Like something out of a Philip K. Dick novel, VMSC Emergency Medical Services in Hatfield Township, through the use of A.I., knows where their ambulances and medics will be needed on a daily basis even before someone suffers an emergency.
Instead of a pool of floating precognitive individuals, VMSC has its own internal dispatch center connected to Montgomery County’s 911 center, thanks to software called MARVLIS.
“The darker the color, the higher probability that there’s going to be a call in that area. It uses historical data and traffic and is within 86% accuracy,” said VMSC EMS Chief Shane Wheeler inside the operations room at VMSC headquarters, located a stone's throw from Lansdale Hospital on Medical Campus Drive. “It’s pretty amazing technology. It allows us to know where we probably should have our ambulances waiting at and it also intercepts 911 calls.”
“The county doesn’t even have this,” he said. “We’re unique in having our own internal dispatch. We wanted to improve our response times and we want to show the value of our system to our municipalities.”
New advancements in health technology continue to be implemented at the nonprofit regional EMS.
Now, with digital technology and live streaming, VMSC personnel can send a real-time heart rhythm of a patient inside the ambulance to one of their three medical directors. This even means hospital admissions and medical personnel can get an up-to-date and accurate status of a patient before arriving at the hospital.
VMSC ambulances are now equipped with advanced stretchers that can raise by themselves at the flip of a switch and devices that help lift and pull the stretcher into the ambulance.
There is even a special bariatric ambulance and response method to aid those patients weighing as much as 1,200 pounds, complete with a winching system and ramps.
The ambulances even have GPS tracking and video recording.
As the community rallies behind VMSC and other area emergency medical agencies as part of EMS Week with numerous gift card donations and electronics, like a PS5, to be raffled to their 200-plus staff across three counties, or special BBQ events led by Jefferson Health Lansdale Hospital, VMSC EMS is grateful for the support.
VMSC has a lot to be thankful for – since Wheeler came on board in 2022, VMSC has become more vital and thriving. He helped create new jobs, expanded salaries of staff, and even guided the VMSC to locking in a federal contract to service the Tobyhanna Army Depot in Monroe County.
It is not uncommon, either, to find VMSC EMS providing emergency transport services for Jefferson Health and Children's Hospital of Philadelphia in Philadelphia County.
“We are a specialty transport provider for CHOP and we provide EMS to Center City for Jefferson campuses down there,” Wheeler said.
As of last year, VMSC has expanded its municipal coverage with the acquisition of ambulance services in Souderton. Now it serves 11 municipalities around the clock: Lansdale Borough, Montgomery Township, Hatfield Township, Hatfield Borough, Upper Gwynedd Township, Towamencin Township, North Wales Borough, Franconia Township, Telford Borough, Souderton Borough, and Salford Township. They have also expanded to seven locations across three counties.
Furthermore, the 200-plus employees now receive payroll and benefits. VMSC still has volunteers that support the organization, such as the volunteer-driven K-9 search and rescue team.
VMSC has operations all over North Penn and Indian Valley and Wheeler said they are trying to get away from brick and mortar and push for more dynamic deployment.
“Our ambulances are moving to street corners and parking lots based on demand and are available based on where the next call is predicted,” Wheeler said. “It’s not your mom and dad’s EMS ambulance service. It’s very technical. By going to new deployment models, we’re able to cut off a minute-and-a-half in response times to our communities.”
VMSC will run about 18,000 ambulance calls this year, he said, adding that personnel respond to 100 calls every month outside their area.
With all this going on, VMSC’s retention remains strong and robust.
“We have some of the highest retention rates in the country,” Wheeler said. “Our attrition rate is 3%. I attribute that to our high earnings – we try to pay a thriving wage – our union is strong, and our benefits are outstanding. Employees don’t pay for medical insurance.”
Wheeler said about 80% of its budget is payroll and benefits.
“It’s a fragile thing, operating EMS now in the nation, particularly in the Commonwealth. There are efforts around improving reimbursements for Medicaid, and we are seeing benefits of those increases,” he said. “Before, we couldn’t get paid for milage less than 20 miles, and we would get a really low pay rate. They raised that to Medicare levels, and it made a significant difference.”
Wheeler said, historically, VMSC reimbursement rates were set on historic precedence.
“Medicare sets the standard for every insurance carrier, and they said ‘we’re going to base reimbursements on what you were customarily charged in the past.’ The demand for ALS and costs for providing it have gone astronomical. We see a 13% gap on patient reimbursement versus expense,” Wheeler said. “The government sees us as transportation.”
VMSC is paid a base load mileage fee. If VMSC personnel come to your house, give you glucose, raise you from a diabetic coma, and then you decide not to go to the hospital, VMSC does not get paid for that.
“We’re not seen as clinicians; we’re seen as transportation,” Wheeler said. “It’s very difficult to get any kind of reimbursement if we are not transporting the patient.”
Thus, it creates gaps, he said. Some EMS companies cannot pay a thriving wage, like VMSC, and it forces multiple EMTs to work multiple jobs to survive, he said.
“We’ve changed that model. We said, listen, we’ll do everything we can to create other opportunities in our EMS,” he said. “(The Tobyhanna contract) dumps in excess of about $15,000 a month for operations, and that helped incur that 13%. All money is coming back here to support our operation.”
That goes for the operations in Philadelphia as well.
“That money is coming back to North Penn and Indian Valley operations so we can buy things like ambulances,” he said.
VMSC wants to deter the taxpayer burden by having other alternative business lines versus an authority model, which puts the burden on taxpayers, he said.
“We went out and talked to all our municipalities and got support from all the municipalities,” he said, adding Towamencin Township was the first one to give VMSC a millage in its tax structure. “We are starting conversations with Indian Valley municipalities this year, and asking for their contributions. Slowly, we make our emergency ambulance operations sustainable.”
The sustainability includes training sessions like the “Simbulance,” a simulation ambulance located inside the Hatfield Township headquarters.
“We invested this year about $170,000 in education,” Wheeler said. “Our various educational programs would not be possible without funding we get from municipalities.”
He said municipal support accounts for 1% of its funding.
VMSC is also in the midst of two new programs. The first is an on-site, 15-month paramedic program. This year, 10 students who are VMSC staff will complete classes and be introduced as new paramedics into the operation.
All in all, there are 40 paramedics employed with VMSC EMS.
“The union and the organization share a common objective: We understand that if something happens to VMSC, the union is gone too. We’ve had a great partnership in communicating needs for employees and working with us to ensure that the wages and benefits we provide are keeping our people here and keeping our people happy and part of a great culture here. There is a due process associated with things and it makes us a better run organization.”
The second program is a mobile integrated health program with Lansdale Hospital, launched last month, that focuses on bettering the lives of patients with congestive heart failure and COPD. The program is a success when a patient goes 30 days without being readmitted in serious condition for congestive heart failure or COPD. On Thursday, the first patient graduated from the program, he said.
“The program with Jefferson makes sure patients are getting that post-discharge care from the exacerbation of congestive heart failure or COPD,” he said. “Nine patients are enrolled and the pilot program calls for 86 over the course of the year.”
For EMS Week, VMSC has been giving back to the community in the way of advocacy. Wheeler spoke this week at the Pennsylvania Association for Municipal Management conference in Bethlehem and led a discussion panel about EMS sustainability and advocacy.
“This year, we have to focus on EMS as a profession,” he said.
Wheeler has ensured his staff has the proper mental wellness resources and safety on hand to make VMSC a welcoming place to work. He said recent studies showed that seven out of 10 EMTs in their career have been victims of assault or violence.
Each VMSC EMT and medic wears body armor to every call, which allows them minutes to escape danger.
“The demands mentally of dealing with high pressure and high stress situations, and responding to scenes with children dying, is hard on people,” he said. “The readiness goes into providing infrastructure that many systems lack. We have a wellness team at VMSC and a volunteer chaplain in Debra Darlington.”
Wheeler said the organization offers its staff chances to work with animals at Last Chance Ranch or even gardening at their Hatfield facility to preoccupy minds and get personnel out of headspaces.
“There is a huge infrastructure surrounding our culture here. We are taking care of the total person,” he said. “It takes a certain type of person to work in this environment, but they won’t work in it long without the infrastructure to support their mental wellbeing.”
VMSC has been blessed with longevity. A lot of EMTs and medics, Wheeler said, have been there for upwards of 30 years.
“Clinically preparing our staff for what comes down the road is super important,” he said. “We are constantly learning.”
Advocacy is the big thing for VMSC right now. In the United States, there are 39 states that do not recognize EMS as an essential service. Fortunately, Pennsylvania is not one of them.
“Recognizing systems as an essential service puts a burden on the government to fund the system and provide mechanisms for it,” Wheeler said. “It’s a highly competitive world with regard to funding. Our model is trying to find ways to deter that financial burden on our communities.”
EMT Michael Cavallero, of Montgomery Township, wanted to be involved with VMSC ever since he was snapped in the back of an ambulance during a community event as a kindergartener.
“I wanted to do this since I was a kid. I begged my mom to go to the Montgomery Township fair to play in the back of the ambulance. They’d answer my questions and I never grew out of it,” he said.
Cavallero said he was always passionate about the medical field.
“Being able to get my experience and get higher certification levels with VMSC and JeffStat is awesome,” he said.
“I knew I was put on this planet to make it a better place before I left it. My way of doing my best is by helping people in an ambulance,” he said.
John Scheetz, of Alburtis, received his EMT experience when he went into the military.
“Luckily,” the 24-years-in EMT said, “I had an affinity for it. I genuinely enjoy helping people. VMSC is a wonderful organization.”
Scheetz said VMSC is going through a renaissance with training.
“The assets and resources that Chief and his staff have been able to provide for us really makes it not only an amazing place to work, but it also allows us to do so much more,” he said.
Jon Golonka, of Delaware County, left the retail world for the EMS world.
“I wanted to get into medicine,” he said, “and this was the best way to do it. It’s been quite a journey.”
Carmen Shanahan, raised in the Hatfield area and now residing in Souderton, used to be a firefighter in what was once a male-dominated world.
“I wanted to run into burning buildings,” she said. “I did that, then I got bored.”
One day, when her mom was having complications after knee replacement surgery, Shanahan had to call VMSC.
“They showed up, and took care of her, and that’s when I was like, this is where I want to be, and I’m here 17 years later,” she said. “We’re a very progressive organization, and I like that. We are constantly on our toes and seeing new technologies, like ultrasounds.”
“It’s a wonderful organization for us and the community,” she continued. “I was born and raised here, and having all this to offer to people that live here is awesome.”
