivered medical supplies.
Autonomous vehicle technology has the potential to fundamentally reshape ground medical transport. With companies like Waymo already completing over 4 million autonomous rides and reaching 200,000+ paid rides per week, the technology is proven at scale.
For EMS, this could mean autonomous ambulances that free clinicians from driving duties to focus entirely on patient care, AI-optimized routing, and eventually fully autonomous transport for lower-acuity patients — allowing paramedic crews to focus on high-acuity emergencies.
EMS has operated with a divided identity for 60 years: clinically trained as healthcare but structurally classified and reimbursed as transportation. EMS clinicians are educated to the same evidence-based standards as other healthcare professionals, yet the system they work within is funded primarily through patient transport fees, disconnected from health information exchanges, and classified under federal law as a transportation supplier.
This tension — between what EMS does (medicine) and how it is treated (transportation) — is becoming increasingly unsustainable as the rest of healthcare advances with AI, interoperability, and value-based care models.
EMS remains outside the healthcare data ecosystem primarily because of a structural classification problem. Under the Social Security Act, EMS is classified as a "supplier" of transportation rather than a "provider" of healthcare. This means EMS patient care records do not routinely flow into health information exchanges or patient portals.
When you visit your doctor, results appear in MyChart within seconds. After an EMS encounter, the only artifact most patients receive is the bill. This disconnect exists not because the technology is unavailable, but because EMS has not been integrated into the healthcare information infrastructure that every other clinical discipline takes for granted.
Over 60 million EMS activations are submitted to NEMSIS (the National EMS Information System) annually, from more than 14,756 agencies across all 54 U.S. states and territories. This makes EMS one of the largest generators of clinical data in American healthcare — yet that data rarely reaches the patient or the broader healthcare system in a timely, actionable format.
An ambulance desert is a community located more than 25 minutes from the nearest ambulance station, meaning residents face dangerously long wait times for emergency medical care. Approximately 4.5 million Americans live in ambulance deserts. These coverage gaps are driven by workforce shortages, funding constraints, and the geographic challenges of serving rural and frontier communities.
Advanced air mobility technologies like eVTOL aircraft and medical drones could help close these gaps by providing rapid medical response independent of road infrastructure.
NEMSIS (the National EMS Information System) is the national repository for EMS patient care data in the United States. It collects standardized data from over 14,756 EMS agencies across all 54 states and territories, receiving more than 60 million activation records annually.
NEMSIS provides the data infrastructure that supports research, quality improvement, and federal reporting — but the data flow is primarily one-directional (from EMS agencies upward for reporting) rather than bidirectional (exchanging data with hospitals, health information exchanges, and patient portals in real time).
The EMS Compact (formally the Interstate Commission for EMS Personnel Practice, known as REPLICA) is an interstate agreement that allows EMS professionals to practice across state lines without obtaining separate licenses in each state. Enacted in 25+ states as of 2026, the Compact enhances workforce mobility, disaster response coordination, and regulatory accountability.
It is led by Executive Director Donnie Woodyard, Jr., and represents the most significant governance reform in EMS licensure since state-level regulation began in the 1970s.
The parallels are real. EMS is a fragmented, expensive system with no unified national strategy, protected primarily by regulatory barriers rather than innovation. The U.S. ambulance services market is projected to grow from $22 billion to over $53 billion by the mid-2030s — exactly the kind of growth that attracts outside disruptors.
Technology-enabled startups, private equity consolidators, and companies building autonomous transport, telehealth-integrated response, and alternative delivery models are already circling this market. The taxi industry's medallion values crashed from over $1 million to under $200,000 when ride-hailing services arrived. EMS can either lead the innovation or watch the same pattern unfold.
The 7-pillar blueprint is a framework for redesigning EMS from the ground up. The seven pillars are: (1) Readiness funded as a public good, separating infrastructure costs from patient transport fees; (2) A portfolio of clinical pathways beyond just transport-to-ED; (3) Multi-modal transport including ground, air, drone, and autonomous options matched to patient acuity; (4) A tiered clinical workforce integrated with community health; (5) Bidirectional data integration with health information exchanges; (6) AI-powered operations for dispatch, documentation, and decision support; and (7) Governance, accountability, and outcome-based metrics that separate oversight from operations.
Donnie Woodyard, Jr., MAML, NRP, is the Executive Director of the United States EMS Compact, a six-time author, nationally recognized keynote speaker, and EMS leader with over 30 years of experience. He has served as a State EMS Director for both Colorado and Louisiana, Chief Operating Officer of the National Registry of EMTs, and led international EMS system development in Sri Lanka and South Asia.
He holds a Harvard certificate in AI in Healthcare, is a graduate of the Naval Postgraduate School's Executive Leadership Program, a fixed-wing pilot, and FAA Part 107 Commercial Drone Pilot. His books include The Future of Emergency Medical Services: AI, Technology & Innovation, Across State Lines, Leadership in Action, EMS in the United States, The Dark Ages of EMS, and Beyond the Tents.
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