Can AMR toe the line?

Town officials have failed to allay concerns about the capabilities of the town's emergency services. Despite the fact that American Medical Response fell short of its obligations to the town for eight of 11 months in 2007, there has been no documentation of any definitive actions taken to deal with those deficiencies. Residents have been left wondering about AMR's ambulance response times, and whether they can rely on the emergency services available to them.

Ambulance response times came under scrutiny because of a prolonged response time by an AMR ambulance to a medical emergency on Dec. 20. A special meeting of the Emergency Medical Services Commission was held on Jan. 4 to address any concerns stemming from that event.

After careful scrutiny of AMR's 2007 priority 1 (life-threatening) ambulance response times, it became apparent that AMR was consistently failing to meet its response time requirements. Despite that fact, the Jan. 4 minutes posted on the town Web site made no mention of this discussion.

Additionally, the EMS Commission spoke at the Board of Selectman meeting on Jan. 9 to recap the Jan. 4 meeting. During the meeting, it was stated that the AMR contract had been renewed for three more years because the town was "pleased with their (AMR) service." The only compliance problem addressed concerned the Dec. 20 incident.

During the Jan. 4 special meeting, mention was made that AMR was allowed response time exceptions under certain conditions, such as during inclement weather. This suggests that contractual exceptions could account for the response deficiencies for the eight months during 2007 in which AMR did not meet its contractual requirements.

The EMS Commission emphasized that the paramedic was on the scene within contractual requirements consistently. Although delivering rapid advanced life support is imperative in emergency situations, it is not enough. Patients also need rapid transport to have access to therapies only available in a hospital.

It was also suggested at the Jan. 4 meeting that requiring an ambulance to respond to a life-threatening emergency within 13 minutes might not be necessary, since there had been no "untoward" outcomes. However, commission members would not be privy to the scope of medical outcomes for AMR-transported patients because of privacy laws.

When town officials made the decision to go with AMR in 2001, they assured residents that there would be no compromise in the town's emergency medical services. As before, the town would continue to have a dedicated paramedic for on-scene care but would no longer have an ambulance stationed in town. Ambulance services would henceforward be supplied on a regional basis, and AMR contract requirements would ensure effective ambulance service.

Not holding AMR to contract standards compromises emergency medical services for residents. And the suggestion of allowing ambulance response times to be longer than 13 minutes would compromise services even further.

No one should expect perfect performance by AMR. However, when AMR's services are found wanting, residents should be able to expect that those overseeing the emergency medical services for the town would act quickly, decisively and openly to correct any problems.