EMS One-Stop

In this episode of EMS One-Stop, Rob Lawrence is joined by his own Medical Director, Dr. Maia Dorsett, to unpack the 2025 NEMSQA Measures Report — a deep dive into trauma-focused quality measures built largely from NEMSIS data.

Dr. Dorsett frames the discussion around the central aim of quality improvement:

From pediatric vital signs to traumatic brain injury (TBI) fundamentals, she walks listeners through what the report reveals, what it can’t reliably measure yet, and why some of the “sexy” procedures are too rare to serve as useful system-wide metrics.

The conversation highlights a recurring theme: fundamentals matter most. Dr. Dorsett explains how measures like complete vital signs and avoiding secondary brain injury in TBI (hypoxia, hypotension, hyperventilation) can drive meaningful outcomes — even during relatively short prehospital intervals.

She also points out where current measurement approaches unintentionally create documentation burden for clinicians, arguing that systems should do more of the “figuring out” (like trauma center designation and prenotification capture) without requiring extra clicks.

The episode closes with a call to action: anyone can join NEMSQA, contribute to the work, and help shape what EMS quality measurement becomes next.

Memorable quotes from Dr. Maia Dorsett

“I think the most fundamental question in quality improvement is, are we doing a good job?”

“I think part of the value of this report is specifically looking at those things and saying what should we be measuring using NEMSIS data or how should things be integrated into that database so that the answers are there rather than needing to be documented on each individual case?”

“If there's one thing that you're going to take away from this trauma report is that, the sexy stuff is important, but it happens rarely. And if you want to improve care in your system, it's about the fundamentals of good care.”

Additional resources

Episode timeline

00:31 – Rob welcomes listeners; introduces the 2025 NEMSQA measures discussion and notes prior episode with Dr. Jeff Jarvis

01:10 – Dr. Dorsett joins; holiday surge discussion and flu impact on EDs and admissions

03:08 – Dr. Dorsett explains her role as co-chair of NEMSQA’s Measure Analysis and Research Committee; trauma focus of the 2025 report; pain measures not included due to active research

05:00 – NEMSIS scale and opportunity: extracting meaningful measures from a massive national dataset

05:35 – Dr. Dorsett on what NEMSIS measures well vs. what it shouldn’t force clinicians to document (system should determine trauma center status)

07:46 – “HALO procedures” table: why rare interventions shouldn’t become national quality measures

10:17 – Trauma 08: complete vital signs; pediatric gap (adults ~93% vs pediatrics ~85% in discussion)

14:22 – TBI measures: preventing secondary brain injury; why fundamentals outperform “sexy” fixes; correction rates for hypotension/hypoxia discussed

21:39 – Trauma 04: trauma triage criteria and transport to trauma centers; why national measure looks low; documentation field limitations

24:17 – State collaboration comparison: using state trauma center designation data shifts performance dramatically (often 75–90%+ in examples)

26:55 – Trauma 14: hospital prenotification; importance and measurement challenges (multiple modalities, inconsistent capture)

30:01 – Rob raises operational/policy concerns about trauma alerts and incentives; Dr. Dorsett adds nuance about local criteria variation

33:22 – Closing: Dr. Dorsett’s “fundamentals matter” takeaway; impact at scale

34:44 – Dr. Dorsett plugs joining NEMSQA as an individual/agency; committees are open

35:31 – NAEMSP Tampa preview; Dr. Dorsett: “The people” are why she goes — leaves energized with new ideas

Enjoying the show? Email [email protected] to share feedback or suggest guests for a future episode. 

This week on Inside EMS, Chris Cebollero kicks off 2026 with a heartfelt conversation featuring Eric Morrison, vice president of the National EMS Memorial Bike Ride and EMS director for Iredell County, North Carolina.

The ride, founded 26 years ago, exists to honor the memory of EMS providers who died in the line of duty, from illness or mental health struggles. Each rider wears a dog tag bearing the name of a fallen provider, often connecting with their families along the journey.

Eric shares his personal journey from lifeguard to leader and how his rekindled love for cycling — along with the loss of friend and EMS wellness advocate Brian Fass — led him to the ride. He breaks down what it takes to join (hint: it’s more doable than you think), the logistics of the ride, and how EMS agencies and individuals can support the cause, even off the bike.

“All of us are focused on the idea that our providers matter. They matter to their families, they matter to their communities, and they should matter to all of us.”

“People that didn't even know that person are recognizing their service. They're recognizing their commitment to the community, and they're honoring them and remembering them.”

“Once you come out and see what the ride is really about, you understand the mission and you see the impact it has on these families that we're able to meet with.”

Enjoying Inside EMS? Email [email protected] to share feedback or suggest a guest for a future episode. 

Dr. Douglas Kupas joins Rob Lawrence to kick off EMS One-Stop in 2026, reflecting on his first year as President of NAEMSP — a year he describes as fast-moving, complex and occasionally “whack-a-mole,” with emerging issues demanding real-time leadership while long-term priorities still had to move forward.

He shares what he’s learned about the presidency, the value of NAEMSP’s leadership “bench strength,” and why advocacy and coalition-building across national EMS organizations has become more coordinated, more strategic and more essential.

The conversation then turns to what’s immediately ahead: the NAEMSP Annual Meeting in Tampa (late January), including pre-conference courses, the flagship Medical Director’s Course, and a packed scientific program. Kupas highlights a keynote focused on transforming battlefield trauma care; major research programming through oral abstracts and hundreds of posters; and high-impact sessions spanning clinical care, operations, legal issues, and international perspectives — reinforcing why the Tampa meeting remains a must-attend event for anyone serious about the science and future of EMS.

00:00 – Rob tees up NAEMSP Annual Meeting growth as a “good problem to have”

Enjoying the show? Email [email protected] to share feedback or suggest guests for a future episode. 

As the year wraps, Rob Lawrence welcomes back the “EMS Avenger” Jimmy Apple for a fast-moving, end-of-year pulse check on the EMS universe — through the lens of social media, research and what frontline clinicians are actually saying when the mic is on and the comments are open.

Building on last week’s data-and-trends conversation , this episode pivots into “the world according to Jimmy Apple” and his alter ego, the EMS Avenger, exploring what’s made providers lean in, push back or flat-out declare “enough is enough.”

| SHARE YOUR STORY: A call for real stories from the EMS field, station and beyond 

From burnout and workforce conditions to AI-assisted ECG interpretation and the rise of microlearning, the conversation lands on a central theme: the future of EMS isn’t just protocols — it’s people, technology and how we choose to learn, adapt and debate. Jimmy also names his “paper of the year” on spinal immobilization, explains how he handles disagreement without falling into “quicksand arguments,” and previews a packed 2026 speaking calendar — plus a relaunch of his podcast.

“If we can just verify that you’re retaining the information, that’s much more important than the veracity of how long it took you to get that information.” — Jimmy Apple

“You can catch more flies with honey than you can with vinegar.” — Jimmy Apple

“That’s the future; is that literally, we’re going to swipe it, absorb it and swipe away again.” — Rob Lawrence

“My paper of the year is the paper that was published on spinal mobilization … It does not support the use of backboards as anything other than an extrication tool.” — Jimmy Apple

“I think that a big push that I’m making this year is to really start talking about the EMS provider as the person.” — Jimmy Apple

00:56 — Rob welcomes listeners, references year-in-review data and notes ambulance thefts continue to trend.

01:38 — Rob brings Jimmy back and asks for a quick summary of Jimmy’s year and growing reach, and the top themes Jimmy has seen.

04:12 — Jimmy identifies provider conditions and mindset as the dominant theme and describes discussion of collapse/collapsing systems.

06:12 — Jimmy explains social media as the pulse point and highlights burnout, anger and provider frustration.

06:52 — Jimmy pivots to technology’s growing role and EMS resistance to tech encroachment in practice.

07:23 — Rob connects the tech thread to conference observations (Axon, AI). Jimmy gives examples (AI 12-lead, apps) and argues tech advancement shouldn’t be rejected due to “skill deterioration” fears.

09:34 — Rob asks Jimmy’s “how do you explain complex concepts quickly?” Jimmy uses the Michelangelo anecdote to describe stripping concepts to essentials; critiques padded, time-gated education.

12:29 — Jimmy argues for education credit models that recognize microlearning and self-directed learning if retention can be verified.

14:04 — Rob asks for standout research; Jimmy discusses RSI/induction agent considerations, pressors debate and prehospital antibiotics.

16:47 — Rob and Jimmy preview NAEMSP’s annual meeting (“research Disney”), value of posters, networking and clinical depth.

18:26 — Jimmy names spinal immobilization evidence review as his “paper of the year” and explains its conclusions.

21:36 — Rob asks how Jimmy handles disagreement/detractors with a larger platform — Jimmy describes disagreement as healthy, focuses on respectful pushback and staying anchored in data.

29:00 — Final question: Jimmy emphasizes “provider as person,” healing the clinician and a sponsored podcast relaunch in January.

Meet the EMS Avenger: Saving lives with kindness and content. TikTok sensation and pediatric critical care paramedic Jimmy Apple shares his rise in EMS education, battling misinformation with heart and hustle

Jimmy Apple’s “paper of the year:” Millin MG, Innes JC, King GD, Abo BN, et al. “Prehospital Trauma Compendium: Prehospital Management of Spinal Cord Injuries — A NAEMSP Comprehensive Review and Analysis of the Literature.” Prehosp Emerg Care. 2025 Aug.

Connect with Jimmy Apple, better known as The EMS Avenger:

TikTok — Jimmy offers short-form, evidence-based EMS content here: @emsavenger

Instagram — Engage with in-depth reels, visuals, and professional updates: @emsavenger

X (formerly Twitter) — Follow EMS commentary, conversation, and boosts: @EMSAvenger

Facebook — Join the group for discussions and shared insights: EMS Avenger community

Apple Podcasts — Listen to “EMS Avenger: 20 Minutes to Save the World”: Weekly podcast series

AAA & AIMHI EMS Media Log: EMS Intel

Enjoying the show? Contact the EMS One-Stop team at [email protected] to share ideas, suggestions and feedback.

As EMS closes out 2025, host Rob Lawrence is joined by Matt Zavadsky (PWWAG) and Rodney Dyche (Patient Care EMS Solutions) for their second annual EMSIntel.org “year in review” conversation — a fast-moving tour through the biggest stories shaping the EMS profession.

Drawing from the EMSIntel news log (now 3,849 stories as of the morning of recording), the trio connects what’s making headlines to what EMS leaders are experiencing on the ground: unstable economics, governance pressure, system redesign and rising operational risk.

The discussion lands on several recurring themes: economic sustainability as the dominant issue; the real-world politics of tax levies and “essential service” designations; the ongoing obsession with response times (and what they cost); preventable ambulance thefts escalating in severity; and the importance of measuring and publishing clinical outcomes and meaningful performance metrics. The through-line: communities are being forced into more honest conversations about what they can afford — and what EMS should look like going into 2026.

| SHARE YOUR STORY: A call for real stories from the EMS field, station and beyond

Additional resources:

Enjoying EMS One-Stop? Email [email protected] to share feedback or suggest guests for future episodes. 

In this end-of-year special, Chris Cebollero and Kelly Grayson wrap 2025 with their trademark mix of humor, insight and zero sugarcoating. From venomous bites to venomous behavior, the Inside EMS duo continue counting down the top EMS stories that had the industry buzzing this year — and occasionally cringing.

As always, the guys don’t shy away from the tough stuff, but they make sure to end on a note of gratitude for the everyday EMS pros out there doing the job with compassion, competence and quiet heroism.

“Every day, EMS providers go out there, do their jobs and bring some kindness and some comfort to a really bad day for their patients. And I think we need to look forward to more of that in 2026.”

“Sometimes we've done things that maybe we shouldn't have, because it isn't in our scope of protocols, but I think we make a difference. Where's the line?”

“Most of the advantages of mechanical CPR are not advantages at all.”

Representatives Glenn Thompson and John Mannion introduced the EMS Counts Act

Social Security Fairness Act signed into law, boosting retirement benefits for first responders

Kentucky EMTs face KBEMS hearing for administering antivenom after mamba bite

Elkhart firefighter appeals loss of paramedic duties after nurse’s harassment complaint

American Heart Association's 2025 CPR guidelines: Choking, opioids & survival chain

Ill. city council makes $500 lift assist fee permanent

Warren-Wentworth Ambulance shuts down after entire staff quits

'Shut the f**k up!': North Babylon Fire Chief Peter Alt on leave after video shows him cursing at patient

Orange County fire chiefs demand removal of EMS director for halting blood transfusions, ketamine use

Colo. paramedic charged with manslaughter after sedating, restraining man

National EMS Advisory Council board members terminated

Enjoying Inside EMS? Email [email protected] to share feedback or suggest guests for an upcoming episode. 

In this special Christmas edition of the Inside EMS podcast, cohosts Chris Cebollero and Kelly Grayson unwrap five of the biggest EMS stories of 2025 — and it’s not all eggnog and cheer. This year delivered more than its fair share of gut punches to the profession, from a paramedic who was charged with manslaughter, to footage of a fire chief yelling at a 10-year-old patient (yeah, that happened).

Next week’s show will break down the final five EMS stories of the year, but in 2026, we’re flipping the spotlight. Chris and Kelly are calling on you to step up and share your real EMS stories — the funny, the frustrating, the calls that changed you. Got a moment that shaped your career? Our cohosts want to hear it, and you might even get an invite to appear on the podcast. ‘Tis the season to be heard; email [email protected] to share your story!

“You're the grownup. You can't pitch a fit. You gotta be the grownup in the situation and diffuse it.”

“If your only incentive for doing the right thing is that somebody might catch you being a jerk on video, then it's time for you to get out of the profession.”

“The cost of readiness is hugely expensive.”

Enjoying Inside EMS? Email [email protected] to share feedback or suggest guests for future episodes. 

In this episode of the EMS One-Stop podcast, host Rob Lawrence revisits an issue close to the heart of every EMS professional: creating a permanent National EMS Memorial in Washington, D.C.

Rob is joined by Tony O’Brien and James Robinson from the National EMS Memorial Foundation to provide a clear, candid update on where the project stands, why it matters, and what still needs to be done.

From the Weekend of Remembrance to the dream of a year-round place of solace and reverence in the nation’s capital, this conversation lays out the long road from idea to reality — and why EMS, as James puts it, truly deserves this.

Tony and James walk listeners through the 24-step federal Commemorative Works Act process, the hard work of narrowing 312 potential sites down to three, and the current push to reauthorize the Foundation’s federal authority through House Resolution 2196 and Senate Bill 2546.

They explain the preferred site in front of the Hubert H. Humphrey Building (HHS), the partnership with MIT’s School of Architecture and Urban Risk Lab on a powerful design, and the practical realities of funding, sponsorship and bureaucracy.

Most importantly, they end with a clear call to action for the EMS community: contact your elected officials, donate what you can, and help spread the word so that a permanent memorial to EMS can finally take its place in Washington, D.C.

EMS Memorial

EMS Memorial Bills:

HR 2196 

S2546 

2025 National EMS Weekend of Honor recognizes 29 fallen EMS workers

‘Never forgotten’: 2025 Moving Honors procession honors 29 EMS providers lost in the line of duty

00:44 – Rob introduces the episode, sets the scene for a revisit of the National EMS Memorial effort, and welcomes guests Tony O’Brien and James Robinson.

01:30 – Tony and James share their backstories.

03:53 – Tony explains the origins of the Foundation at the Weekend of Remembrance/Weekend of Honor and the realization that EMS needs a permanent memorial people can visit year-round.

06:54 – James outlines the Commemorative Works Act, the 24-step process, and how the Foundation has reached step 15-16 over roughly 15 years.

07:54 – Tony details the grueling site-selection work: visiting 312 sites, environmental and noise studies, traffic and solitude considerations, and narrowing to three candidate locations.

10:48 – James describes the need for an Act of Congress to begin, Congressman Stephen Lynch’s early sponsorship, and the 2018 authorization that started a 7-year clock — complicated by the pandemic and federal shutdowns.

13:12 – Tony explains how the initial authorization expired, the need for reauthorization and the most recent Senate subcommittee hearing on federal lands where James testified.

16:41 – James and Tony frame the new bills: Senate Bill 2546 and House Resolution 2196, their bipartisan sponsors and the push for more co-sponsors.

19:49 – Tony lays out the three-point call to action: contact Congress, donate via EMSMemorial.org, and follow/share @EMSMemorial on social media.

23:06 – Tony describes the three remaining sites and why Independence Ave. & 3rd St SW, in front of HHS, is the preferred location.

24:42 – Tony highlights the pro-bono design work by MIT’s School of Architecture and Urban Risk Lab, and the deep engagement with providers, families and survivors.

26:32 – James explains the historical nexus of EMS with HEW/HHS and why the Humphrey Building plaza offers the right reverence, proximity to the Capitol and connection to EMS history.

29:01 – Tony and James discuss next steps: reauthorization first, then finalizing site and design to approach major sponsors with clear answers on location, look and cost — while acknowledging the project has been bootstrapped so far.

32:03 – Tony reassures donors: the Foundation is a 501(c)(3), the board are all volunteers with only necessary professional services paid from donations.

33:13 – Tony gives shout-outs to the National EMS Memorial Service and the National EMS Memorial Bike Ride, and explains how the three organizations’ missions align.

37:12 – Rob recaps the journey, reinforces the call to action, and closes the show with thanks to Tony and James and a reminder to visit EMSMemorial.org and like/subscribe to EMS One-Stop.

Enjoying the show? Please take a moment to rate and review us on Apple Podcasts. Contact the EMS One-Stop team at [email protected] to share ideas, suggestions and feedback.

Listen on Apple Podcasts, Amazon Music, Spotify and RSS feed.

What do you do when someone on your team is struggling — and it’s on you to say something? In this episode of the Inside EMS podcast, Chris Cebollero and Kelly Grayson dive headfirst into one of leadership’s toughest challenges: holding people accountable without losing your humanity.

This episode challenges leaders to ditch outdated progressive discipline models and start leading with clarity and empathy. Whether you’re a seasoned supervisor or new to the hot seat, this one hits home. And if you’ve been avoiding a conversation, consider this your nudge to stop choosing comfort over your own integrity.

“Firing people with compassion, managing your ego, their ego, admitting mistakes and just being human — these are the places where real leaders show up.”

“One of the things I try to teach is that I don't fire anybody — I just process the paperwork. People fire themselves.”

“EMS is a very egotistical business, and it's that ego that keeps us from asking questions. Because we don't want to look like we don't know what we're talking about in front of our peers.”

Enjoying Inside EMS? Email [email protected] to share feedback or suggest a guest!

Recorded on the floor of the EMS|MC EMSpire Conference in Charleston, South Carolina, this episode of EMS One-Stop finds host Rob Lawrence in conversation with long-time collaborator and EMS advocate Matt Zavadsky.

Fresh off the longest federal government shutdown in history, Rob and Matt unpack what the hyper-turbulence in Washington really means for EMS: suspended Medicare extenders, disrupted grant programs, agencies taking out loans just to meet payroll and training programs put on hold.

They break down NAEMT’s flash poll on the shutdown’s impact, the promise of the Treatment in Place (TIP) legislation, and why associations “hunting as a pack” on Capitol Hill matters more than ever.

Along the way, they spotlight EMSIntel.org as a national barometer of EMS funding, staffing and response time crises, and issue a clear call to action for providers, billers and leaders to use association tools to contact their members of Congress.

| MORE: Government reopens: What EMS providers need to know right now

In the second half, Rob is joined by Dr. Shannon Gollnick, paramedic, EMS leader and organizational psychologist, to explore how artificial intelligence is reshaping EMS — right now.

Shannon makes the case that AI is “not the future; it is the present,” and that agency leaders must urgently build literacy, policies and guardrails around its use. They dig into the difference between HIPAA-compliant, embedded AI in ePCR systems, and risky open tools like ChatGPT, touching on hallucinations, embedded code and emerging Medicare fraud-detection programs.

| MORE: Artificial to augmented intelligence. How Dr. Shannon Gollnick wants EMS to work smarter, not harder

Rob and Shannon talk about AI as a powerful but potentially dangerous tool — “like having a tiger” — and outline practical steps for chiefs:

Ask: “Do we have an AI policy?”

Define what AI can and cannot be used for

Insist that every AI-generated work product is double-checked by a human before it hits the record

“We weren't here to actually scare you off it. We're here to let you know that it's here, but it's like having a tiger, right? We all love to have a tiger, but it has to be contained in some sort of guard, otherwise it's going to run rife and cause havoc, and we don't want that.” — Rob Lawrence

“This is part of the hyper-turbulence that's occurring in EMS right now.” — Matt Zavadsky

“So I think the message for the profession right now is, now is not the time to put your foot on the brake. It's time to put your foot on the gas.” — Matt Zavadsky

“We put the fun into function.” — Dr. Shannon Gollnick

“I think it's important to understand that AI is not the future. It is the present. We are currently here right now. And it's nothing to be afraid of.” — Dr. Shannon Gollnick

“If you're not doing it, I promise you that your staff is doing it and they're playing around with AI.” — Dr. Shannon Gollnick

“Guardrails don't exist from a congressional standpoint. They don't exist from a regulatory standpoint. The technology is moving far too fast. So we as agency leaders have to take the lead in putting up some of those guardrails.” — Dr. Shannon Gollnick

“There are ePCR software out there that are using proprietary AI that will use AI-generated narratives. And that absolutely is 100% good to go. What we don't want to see is our crews putting in their ChatGPT to have ChatGPT write their narrative.” — Dr. Shannon Gollnick

“ChatGPT has embedded code inside of it that you can't see, but that code is there ... so what we're kind of afraid to do is to say, hey, what happens 6 months from now, 8 months from now when Medicare does an audit, they run your ePCRs and find all of this embedded code from ChatGPT ... you open yourself up for a lot of compliance issues.” — Dr. Shannon Gollnick

Additional resources:

EMS Intel EMS News Tracker

American Ambulance Association Advocacy

NAEMT Advocacy

EMS shutdown survival: What leaders need to know now

Charting the future: How AI is rewriting the EMS narrative

Episode timeline:

00:21 – Rob introduces guest Matt Zavadsky

02:02 – Rob recaps the 40-plus-day federal government shutdown, questions about reopening, and his upcoming return to Capitol Hill for renewed advocacy

02:02 – Matt frames the shutdown as part of the “hyper turbulence” in EMS; explains the regulatory suspensions, pauses in Medicare extenders and grants, and how cash-flow uncertainty forced some agencies to take out loans just to make payroll

03:04 – Matt details NAEMT’s flash poll (408 agency responses) showing suspended training and grant-funded programs, and warns of a possible repeat shutdown around January 30

03:54 – Rob and Matt discuss the reopening of government, ongoing bipartisan work, and the risk that everything “comes to a grinding halt” again if Congress can’t agree

04:51 – Matt explains why NAEMT released the shutdown-impact poll even as government reopened and stresses the need to keep pushing for permanent relief from Medicare extenders and advancement of key bills like Treatment in Place (TIP)

06:03 – Matt outlines the House and Senate TIP companion bills and why Medicare paying for treatment in place is better for patients, EMS, the health system and the Medicare trust fund

06:54 – Rob notes broad association/provider support and professional lobbyists on the Hill; Matt stresses that field providers, administrators and billers must still use association legislative portals to send letters to Congress

08:08 – Matt describes a surge in communities reevaluating their EMS delivery models because of staffing, finance and subsidy challenges — “a great time to be an EMS consultant”

09:09 – Rob introduces EMSIntel.org as a curated clearinghouse of EMS news, used to show communities they aren’t alone; describes failed tax measures and funding referenda

10:15 – Matt cites EMS Intel data: ~85% of stories each month involve funding, staffing or response times; Rob and Matt stress the ubiquity of these themes from big cities to small towns

11:09 – Rob highlights mutual aid tensions and taxpayers questioning why they “pay to send our resources somewhere else;” both emphasize that hyper-turbulence and funding gaps are national issues

13:23 – Rob resets the scene from the EMSpire conference and recaps Matt’s Hill update before introducing Dr. Shannon Gollnick

14:41 – Shannon gives his backstory: in EMS since 1996, paramedic since 2002, progression into EMS leadership, doctorate in organizational psychology and focus on how organizations function

15:14 – “We put the fun into function.”

15:24 – Rob invites Shannon to talk AI, calling it “the specter we are embracing everywhere,” and references HIPAA concerns; Shannon opens with the core message: AI is not the future, it’s the present, and nothing to be afraid of

16:03 – Shannon urges leaders to build AI literacy, noting that if agencies aren’t using it, their staff and the younger generation already are

16:28 – Shannon emphasizes policy and procedure: AI guardrails aren’t coming from Congress or regulators, so agency leaders must define how AI will be used and where its limits are

16:55 – Rob reminds listeners that AI in EMS isn’t new, citing early monitor rhythm interpretation in the UK; Shannon underscores that crews already use AI tools and that unmanaged cut-and-paste practices can create billing and compliance risks

17:24 – Shannon explains the dangers of using open tools like ChatGPT for ePCR narratives: potential PHI exposure in a “black box” system and AI hallucinations generating plausible but false patient information

18:21 – Shannon describes how AI “wants to answer your question and make you happy,” leading to made-up details, and shares examples from testing minimal-input scenarios that returned overly detailed, inaccurate narratives.

19:03 – Shannon calls ChatGPT “kind of a snitch,” explaining embedded code markers that fraud detection tools — and increasingly Medicare’s AI-based “Wiser” program — can use to identify AI-written content in documentation

19:59 – Shannon warns about retrospective audits and compliance exposure if ChatGPT-coded narratives are found in ePCRs, noting that AI rules are still emerging and tech is outrunning regulation

20:51 – Rob summarizes the mixed message: AI is here and being built into devices and software, but there are real dangers. They discuss data going “to the cloud” — which Shannon defines as “somebody else’s computer.”

21:24 – Shannon frames AI as a powerful tool that can “put a lot of holes in the wall” if misused; he references fraudulent AI uses and deepfakes as emerging issues

22:05 – Shannon compares AI’s impact to the internet’s paradigm shift; Rob gives a “spoiler alert” about his own workflow using transcripts and ChatGPT agents, and notes the importance of reading and checking any AI-generated output

22:45 – Shannon reinforces that AI makes mistakes and cannot understand human context; he uses his “How you doing?” Joey Tribbiani vs. Tony Soprano example to illustrate contextual nuance

23:06 – Rob expands the context point with the “Friends”/“Sopranos” slide and reminds listeners that once AI-written words are published, “you said it.” Shannon highlights the WebMD effect and AI-driven self-diagnosis risks.

24:02 – They note that ChatGPT can generate long, complex diagnoses without sufficient patient context, leading to errant or misleading outcomes if misused clinically

25:00 – Rob summarizes: AI is here and, used correctly, is a good thing; advises chiefs to ask their teams, “Do we have an AI policy?”

25:27 – Shannon outlines what an AI policy should contain: acknowledgment that AI is here; clear, non-fearful framing; specificity on what decisions AI can support; and clarity on which tools (e.g., embedded EPCR AI) are allowed versus prohibited uses of ChatGPT

26:17 – Shannon stresses AI should not be used for clinical decision-making or clinical narrative writing; its role should be administrative only, and all outputs must be double-checked

Enjoying the show? Email [email protected] to share feedback or suggest a guest for a future episode.