Mike Vallee, Vice President of Business Development at Air Ambulance Worldwide
The process of repatriating a patient via air ambulance has become (for the most part) a well-defined one – despite the occasional demands placed on the industry by global pandemics and war in the Ukraine. Most assistance companies and air ambulance providers have an established process for requesting quotes that makes it painless.
The key information that is usually required to produce a quote includes patient location and destination, as well as the diagnosis. Over the past two decades, we’ve seen the addition of patient height and weight as a quoting staple, as the population has become more rubenesque, yet aircraft doors and fuselages have remained largely the same in terms of dimensions.
A recent addition to that list now includes whether the patient is Covid positive or not. This becomes particularly important when transporting patients over great distances with fuel stops in several countries, as requirements vary from nation to nation and can change without prior notice.
While the process of quoting is a fairly simple one, the operations team tasked with producing the quote are often frustrated by the knowledge that the process is by design a flawed one: they quote in a vacuum – not knowing the timeline of when the patient transfer is required. This is often because the absolute minimum amount of required information is entered into an email or quoting platform to get the three quotes required by the underwriter. It is also understood that it can more often be the expectation that the case manager simply doesn’t have a firm idea of when the patient will be fit to fly, where or when the receiving bed will be available, or if the claim is even covered. The process can be equally frustrating for the case manager, who likely has no idea of actual aircraft availability and for whom the air ambulance transport is only one piece of a complex puzzle that includes hospitals, family members and
Our ideal quote form would include patient location and intended destination, patient age (in the event that it is a paediatric or neonatal mission requiring specialty teams), patient height and weight (and should the patient be over 250lb, patient girth). The patient diagnosis and Covid status, as well as whether the patient will be accompanied by a family member and – if yes – their Covid status as well.
As our team members try to anticipate and avoid potential snags, we also would want to know whether the flight is a pending mission or strictly a preliminary quote. Ideally, the case manager can tell us if the patient has a receiving bed, or whether they would like us to help in obtaining one. This is a routine occurrence, but the steps – while easy enough to obtain with our partners in places like South Florida, can slow the process down in Kansas City, where they are less familiar with the process.
Our most successful client relationships are with those organisations who see us as an extension of their assistance team – the air medical transport arm of their company. Providing the necessary information up front avoids the frustration of queuing a transport only to have it hit a snag downstream when an important and missing detail eventually becomes known.
Tom Hienckes, Business Development Manager at European Air Ambulance
The key information we require is the timeframe for the repatriation, as we need to check the availability of our aircraft, flight and medical crew. A specific date often helps to prepare an accurate quote. Statements like ‘as soon as possible’, ‘must move within 24hrs’, if the patient can be transported within the next couple of days in combination with another case, or if the case can wait until an empty leg opportunity arises, are helpful in order to judge the urgency of the case.
The patient’s exact location needs to be known, as we need to choose the closest suitable airport for our operation. Of course, we require the same information for the admitting hospital to evaluate the best option for the destination airport.
To have an industry standard would be the best-case scenario. For the time being, assistance companies are using different methods to ask for quotations
For the medical part, we prefer to have a full medical report before sending the quote. With the report in hand, our medical regulators can already retrieve most of the required information. With the provided information, they can judge if, for example, a sea-level flight is required, an extra medical crew or special devices/equipment are needed to operate the mission. To carry out the mission, we require the bed admission, doctor’s and hospital’s contact details, preferably with ward or department details.
Other essential information we need to have in order to quote accurately is to know if a bed-to-bed service and/or the ground transportation should be organised and included in the quote, or if we can expect a tarmac delivery/pick up, as this can have an impact on the planning and on the price of the mission.
It is always good to know upfront if we can expect additional passengers and the amount of luggage in order to evaluate if it will fit into the aircraft or not. Needless to say, since the start of the pandemic, the nationality of the patient, negative Covid test results and the patient’s vaccination status have become important information in order to obtain landing permits.
To have an industry standard would be the best-case scenario. For the time being, assistance companies are using different methods to ask for quotations. Some just send emails with the content, some send emails with attachments, others only provide the case details via their own dedicated systems.
It is not unusual that we receive quotation requests with very little information. After the first quotations are sent, we often need to re-do them, as we receive further important information of the medical status of the patient(s), which requires us to update the quotation. If we could provide an industry standard, we would like to use the following key information:
- Time frame
- Pick-up location/drop-off location
- Medical details (medical report/contact details hospitals and doctors)
- Logistical details (bed-to bed/ground transportation/additional passengers luggage)
- Patient details (ID/passport, vaccination status).
David Fox, President of Fox Flight Air Ambulance
Once you have the medical aspects of the mission figured out – do you want a physician or not – all we really need to know is; where is the patient coming from, where is the patient going to, and when do you want us to move the patient? The physician onboard will impact the price of the flight, but other than that we are always equipped with two vents, two monitors, doubling up on all the key medical equipment, so we are ready to move any type of patient. That’s important, because if the patient’s condition deteriorates while we are on our way to get them, or if it deteriorates in transit, we have to be ready with chest tubes or whatever you might need to look after a critical care patient.
We are fortunate in that our assistance company clients have been doing this for a long time and know the information we need to make the transfer. They give us the patient’s personal and medical details and all the documentation we need to handle customs requirements. I can’t speak for every assistance company, of course, but certainly the clients we deal with are very well versed in what is needed to carry out even the most complex mission. They know we need the patient’s passport information, vaccination information, sending and receiving physician contacts, where the hospitals are in a given city, and information on a patient companion if there is one.
The challenge comes when you deal with private clients, and they don’t know what is needed; they just want us to get going and get the patient out of wherever they are. They don’t understand that you may need visas, overflight permissions and landing permits depending on where you have to go. That is the main role of the assistance company; to collect all the relevant information and pass it on to us so we can do our job.