Communication, consolidation and care

Air Ambulance Review | March 2018
The ability to stay ahead of the curve regarding technology and regulatory requirements of 2020 aviation standards will present challenges for some of the smaller providers
Mark Jones
Air Ambulance Worldwide
Mark Jones, Owner of Air Ambulance Worldwide, spoke to ITIJ about his time in the industry
You’ve been in the international air ambulance business since 2004; what are the main changes you’ve witnessed during this time?
I have witnessed many – but the main changes that I have seen are the improvements in communications. These have come in the form of cellular, satellite and internet quality and availability. This allows the clients, providers and medical teams on flights to be more effective and efficient. The quality of medical care and overall process is enhanced by these improvements.  Also, there have been improvements in aeromedicine and medical equipment. Another change is the recent consolidation of companies over the past three to five years.
Communication is a top priority in the travel and health insurance sector; how does AAW ensure that clear and sufficient medical advice is obtained from a treating hospital before you pick up a patient?
The first step in attempting to confirm a patient’s medical condition is to ensure that we have obtained the best possible pre-flight medical report. The quality of the report can vary based on factors such as location, language and in some cases the availability of the medical staff providing the report. Some countries or hospitals will only give doctor-to doctor reports, and we try to plan for this eventuality so as not to delay the flight. We have had cases where we required a translation service, but typically our staff handle the day-to-day cases. We obtain all current medical records from the sending facility, including CT scans, H&P and so on before we depart. Our standard protocol is to go to the treating facility to perform a bedside assessment of the patient. This confirms the information that we were provided and ensures that the patient’s medical condition has not evolved since the pre-flight assessment was obtained. Once it is confirmed the patient is fit to fly, we will then depart.
Your recent purchase of Aero National has increased your ability to serve US-based patients; is this acquisition the beginning of a global expansion plan?
The purchase of Aero National, although early in the integration, has proven to be a solid strategic move. Their location adds to our geographic footprint and increases the value proposition to our clients by providing a high-quality provider in an area where there is little service. When it comes to expansion, we are looking at strategic rather than global expansion. The location of Aero National lends itself to further expansion and to providing a comprehensive solution for our hospital, assistance and individual clients.
The value of accreditation is an ongoing debate in the air ambulance sector; what made you decide to obtain EURAMI accreditation, and why did you choose this organisation rather than another one? Do you find that insurers were more willing to work with an accredited air ambulance company?
I hold true to my belief that accreditation does add value to a company, the industry and the clients that we serve. We first applied for accreditation in 2009 because I could see the value that accreditation brought to a company. Not necessarily that it would help us obtain additional clients, although it did, but that by going through the ‘process of accreditation’ and having the organisation work with us, it would improve our company as a whole.  
We chose EURAMI for a few reasons; one was that we were dedicated to serving the worldwide demand for quality providers and EURAMI was the only worldwide accreditation organisation in 2009. The other credentialing organisations were domestic US only, although that has changed to a degree now. Also, I was familiar with the other organisations and we believed that we would get the greatest hands-on support from EURAMI. They were helpful in answering questions that are a normal part of our striving for continuous improvement. In regard to insurers working with accredited providers, that is why I had made the decision in 2009 to become EURAMI accredited, I could see that the industry was moving in that direction and so we committed the resources to obtaining accreditation.
You have Special Care accreditation from EURAMI – how much more difficult was this level of accreditation to achieve than an ordinary accreditation?
We are always working to improve our service and continually raise the bar of excellence for our teams. We were honoured to reach the level of recognition that we did during our last audit which was Long Range / Intercontinental Fixed Wing - Advanced Adult Critical Care. We were able to reach the advanced level due to the type of cases and the level of care that we can provide. If a company cannot provide a certain level of care, it will merely take time and dedication of resources to obtain the next level of care if they so desire. Everyone may not have the need to reach other levels, yet they can be a good provider.  
At the recent ITIC Global in Geneva, cases were discussed where air ambulances had taken off to collect a patient before landing permits were obtained, or where a guarantee of payment/coverage had yet to be issued. Have you experience in such missions, and how do you manage these risks?
In the scenario that you ask about (leaving without a landing permit) there are multiple risk factors that must be considered. Key considerations are the patients’ medical condition, current level of care and the experience we have with the country in question. Sometimes the risk is low because of the frequency and familiarity that you have with them. Others, such as Cuba, preclude departure without an issued permit. Like much of what we do, the decision is often based on the relationship we share with the client. Mutual trust goes a long way when weighing these factors.
What do you enjoy most about your role?
Every day, I look forward to walking into our corporate office and seeing each and every one of our employees. I know that over the next 24 hours we will help our clients, patients and their family members through a difficult time in their life. No one wakes up and says, ‘I think today I will need an air ambulance’, but when they do, we will be there to help them. That makes me feel good.
What do you view as the biggest challenge facing the air ambulance industry in the current economic climate?
I am sure that there are many challenges that will come to light over the next few years, but the aircraft upgrades are certainly looming large on the horizon for some. The ability to stay ahead of the curve regarding technology and regulatory requirements of 2020 aviation standards will present challenges for some of the smaller providers. Upgrades are both expensive and time consuming to install, and the process has the added disadvantage of grounding part of your fleet for the duration of the upgrade process. Like so much of our existence – planning becomes key. 

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