alabama's. - Air Ambulance Card

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                                                                                             By BarbaraSloan · Photosby DennisKeirn

Home to three of the nation's air ambulance services,
each relies heavily on today's technology to stay
abreast of their operations and their customers.


 Nestled among nodding dogwoods and oaks just off 1-459 in Vestavia Hill's peaceful
 Liberty Park is a busy control room that rivals one of NASA's. CEO Jeff Tolbert punches a
 code into the locked doorway and enters a headquarters    manned 24/7. Eight enormous
 reflective screens portray live maps, video feeds and two national news networks, all
 projected from overhead devices.
     GPS,satellites, Internet, computers and telephones all playa    ambulance jets for over 25 years. And their benefits are available on
 role in this business. A nurse is director of the communications    a fee-for-servicebasis, as well as via membership for as little as $95.
 center because this is AirMedInternational, the country's leading       With experienced air medical-transport crews, the company
 air ambulance company.Recently winning the prestigious Air          has been chosen as the fixed-wingtransport for the world-famous
 Ambulance of the YearAward at the 15th annual International         Mayo Clinic,as well as a preferred carrier for the U.S.Department of
 Travel Insurance Journal (ITIJ)Awards ceremony in Venice,the        Defense. Unlikeother air medical companies, AirMed owns a fleet
 company offers medical care and bedside-ta-bedside transportation   of fullycustomized fixed-wingaircraft and operates from its home
 on a worldwide basis. AirMed,providing service to more than 1       base in Birmingham,with additional bases in Honolulu,Hawaii,
 millionmembers in the U.S.and Canada, has operated fixed-wing       and Rochester, Minn. In March, AirMed opened an operation in

  Technology Alabama                                                                                                    SUMMER 2008        11
               AIR        AMBULANCE

Hong Kong,making it the first U.S.air ambulance company with                          hundreds of miles away) to the criticallyill 13-year-old  recipient.
a permanent base in Asia. AirMedhas purchased an additional                           With such a successful mission, Tolbert dedicated a part of his
Hawker 800long-range aircraft for that base.                                          business to air ambulance service, and in 1982became the first in
     On this particular day, four people operate computers in                         North America to use jets exclusivelyfor medical transport.
the control room - all are EMTqualified.A map shows a plane                                Later,Tolbert devised a revolutionary idea of membership in
flyingfrom Cincinnatito Birmingham at 28,000feet. Three of the                        air medical services after a familywas almost bankrupted. His
computers are dedicated to U.S.and international business. The                        company received a call from a distressed father whose son was
fourth concentrates on a busy Hawaiian base of operation. A                           severely injured in the mountains of Afghanistan while on a photo
liveweb-camera shot reveals a plane taxiing down the Honolulu                         assignment forNational Geographic and the cost for transport
runway.                                                                               home to Cincinnati was staggering.
     Tolbert explains that a recent patient who was transported                            All air ambulance companies have heroic oversees rescue
from Norway to Minnesota with a physician, nurse and respiratory                      stories, but Tolbert says 80 percent of their flights are domestic.
therapist would have paid $93,993for the trip without AirMed                          Over 30 percent of their members use benefits to move to another
Traveler membership. "Weare about to move a member from a                             facility,such as the Mayo Clinic.A cardiac problem is the number
spring break location back to Alabama. That would be an $8,000                        one cause for transport, with motor vehicle accidents rating
flight without coverage.'                                                             second in AirMed's data. That statistically makes the average age
     Not only CEO,but founder of AirMed International, Tolbert                        for conveyance 44.
had his pilot's license by age 17and started an air charter service,                       Technology is involved in every area of AirMed's operations,
 JETCO,while still in school at the Universityof Alabama. Soon                        from the planes utilizingtheir own satellite transmitters to give
 after attaining his Bachelor of Science degree, he jumped into                       the home base their speed, altitude and direction of travel, to the
 the air medical business when he began transporting human                            most elaborate medical equipment onboard. In a room beyond the
 transplant organs. In fact, as the Universityof Alabama Schoolof                     control room,an aviation dispatch area gives pilots information
 Medicine's hospital prepared for the first heart transplant in the                   critical for their operations. Most countries require landing permits.
 South, Tolbert was selected to fly the donor (stillon lifesupport                    Many oversees airports do not operate 24 hours a day, so timing
                                                                                      can be crucial. But after so many years in the business, AirMed
     .                                                        !fl
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                                      .v                                          '
                                                                                      is the expert in the field.Their planes are tied into Homeland
                                                                                      Security and meet Department of Defense criteria. In fact, they are
                                                                                      one of only three air ambulance companies approved by the USDD.
                                                                                           Soon AirMedwill be the first company to have all patients' vital
                                                                                      signs monitored online. Their server room, behind locked doors,
                     ~)                                                               has mirror image backup. As the carrier for Blue Cross/Blue Shield
                                                                                      of Alabama and other insurance companies, their data storage
                                                                                      complies with the Health Insurance Portabilityand Accountability
    ~                53                            ~'            ~_ -       .~.
                                                                                      Act (HIPAA). generator with two-clay'sworth of diesel fuel stays
                 -~           ~..-                                      I
                                                                     1'Co1            ready for backup of the entire operation.
                                                                                           AirMedis proud of an impeccable reputation. Onlytwo of over
                                          . /~..          .-.:.. D.    4          .
                                                                                  I    12,000flights have been diverted, and those were due to non-
                                                             -'''=                I
                                                             OC-CT                     emergency issues. They routinely provide service to Fortune 500
                                                                                       companies, prominent medical centers, international assistance

                                                         lit                           companies, major universities, embassies and other foreign
                                                                                       government agencies.

                                                                                      Not Alone in the Skies
                                                                                          But AirMedis not the only highly respected air ambulance
                                                                                      service in the state. Air Ambulance Card and MedJetAssist, also
                                                                                      located in Birmingham,serve the public in a way that differs
                                                                                      greatly from travel industry insurance.
                                                                                          Air Ambulance Card LLCManaging Director Sam Jackson
                                                                                      notes, "The three Alabama air ambulance companies filla niche in
                                                                                      the market. None of us ask if it is medically necessary to bring you
                                                                                      home. We just do it ifyou meet the criteria."His company focuses
                                                                                      only on one product: a yearly membership. He believes it allows
                                                                                      them to be the lowest cost alternative to travelers, while offering a
                                                                                      high level of protection.
                                                                                          Jackson says travel companies often have a medical
                                                    JeffT olbert, CEOof
                                                   AirMed International,              evacuation component, and, in the case of a medical necessity
                                                stands in front of one of             (and they decide what that definition is),they will arrange to
                                               the company's airplanes.               transport a traveler to the closest medical facility "Theyput a cap

 12 SUMMER2008                                                                                                                       Technology Alabama

              AIR       AMBULANCE                                                                                    I

of something like $25,000to $75,000on their benefits. And they will only
fly you where they choose."
     John Gobbels,vice president and COOof MedjetAssist, agrees
with Jackson that Alabama's companies are special. MedjetAssist
started in 1998as a consultation membership program, backed by a
powerful investment team with Alabama ties. He says, "Regardless of
medical necessity, if a member becomes injured or ill,domestically or
internationally,and requires inpatient hospital care, MedjetAssist will
transport the member to the hospital of their choice with virtually no
pre-existing condition exclusions, health questions, deductibles, co-
insurance or claim forms. There are no monetary limits to the program
benefits, and no restrictions on how often the member pursues travel
during the membership period."
     Gobbels explains that if you are vacationing in Los Angeles and have
a small stroke, some companies would not qualify a flight back home
to New YorkCityor Mobileas a medical necessity. The three Alabama
air ambulance companies will convey you to your hospital of choice, no
questions asked.
     While Jackson says his company treasures their Alabama
clients, most of Air Ambulance Card's marketing is outside the state.
 Confidentialityissues keep some of their "top"clients a secret, but they
 do claim Care First/Blue Cross and Blue Shield of the Washington and
 Maryland area, and the North American Travel Journalists among
 their rosters. MedjetAssist numbers Regions Financial, Safari Club
 International (the premier outdoor enthusiasts), and Southern Medical
 Associates among its customers.
     In the last few years, both Air Ambulance Card and MedjetAssist
 have witnessed huge technological impacts with the Internet and

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      Systems                  Engineering,                  Integration,   and    Collaboration

         990 Explorer Drive, Suite B; Huntsville, Alabama 35806                   Phone: 256.922.8791
         Alabama                                                                                   SUMMER2008   13
                                                    AIR       AMBULANCE

its ability to transmit more messages to more people in more
places. Jackson says, "It makes us a 24-hour-a-day,365-days-a-year
     Gobbels explains that while MedjetAssist is a membership
and not an aircraft company, they maintain affiliateswith fleets.
"Andof course, there is a lot of technology involvedin the aircraft
and its medical devices, but what has impacted us tremendously
is our use of databases and member databases. We now serve
over 100,000members, and we have to maintain informationon
them. When someone calls for service, we have to know their
current membership status and their medical background. Our
plus program has MedFlash - Real-Timeand online data storage
of medical information,so through a UBSdevice, we can access
informationonline and email it to a physician in another country."
     Jackson adds that computers and databases can now
track trends in sales and marketing, as well as demographics
of membership. The Internet eases communication. People can
easily ask questions without waiting for normal business hours. If
something comes up, a person can email a question at 2 o'clock in
the morning.
     In the business since 2002,Jackson says in six short years,
 communication and record keeping have become tremendously
 easier. "Whenwe started less than a decade ago, all our
 emollments were done by hand. People called or mailed or
 faxed in their information,because no one trusted the Internet
 to conduct business. But the web makes our business and our
 customers' lives so much easier. We have seen a tremendous
                                                increase in online
                                                emollments over
                                               the last six years."
                                                   Another big
                                               change is that when .
                                               Air Ambulance
                                               Card started doing business, they did not even ask for a cell number. "Nowthat is the most
                                               important item we obtain,"Jackson admits. "Now almost everyone has a cell or satellite
                                               phone. Leisure and business travelers use them all over the world. They can reach us from
                                               Birmingham,England or Birmingham,Alabama."
                                                   Gobbels also has seen this trend: "Peopletravel to remote places these days, and sat phone
                                               use has increased tremendously."
                                                   Since neither Air Ambulance Card nor MedJetAssist use their own planes, the Internet
                                               assists the businesses in easily coordinating flights.Jackson explains, "There are companies
                                               that transport patients internationally that routinely email or make available on the net
                                               when and where their planes are going. Ifwe have a patient in Israel. and a plane has taken
                                               someone there, we have the availabilityto use the plane on its return trip."
                                                   Gobbels says they used to make a phone call to an affiliatewho might report being four
                                               hours over the Atlantic Ocean. Now they are able to track commercial and air medical craft all
                                                over world online and see when they are due in at their next location.
                                                   Jackson adds that it is a great time to be in this business. Baby boomers are young at
                                               heart, adventurous, and want to see America and the rest of the world. "Wetell them to go and
                                               have an adventure and if something happens, we'll bring them back home."
                                                   MedJetAssist has just become the exclusive provider of worldwide air ambulance and
                                                medical repatriation services for AARP.Gobbels says this group has an ideal customer profile.
                                                "Theirmembers have a propensity to travel domestically and occasionally on an international
                                                basis, as well as an innate understanding that illness or injury can happen anywhere and
                                                anytime. These people desire to remain in control of their options when it comes to the care
                                                they receive."

                                                   Barbara Sloan is a freelance writer for Technology Alabama.

14 SUMMER2008                                                                                                          Technology Alabama