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The ASA+ FNA Conference Photo Competition for 30th Aeromedical Society of Australasia and Flight Nur

Necessity to Luxury: the role of governance in system design

Thomas Judge
LifeFlight of Maine / The LifeFlight Foundation, Port Clyde, United States



With particular interest in patient safety, risk, governance, and effects of health care policy for access and equity in rural medical care, Thomas has worked extensively in the design and implementation of emergency care systems national and internationally. He has served as a subject matter expert in countless reviews including five terms on the National EMS Advisory Council.

A 1996 Atlantic Fellow in Public Policy Thomas was posted at the MCRU/ University of Sheffield, the Scottish National Ambulance Service, the King’ Fund, and was a founding member of the Faculty of Pre-Hospital Care of the Royal College of Surgeons Edinburgh.


Air medicine is recognized as a valuable lifesaving utility in the medical system but concerns about cost continue to challenge providers in establishing value. From early beginnings and measured growth, air medical transport in the US has grown rapidly more than doubling the number of aircraft in a decade. The open market approach has simultaneously led to areas over-served while adjoining populations are underserved. In addition ongoing concerns regarding utilization, safety, standards, and costs challenge the value equation. Misalignments between aviation and healthcare policy and disconnects in federal and state level policy add complexity.


This presentation examines the role of healthcare policy incentives and corporate governance in system design. Using a compare and contrast format to examine the current configuration of the organization of air medical services in the USA, the presentation uses Maxwell principles to develop a matrix model for measuring value including standards and cost effectiveness in air medical transport.


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