Explore and evolve

As demands on healthcare systems evolve, so too must the systems to meet those demands. As alluded to by colleagues in previous editorials, paramedicine needs to adapt. Our primary service delivery models and educational models are predominantly reflective of what we traditionally considered to be paramedic practice: prehospital emergency care and transport to hospital. Not to discount this aspect of the profession—it is after all a reality that we provide such a service. However, to consider paramedic practice without its complex intersection of healthcare, public health, and social care is to do ourselves (and our patients) a disservice. This complexity presents challenges when we attempt to articulate it. Just as no two patient presentations are the same, paramedics, local contexts and paramedic services differ. A one-size-fits-all approach will not help when it comes to considering this complexity. So how do we begin to approach it?

We can start by ultimately recognising that paramedicine is enacted within the broader contexts of social and healthcare systems. We need to accept the fact that the system (and all it encompasses) is ever-changing. Although uncomfortable, we need to embrace the uncertainty of the future of the system; yet at the same time, ensure that we are agile enough as a profession to respond to opportunities. We need to examine what we do, and what we might need to do in the future. In fact, we also need to influence what we might want to do in the future. The role of technology in paramedic practice (including the role of emerging technologies such as machine learning, artificial intelligence (AI) and remote monitoring) needs to be explored. New forms of service delivery will need to be considered in the context of finite resources and demands on existing healthcare services. Expanding and enhancing roles, aligning educational outcomes, and increasing clinical autonomy will likely be required in order to meet the complex needs of our patients. Paramedics also need to consider their potential role in relation to public health and public policy.