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HEMS Definition
       HEMS is an air transportation activity using helicopters to rescue and transport patients under the condition of first-aid and medical monitoring, which has incomparable superiority. Air ambulances are usually considered as ICU (Intensive Care Unit)
       Air ambulances are mainly used to transport those critically ill patients who could not be transported by ground ambulances timely and safely in case of emergency, as well as those patients that could not be treated continuously or cured completely by local hospital or medical institutions. At the same time, air ambulances are not limited by geographical condition. They can not only carry out regional transport, but can undertake international air medical transport.
Operational Model of Air Rescue
      In terms of operational model, air rescue can be divided into two main categories (take Europe for example):
       One is the government backing model, such as Britain, France, Italy and other countries. Civil police undertakes most of the tasks, and funds mainly come from local governments.
       Another is large-scale private medical rescue organization in Germany, Switzerland, Austria and other countries. Such as national federation of German air rescue can provide services for the whole Germany, and each car driver only needs to pay membership fees every year to enjoy the service. At the same time, the project enjoys large foundation grants.
       The ADAC (Allgemeiner Deutscher Automobil-Club e.V.) (General German Automobile Club) is an automobile club in Germany, founded on May 24, 1903 as German Motorbiker Association, and was renamed to its present name in 1911.
        With more than 18 million members in May 2012, it is the largest automobile club in Europe. It is also the largest motorcyclist association in the world, with 1.5 million members. After the establishment of civil air medical service system in Germany in 1970, the agency began to set up its own air medical service department in 1973. Now ADAC has 27 bases and provides 44 air ambulance helicopters for urgent medical rescues in Germany, strategically placed so that any location can be reached within 15 minutes. ADAC also has 8 fixed wing aircrafts providing long distance medical transport services for its members. Its primary aircraft type includes Donir 328-300, King Air A350 and Learjet and has 46 full time physicians and 300 part- time physicians. Since it was founded in 1975, ADAC has transferred 240000 patients; Now ADAC receives more than 47000 patient calls each year and conducts 16000 actual patients transportation every year.
       REGA (Swiss Aerial Rescue Guard): On April 27, 1952, Dr. Rudolf Bucher established Swiss air Rescue Service, which is an enterprise member subordinate to Swiss Red Cross. REGA operates 19 rescue helicopters and 3 large fixed wing jet air ambulances, with 2 million members, carrying out 12,000 air medical transports each year, annual revenue reaching $140 million.
       In western developed countries, air medical service from scratch has undergone nearly hundred years of development, among which civil air medical service has developed for more than half a century. From the initial transport only for those patients who need treatment in remote areas to providing diversified services for patients in developed areas, air medical rescue philosophy is proved to be successful, which can not only give patients timely treatment, bring hope of survival to patients, but also develop and perfect itself continuously, and has developed into a widely needed industry. Take America with a population of more than 300 million for example, there are over 100 air rescue transportation companies with a coverage area of one rescue aircraft per 300,000 people.         According to the air rescue development situation in western developed countries, there are two main methods of air rescue service charges:   
        1. Fee for Single Service. Because single air medical service fee is usually expensive, at the same time service providers are mainly airlines, hospital and first aid providers with profit purposes, therefore, these institutions usually charge fees based on customized service when providing air medical services.   
        However, due to perfect insurance protection in western countries, although each air rescue service fee is expensive, the payment is usually covered by the patient's insurance company.   
       2. Fee for Membership : Although insurance companies usually have the insurance liability for air medical service, given the high cost of medical service, insurance companies tend to have more strict ill condition limit and claims settlement approval when providing the insured with air medical service, thus to some extent, restricting the implementation of air medical service. In order to be able to provide more diversified services and solutions, membership-based service was introduced into air medical rescue industry. As long as the members pay a certain amount of membership fee per year, they can enjoy a free air medical service. Compared with insurance products with air medical rescue services, membership products have no strict restrictions in terms of patients' condition. Members can apply for air medical rescue after admission to hospital.
Air Rescue Task Model
        According to task model, air rescue can be classified into two categories: The first task is emergency rescue and the second task is planned hospital transfers and human organ transportation
        The first task focuses on effectiveness, such as using helicopters to transport the rescue personnel and equipment to the severe accidents scene at the first time (golden one hour principle). A helicopter can save time best because it can take off at any time, directly land at accident scene and arrive at the hospital helipads.
        Golden one hour in emergency medical treatment means that if patients can get effective medical treatment within one hour, mortality rates can be reduced by 25%. Rescue aircrafts equipped with far more complete medical equipment than that of conventional ambulances and their speed and efficiency is far beyond land and water transportation.
       The second task is planned hospital transfers and human organ transportation. If the task has high demand on time and transportation time is within 2 hours, helicopters are generally adopted. Converted fixed wing aircrafts are often used in case of long distance transfers, but ambulances to and from airports (even helicopters) are needed to do transport connection work.
        According to statistics, reasonably using a helicopter equals to the efficacy of more than 10 ambulances, which can save time and a multitude of accessory medical personnel , making it a first aid means with high-efficiency. Patients in a helicopter feel tiny vibration and accelerated speed. Also, the comfort level of patients in a helicopter is much higher than that in the most advanced ambulances. Finding a unique air medical rescue mode suitable for China will definitely bring benefits to the masses for a long time.