Founded in 1980, Air Methods Corporation has grown to become a titan in the world of emergency medical aviation, with operations across much of the continental US, as well as Alaska and Hawaii, delivering care to approximately 70,000 people every year.

According to Denisse Coffman, Air Methods has a fleet of over 400 aircraft, with both single and twin-engine helicopters and fixed-wing turboprop planes.

A continent-spanning provider of emergency aviation

To maintain operations across this nationwide network, Coffman explains, ‘local base sites have the resources to independently drive operations for a short duration’ but are primarily designed to coordinate with other bases to ensure maximum output.

Coffman expanded: “Our strength comes from a robust network of central resources that support all field operations. Every air medical base serves the surrounding communities, [but] sometimes our mission is to cover a neighboring region because their local aircraft is unable to respond. Other times, our team is on a mission when a second call comes in, and a neighboring team responds. These practices of sharing resources are in the best interest of our community.

“Flight operations are monitored in our Operational Control Center, and also flight followed by our communications centers,” Coffman said. “Integrating satellite tracking systems with flight data monitoring provides data to maintain safety and to drive our voluntary Flight Operations Quality Assurance program.”

Despite placing a high priority on sharing resources and coordinating operations, Coffman added that each base is still afforded the independence to meet the unique needs of the communities it serves.

“We realize each community’s needs are different,” said Coffman. “States may have different rules and regulations that we adhere to on every mission. Additionally, our base serving Yellowstone National Park often sees very different missions than those in and around New York City. Our teams are prepared and empowered to meet whatever unique and appropriate needs exist in the area, and robust policies and procedures ensure we stay in compliance while remaining flexible.”

In addition to careful compliance with all relevant flight regulations, Air Methods also invests heavily in a range of technologies intended to improve reliability and safety, spending over US$100 million on safety programs and technology since 2015. The company has equipped many of its aircraft with night vision goggle (NVG) technology to operate at night, modern avionics, as well as other technologies such as Helicopter Terrain Awareness and Warning Systems (HTAWS), aimed at preventing ‘controlled flight into terrain’ incidents where possible.

The company most recently agreed a deal in May 2022 with avionics firm Skyryse to retrofit over 400 aircraft in its fleet with Skyryse’s FlightOS flight control solution – replacing older manual flight control systems to improve crew and patient safety.

Coffman added that: “Additional computer applications help to interconnect our network of providers and allow for oversight and unified control of operations. Pilots use Electronic Flight Bags to access the system services and to stay connected to operational requests, flight planning, risk analysis, and weather information. Comprehensive education is at the heart of medical practice and the best way to build the skills and confidence of healthcare professionals to make the right decisions to achieve the best patient outcomes.”

Leveraging large resource pool for a high standard of training

Beyond just investing in new onboard technology, Coffman says that Air Methods places a high level of importance on training. As with coordinating its aviation operations, Coffman says that Air Methods benefits from being able to ‘leverage a large pool of resources’.

The company coordinates training at several primary training centers across the country, enabling them to invest in advanced simulators and explore new teaching methods, including the use of virtual reality (VR) in medical training.

Today, Air Methods maintains a fleet of Level D simulators for the AS350, B407, EC130, EC135 and EC145 model helicopters. “We have primary training centers in Denver that allow for high-fidelity simulation training for pilots and clinicians,” she said.

Coffman noted that Air Methods has invested heavily in simulator technology, including recent partnerships with aircraft simulator developer FlightSafety International ‘to develop the first Level D Full Flight Simulators for light, single-engine helicopters’.

On the clinical side of Air Methods’ training operations, the corporation is also exploring the potential of VR, partnering with California-based VR developer SimX to create what Coffman describes as ‘the first large-scale air medical VR training program’.

Exploring VR for clinical training

Coffman added that the success of Air Methods’ exploration of VR for clinical training, as well as the pressing need to train clinicians remotely during the coronavirus pandemic, has led them to ‘redesign its clinical education to embrace these emerging technologies’. Consequently, the Air Methods clinical education team is currently developing a VR library of advanced clinical scenarios, in which multiple players can participate at once, based around medical scenarios such as ‘resuscitation, ventilator management, balloon pump, extracorporeal membrane oxygenation (ECMO) and various trauma situations’ as well as ‘Air Methods protocols and patient care guidelines’.

“Clinical training is now designed around improving patient outcomes and focusing on problem solving and communication, while caring for simulated patients using a combination of high-fidelity human patient simulators and serious gaming activities,” Coffman explained.

However, she affirmed that while technologies such as these have advanced to the point of being significant educational tools, which have demonstrated their effectiveness in improving decision making skills and knowledge, ‘digital solutions are not a panacea', and that they ‘will not fully replace in-person training and first-hand patient experience’.

‘It takes a special personality’ to fly with Air Methods

Coffman also said that Air Methods must recruit widely when finding new air crew staff, due to the job’s intensity, and finding a new hire who is the best fit and has the right basic skill set can be challenging: “Our air crews are a specialized group of medical and aero professionals. It takes a special personality type to spend each day navigating the stress of life and death situations inside an aircraft,” she explained.

Coffman added that while the pandemic caused a sizeable impact on much of the healthcare industry, Air Methods did not see a ‘significant change’ in finding and recruiting team members. It did, however, bring about some challenges in terms of high demand, which saw Air Methods ‘transporting Covid patients between facilities across the nation’, and crew and patient safety.

“The first challenge was to implement the many new safety protocols, in line with hospital protocols, to best protect our patients and our crews,” Coffman said. “That required our team to secure appropriate personal protective equipment (PPE) and implement specific practices just like every other healthcare provider.”

“Although challenging, it was also very rewarding to know that our team played a role in helping so many people during these historic times,” she added.

Connecting rural areas with drones

The company is also exploring the potential of drone technology for the delivery of medicines, samples and medical supplies to remote communities, having established its medical logistics drone brand Spright in July 2021.

The subsidiary, which is currently navigating its early-stage projects to reach standards outlined by the Federal Aviation Administration, local departments of transportation and other related bodies, announced a commercial agreement worth US$16 million in January 2022 with German drone developer Wingcopter to obtain its Wingcopter 198 drones.

Air Methods plans to employ the drones to create medical delivery networks across the continental US. Spright carried out its first test flight in Oregon a month after its deal with Wingcopter, in partnership with clinical and pathology lab Interpath Laboratory. The 24-km flight between a clinic at the Umatilla Indian Reservation and a medical lab in the town of Pendleton was described as a proof of concept for a lab specimen delivery service to be operated by Spright in partnership with Interpath.

Coffman says that the technology offers clear benefits to healthcare supply chains, ‘especially in rural areas’ that suffer from poor infrastructure and limited funds and resources, adding: “This was acutely demonstrated during the pandemic as PPE and testing supplies slowly filtered through the nation,” explains Coffman.

She added: “There are many new technologies coming into production in the next few years in the aviation sector as well as on the clinical side which the company is exploring."

Supporting the No Surprises Act

Beyond just exploring new technology and training methods, Air Methods has also been a supporter of more radical changes to how medical aviation services are delivered. Despite being a commercial enterprise, Air Methods was also an early proponent of the No Surprises Act among the US HEMS community, with the corporation releasing a statement endorsing the Act the day after its signing by former US President Donald Trump on 27 December 2020.

The Act, which came into force on 1 January 2022, establishes new protections for patients from ‘surprise billing’ and excessive cost sharing for healthcare services.

In the statement, Air Methods said that ‘this new legislation… shows that there is no need for any consumer to buy – or for any provider to sell – memberships’ adding that the legislation’s passing ‘illustrates the need for the air medical industry to evolve’.

Coffman reiterated the company’s support of the Act and its opposition to membership-based HEMS provision, saying that: “Today, no patient should ever worry about the brand name on the side of an aircraft. But inherently that’s what memberships create – a desire for a patient to only be transported by the ‘right’ aircraft during their most desperate hour.

“At the core is the patient. That is the underlying factor for our industry-wide push to set in-network contracts with insurers and why we have been staunch supporters of the No Surprises Act. Air medical providers need to establish in-network contracts with health insurance providers. We are proud to tout that as of today, more than 80 per cent of the US population is in-network with Air Methods, but our goal will always be 100 per cent,” she added.