In emergency care, every minute counts. It’s critical that everyone, from the emergency medical services (EMS) providers who first see the patient to emergency physicians in the hospital, can communicate effectively and work as a team with the goal of providing the best care possible. This team approach is what Jon Krohmer, MD, recently named director of the Office of Emergency Medical Services (OEMS) for the National Highway Traffic Safety Administration (NHTSA), is emphasizing in his new role. As director, he is responsible for guiding national policy and strategy for EMS systems.
Dr. Krohmer recently sat down with ACEP Now Medical Editor in Chief Kevin Klauer, DO, EJD, FACEP, to discuss his new position and what he hopes to accomplish in the role.
KK: I‘m so excited to have this conversation. Tell us about the new position you‘re in.
JK: I’ve been named director of the OEMS for the NHTSA. I’m the first emergency physician director of the office. Historically, it has been someone who has come from the ranks of EMS state administration or EMS administrative oversight. I’m very honored to be the first emergency physician in this position.
KK: It’s definitely very exciting to have you in this role, representing emergency medicine. How did your career path guide you in this direction?
JK: Working full-time in EMS was always my goal. I grew up, as many of us did, very interested in medicine and wanting to ultimately be a doc. I remember a time when I was a kid in the hospital and had an opportunity to chat with one of the orderlies who was taking care of me. That orderly also worked part-time as an ambulance attendant for the local funeral home who supplied the ambulance at that time. In college, I was watching the television show Emergency!—I kept thinking to myself, “Why are these docs that are doing this EMS stuff?” That was in the early ’70s, when they were really just starting EM residencies. My initial undergrad was in pharmacy. I served as an EMT for a volunteer rescue squad. I did my medical school at the University of Michigan and knew that I was going to go into emergency medicine and focus primarily on EMS.
KK: How did you find your pathway into public service beyond EMS?
JK: While I was practicing in Western Michigan as the medical director for a countywide EMS system, I started to become more and more involved in regional and state EMS activities and trauma systems development and EMS and health system preparedness. Then, around 2005, a couple of years after the Department of Homeland Security (DHS) had been created, they realized that they didn‘t have any medical resources to which they could turn when medical issues came up. At that time, Dr. Jeff Runge, who is also an emergency physician, was the administrator at NHTSA. The deputy secretary of DHS asked Jeff to speak with them about medical issues relating to the discipline of homeland security. Based on their conversations, he was asked to become the first chief medical officer at DHS.
He was looking to expand his staff. We had dinner one night, and we talked about the kind of things he was looking forward to doing at DHS. I talked with him about some of the programs I had been working on in Michigan. I interviewed and was accepted for the position of the deputy chief medical officer in September 2006.
KK: When were you offered this new role at NHTSA?
JK: The position is a career civil service position. When the previous director of OEMS retired, they posted it, as they do all federal leadership positions. I had worked very closely with the folks in this office while I was at DHS, so I knew about the posting of the position, and I applied for it. There were roughly 30 folks who were considered for it, and I was lucky enough to get it.
KK: We‘re all lucky that you‘re in this role. How does the role you‘re in differ from the role that, for instance, Dr. Ricardo Martinez had several years ago?
JK: The position that Dr. Martinez had actually was the same position that Jeff Runge subsequently filled. They were both administrators of NHTSA. Ricardo was the first emergency physician to be in that position, and Jeff was the second. The position of the administrator really is the leader of NHTSA, which is one of the components within the Department of Transportation. NHTSA focuses primarily on motor vehicle standards and motor vehicle safety issues.
KK: When did you officially start?
JK: I started with NHTSA on Sept. 4, 2016.
KK: What are you hoping to accomplish in this role?
JK: OEMS at NHTSA is the federal agency that has been involved in emergency medical services activities and oversight the longest. This office was created shortly after the National Academy of Sciences paper that was published in 1966 called “Accidental Death and Disability: The Neglected Disease of Modern Society.” We really focus on global policy and strategic issues of EMS systems growth, development, refinement, and all of the things that support the infrastructure for EMS at the local level. We have developed the EMS scope of practice and the EMS agenda for the future. We‘re focusing very significantly now on issues related to EMS data management and being able to help build up a more robust national infrastructure for EMS data collection and performance measure development and how we can improve data linkages with health information exchanges.
KK: What changes do you think may be worthwhile that you might want to make?
JK: Historically, EMS has focused on emergency response and providing care for emergency illnesses and injuries. There have been a lot of discussions about things like alternative transport destinations and alternative disposition activities for folks that EMS providers care for, including mobile integrated health care delivery. One of the other challenges that we‘re faced with is that EMS has grown so rapidly over recent years. The communication and collaboration among those organizations has been pretty good, but I think that we could probably still improve that a little bit. One of the things I really want to do is make sure that we identify all of the stakeholders as all of the activities move forward so that they have an opportunity to participate in the discussions and to be part of the process. We‘re very fortunate in emergency medicine that ACEP has been very involved in all of the activities associated with EMS for a very long time. The ACEP EMS staff are an extremely talented group. Rick Murray, Pat Elmes, and several others do a phenomenal job of keeping on top of things and making sure that the Board, the EMS Committee, and the membership are aware of all of the EMS issues that are going on.
KK: In the course of the great career that you‘ve had so far, and the great career ahead of you, if you could accomplish one thing through this position that would impact care delivery, what would it be, Jon?
JK: I think it would be that we continue to reinforce to everyone that is involved in EMS that EMS is very much a team sport. We have the folks in the field, clinical providers, educators, quality improvement coordinators, operational administrators, and local and state regulators. We all need to understand that we‘re all part of one team and continue to work together. We also need to continue to reinforce to the folks in the hospital, to whom we transfer care, that we‘re all part of the same team.