A state legislator said Thursday he is ready to bring the discussion about medical helicopter safety to the state Capitol.
Sen. Tom Ivester, D-Sayre, said the service is critical in rural areas of the state where someone who is gravely injured may be hundreds of miles from OU Medical Center, the state's only level one trauma center.
“It saves lives,” Ivester said. “There is no doubt about it. The question would be is it overused and is it as safe as it should be. It's definitely something I am going to look into.”
Ivester said he is considering a recommendation made in a recent study by the University of Oklahoma's emergency medicine department, which suggested making accreditation mandatory for medical helicopter companies.
According to the study, all of the medical helicopter companies operating in Oklahoma are accredited by the Commission on Accreditation of Medical Transport Systems. But accreditation is strictly voluntary.
The main motivation behind recent discussion on medical helicopter companies is a series of fatal crashes of aircraft operated by Kansas-based EagleMed. The company's accreditation was put on-hold after the most recent crash in June, the third since 2010 and the second this year.
EagleMed had just received its three-year accreditation before a February crash in Oklahoma City killed two people and injured a third.
Eileen Frazer, executive director of the Commission on Accreditation of Medical Transport Systems, said the commission will make a supplemental visit to the company and look for trends in light of the series of crashes and also will review the results of official investigations of the crashes by the National Transportation Safety Board.
The most recent edition of the commission's accreditation standards is more than 80 pages long and covers every aspect of operating a medical transport service.
It spells out everything from the education and credentials that should be required of medical personnel, pilots and maintenance workers to the kinds of administrative positions the company should have.
The standards also give specific regulations for when and how aircraft can be operated under various weather and terrain conditions, safety program requirements and continuing education.
The OU study was completed in 2012, before the two most recent crashes. The authors concluded that requiring accreditation would be a wise decision despite some complications it could create.
“The CAMTS requirements are the industry standard, and have truly become the ‘minimum acceptable' performance level,” the study said.
One complication is that the aviation standards required by the commission go beyond Federal Aviation Administration requirements. The state is not able to regulate aviation because that is the domain of the federal government, the study said.
Ivester said he'd like to see more formal regulation of the industry not only as it pertains to safety but also pricing. The OU study found the average cost of a medical helicopter flight is about $20,000.
The flights can be covered by insurance similar to an ambulance ride, but Ivester said he has heard from many people who have received bills they cannot possibly pay after being flown on a medical helicopter.
Such a flight isn't optional.
The decision to call in a medical helicopter is a clinical decision made by a doctor or paramedic.
“Even if their prices were cut in half, which would be a lot, it's still an enormous cost,” Ivester said. “It's necessary, but if it's going to cost $20,000 and insurance isn't going to cover it, it's not like the people who need it have a choice.”
Accreditation for medical helicopter companies
Following are some of the standards required for accreditation by the Commission on Accreditation of Medical Transport Systems:
• Proper financial commitment to support patient care and safety
• Proper insurance coverage for equipment, medical malpractice, workers' compensation and life insurance for personnel.
• Marketing and education programs that include information such as hours of operation, coverage area, type of vehicles operated, capabilities of medical personnel and licensure information
• Ethical business practices demonstrated with a written code of conduct outlining standards, billing practices and contact information for reporting breaches of ethical conduct
• A corporate compliance officer must be responsible for ensuring the service follows all laws and regulations
• Standards for various mission types including staffing levels and medical qualifications of the personnel required.
• Specific education, training and continuing education standards
• Design requirements for aircraft such that they allow for proper medical care
• Policy and procedure requirements for preventing infection and the spread of communicable disease
• Specific flight and equipment safety procedures that go beyond FAA requirements
• Pilot qualifications and regulations including how long a pilot can fly before a relief pilot must take over
• Specific maintenance requirements