Interview: Eileen Frazer, Executive Director, CAMTS & Stefan Becker, President, CAMTS Global

What brought about the formation of the commission on accreditation of medical transport systems (CAMTS) and then CAMTS Global later on?

The Commission on Accreditation of Air Medical Services (CAAMS) was created to reduce the number of fatal helicopter emergency medical services (HEMS) accidents in the late 1980s that were under the scrutiny of the Federal Aviation Administration (FAA) and state regulatory agencies. The Association of Air Medical Services (AAMS), the National Flight Nurses Association (NFNA), the National EMS Pilots Association (NEMSPA), the National Flight Paramedics Association (NFPA) and the Helicopter Association International (HAI) met frequently to develop safety guidelines specific to the HEMS operating environment. At the time, there were fewer than 100 HEMS providers across the USA, but it was a rapidly growing specialty that was becoming an integral part of designated trauma centers.

The safety guidelines, developed by those associations, were then beta tested by several hospital-based HEMS providers. It was quickly realized that safety and patient care were at risk due to the lack of standards. The voluntary guidelines expanded into patient care and training standards for medical personnel, pilots and managers. Voluntary standards are not regulatory, but they are the basis of any accreditation process.

CAAMS was incorporated in 1990 as a non-profit agency and the 1st Edition of Accreditation Standards was published in 1991. Standards are not static and must evolve as experience and professional practices evolve. In 1997, CAAMS became the Commission on Accreditation of Medical Transport Systems (CAMTS). Standards were added for fixed-wing and ground critical care transports, and more recently for special operations – medical retrieval.

As air medical services from outside of the USA began to apply for accreditation, the board of directors realized that they needed standards that differentiated from the regulatory bodies and business practices specific to the USA. In 2017, Stefan Becker, Head of Corporate Development for Swiss Air-Rescue Rega in Zurich, and Eileen Frazer, CAMTS Executive Director, founded CAMTS EU (now CAMTS Global). The mission of CAMTS Global is similar to CAMTS – to improve safety and quality of patient care in the out-of-hospital care environment, but CAMTS Global addresses and serves organizations with a worldwide applicable standard outside the USA.

What makes CAMTS such an important organization?

CAMTS was the first organization in the world to offer a voluntary peer-review process for air medical accreditation. The standards are based on the independent professional experience of experts delegated by scientific bodies and professional organizations. Thus, CAMTS’ and CAMTS Global’s member organizations are not operators who have a vested interest in being accredited. Therefore, the standard development process as well as the accreditation process are absolutely independent and not linked to accreditation-seeking organizations and companies. This independence is also reflected in the respective strict internal compliance provisions to avoid any bias in the accreditation process, which, in turn, assures the high trustworthiness of the accreditation by CAMTS and CAMTS Global.

The experience of our site surveyors and board of directors after conducting more than 2,000 site visits over the past 33 years is invaluable to continuing quality improvement.

CAMTS and CAMTS Global have recently published their Accreditation Standards (2022). What can readers expect to find inside and what is it used for?

The accreditation standards were updated in 2022 for CAMTS and CAMTS Global based on recent scientific results, and feedback from medical transport services, the public and the standards committee. Each board of directors approves the standards as revisions are proposed every two to three years. Accreditation applicants’ policies and practices are measured against substantial compliance with the standards. The Accreditation Standards also provides a valuable blueprint for new services and for services that are not applying for accreditation but want to measure their own compliance with internationally trusted standards. The standards address every aspect of a medical transport system including: quality and safety management; patient care and provider qualifications; communications; and management; and there are specific standards for rotary wing, fixed wing and surface providers, aircraft, vehicles, and medical configurations.

What are the benefits of getting a CAMTS accreditation?

A CAMTS Accreditation is recognized world-wide as a symbol of quality and safety used for marketing, insurance and billing practices. Leading assistance and insurance companies not only accept CAMTS and CAMTS Global accreditations, but even require operators to demonstrate their high competency through an accreditation like the CAMTS or CAMTS Global accreditation. Furthermore, all organizations that undergo a CAMTS or CAMTS Global accreditation benefit from constant process reviews and improvements – and, last but not least, an increase flight and patient safety.

Accreditation actions and decisions are the responsibility of the CAMTS and CAMTS Global board of directors who can deliver fair and impartial decisions because they represent professional associations, not a competing or neighboring medical transport service. There are currently 20 member organizations. These organizations and their current representatives are listed on the camts.org and camtsglobal.org websites.

Camts will exhibit at AMTC23. Why is this an important event for your organization?

This event has been the annual gathering place since our inception. We not only hold a three-day board meeting prior to the AMTC but we also conduct a workshop for accreditation applicants, titled ‘Preparing for Accreditation’, and hold an annual site surveyor meeting. This year, we will also hold a standards committee meeting as we move forward on revisions for the 13th Edition. The exhibit booth is usually very busy and provides an opportunity for executive and office staff to meet and greet personnel from programs and other companies.

What is coming up for CAMTS in the future?

Recognizing the progression of healthcare to out-of-hospital care, CAMTS published standards for a new sector – mobile integrated health (MIH), sometimes known as community paramedicine. These standards were published in January 2023, and we are about to review the first applicant for this accreditation. As with all our standards-setting procedures, we gathered a committee of individuals who manage or work within this type of service for two years before they were approved by the board of directors in October 2022. More ground critical care services and hospital ambulatory care services are expanding into this type of service to bring care to the home and lessen the stress on emergency departments and prevent frequent hospital admissions. CAMTS is the first to establish nationally-recognized standards for MIH, and we consider it and medical transport – air and ground – to be the important aspects of out-of-hospital care.