Claudia Schmiedhuber, founder and CEO of Alpine Health Consulting, and Interim Managing Director and Business Development Manager of the European Aero-Medical Institute (EURAMI), spoke to AirMed&Rescue Magazine about current challenges for the air ambulance sector, and how technology is both a challenge and a boon
Congratulations on your new role with EURAMI. What will this new job involve doing?
Thank you very much. My role with EURAMI includes supporting the organisation with general management tasks, process optimisation, client and member communication, as well as the development of existing and new memberships and business, to name a few of my duties.
As EURAMI has recently undergone some internal (health) challenges, it is my goal to ensure that we will get back on track and set the right path for the future.
How has EURAMI changed its accreditation requirements of late, to ensure that they are keeping current with technological, medical and regulatory changes?
Our standards are continuously reviewed by the Chief Auditor and Executive Board, and input from external sources such as members, auditors and other organisations is discussed during the regular Board meetings. EURAMI understands the necessity to adapt to the changes and challenges we are currently experiencing, so therefore we are working on Version Six of our standards for accreditation right now to reflect these adjustments. I believe that it is important to continuously keep an eye on the market and its developments and ensure that our institution can answer to these innovations.
I think one important point that must be taken into consideration more thoroughly is the handling of patient and health data. With the General Data Protection Regulation (GDPR) this has become a big part for all globally operating providers, and something that is still under development in many companies. It is a crucial point that I want to continue to focus on moving forward, so our members can rest assured that their data is in safe hands.
Another important topic will be to take new technology and innovation into consideration, when talking about accreditation requirements. Our industry is already experiencing these changes, so it will be necessary to consider new flight monitoring, quality assurance, incident reporting and communication tools which must be reflected in the audit process and standards as well.
Having said this, I think one of the biggest advantages of EURAMI is the diversity of its members, auditors and executives, which allows the institution to reach out to all sorts of experts for their input and knowledge, including for the topics mentioned earlier. This not only ensures that EURAMI is continuously exposed to these new developments, but also reassures members that EURAMI continues to stand for quality, expertise and trust in the aeromedical and global health and assistance industry.
Ethical business practices are essential for EURAMI members, as you have to trust them to uphold the standards that were checked when they were accredited throughout the course of their accreditation. Does EURAMI ever do unannounced checks to ensure that ethics and standards are being upheld, or do you think that such visits are unnecessary?
At this point EURAMI does not do unannounced checks, however, this is something that has come up in the past frequently. As our members will tell you, the accreditation and re-accreditation process is quite time consuming and requires a lot of preparation time. We understand that during daily operations it would be hard to take out the key people to sit down with an auditor to review and explain current happenings – which must happen during a thorough audit to ensure all audit requirements are being discussed, checked and confirmed.
However, our members are required to alert any incidents, accidents or violation of regulations to EURAMI. In addition, all changes in management, medical directors, aircraft and such must be reported to the institution, which means the Executive Board has an eye on its members and their development. Furthermore, external providers, institutions and affected parties are able to report any incidents directly to the EURAMI office, which will then be investigated properly.
However, we do trust our members and we are proud of their quality and daily service to our patients. Should a member or external party ever raise any concerns in these areas, our Board will approach this member and evaluate the issue in a neutral and solution-oriented way.
Are there any plans to work with other accreditation bodies, such as CAMTS, to offer air ambulance operators a dual accreditation that will be valid in different parts of the world?
EURAMI offers a worldwide high-quality accreditation programme and we are proud to say that we have accredited providers on every continent of the world. I am not aware of any discussions yet, however EURAMI is always open to talk and discuss with our fellow accreditation programmes. I very much believe that the knowledge exchange between institutions like EURAMI, CAMTS, NAAMTA is something that our industry could appreciate, thus EURAMI would welcome such an approach.
Your new venture is Alpine Health Consulting, which offers consulting and education services to the air ambulance, medical assistance and insurance market. How do you envisage your two roles complementing each other?
Alpine Health Consulting (AHC) is focused on supporting companies with a will to grow, innovate, develop and educate – so my company is offering support and solutions for exactly that. EURAMI has recently undergone a very difficult time due to internal developments, which have affected its market presence, member communication and growth, so when EURAMI approached me to work with them I immediately realised that these two entities and roles complement each other very well.
In my role within EURAMI, I now have the possibility to help rebuild the brand, market presence and the development of new business and memberships, and there is also a renewed emphasis on education and knowledge exchange – something on which I am also focusing with AHC. I currently give lectures at universities on the topic of aeromedical transportation and global medical assistance, and I believe with the expert pool that EURAMI has at its disposal, this is something that is of great interest for such programmes and institutions. After all, both EURAMI and AHC have made it their mission to improve our industry to further enhance the patient experience during medical emergencies abroad.
What are the primary challenges facing international air ambulance providers at the moment, in your opinion?
I think the implementation of new technology, the necessity to innovate and provide an up-to-date operation, as well as the increase in the number of providers and, thus, competition, in a rather small specialised market are the biggest challenges that the international air ambulance providers face now.
Due to the enormous amount of logistical work and co-ordination, the complexity of each mission, and the very small profit margin, it is challenging for air ambulance providers to maintain a professional, high quality and smooth service. Also, the implementation of the GDPR in Europe has added another layer of difficulty for providers, as the processes of ensuring data security in accordance with the law may not always work exactly as planned in the daily operation of an air ambulance business.
Unfortunately, we also still see a lot of fluctuation in ‘new providers’, who enter the market with dumping prices to score missions. These providers, however, are often not focused on performing to the standard that insurer or assistance clients are looking for. This can turn very easily into a disappointing, and sometimes life-threatening, situation for all involved and widens the gap between aeromedical providers, insurers and assistance companies as these situations lead to complaints, frustration and a mistrust that is projected on all air ambulance providers. This is also why companies like EURAMI are so important for our industry, as they strive to provide guidance and quality assurance in this very complex market.
The key for me here – and that is why I started Alpine Health Consulting – is to close that knowledge gap by promoting knowledge exchange and help these entities to understand each other’s challenges and processes better, so that misunderstandings and unsatisfactory missions are avoided or handled differently in the future.
How do you think that Brexit will affect the international air ambulance sector? Do you think that prices for payers will go up?
This is a very popular but unfortunately also very difficult question to answer, as I am not completely sure on what the timeline and development for the Brexit will be in the end. My latest information is that Brexit will still happen on 29 March 2019, however, I personally would not bet on that. I think no one will really be able to tell what will happen after the UK leaves the European Union, and how it will affect our industry. However, what I can imagine is that contract negotiations, payment, travel and existing relations could be affected by the exit of the UK. Regarding pricing, I don’t think that we will be able to increase pricing dramatically as this would put the provider in a very unfavourable position compared to the competition. As our industry is still very price sensitive, I do not believe that this would be something an air ambulance provider could endure for a longer period. To put it in a nutshell – I think we will just have to wait and see – and make sure we monitor the development and be prepared with a strategy for when Brexit does happen.