Has your EMS region spent some time to develop a list of issues that the region would support or oppose as the TCD system in Missouri is revised?

Should we seek to develop a statewide system that is inclusive of all hospitals or as many as we can get?  A huge number of Stroke and STEMI and some trauma patients are "walk-in's" ........they arrive at the nearest hospital in a private vehicle, thus every hospital is already getting these critical patients.  Some state systems seek to include all hospitals as participatory so that they have transfer agreements already in place, collect some basic data and start the clock to help measure our success or failure with treating these critical patients.

How do we finally conquer the data conundrum?  We do not improve the TCD system if we do not collect data from EMS and hospitals, link it together and look at it?  

Funding: Arkansas pumps over $20 million a year into their trauma system.                      https://www.facs.org/media/press-releases/2017/arkansas030817                    Much of that funding helps fund the actual services for the patients filling the gap of un-compensated care provided (hospital and EMS).  Big funding could also help ease the cost of participation by small rural hospitals, fund the data system and improve governance.  That is a big question.  

Do we have the vision to seek the really big dollars that would make the TCD system what folks sought back in 2008 when the legislation was originally passed?