Paramedic Futures · A hub for paramedicine technology · Now forming
Build it with the people who will have to use it at three in the morning
Paramedic Futures is The Paramedic Foundation’s hub for paramedicine technology. It brings together the people who build tools for paramedicine and the people who have to live with them: paramedics, paramedic service chiefs, medical directors, educators, researchers, regulators, professional leaders, founders, and the companies and health systems already working in this market. Three ways to take part, described below, and they are genuinely different relationships. If you are building in this space, or you are tired of software arriving in your service already finished, there is a seat for you.
What this is, in one paragraph
Paramedicine technology gets built at a distance from paramedicine. Paramedic Futures closes that distance in both directions. Founders get structured, honest access to the paramedics, medical directors and service chiefs who determine whether a product survives a real call. Paramedics and the people who lead paramedic services get a working voice in what gets built, early enough to change it. TPF supplies the bench, the convening, and the administrative spine, and publishes the shared reference work the field needs and nobody currently funds.
Three ways in. An independent product and market panel review. A negotiated partnership where TPF may hold a real stake in the outcome. Or membership in the hub, which is the part that makes the other two worth anything.
Why building for paramedicine is hard from the outside
The market is small enough to move and specific enough to get wrong.
- The service adopting your product may have nine paramedics, no informatics staff, and a budget approved by a county board. That constraint kills more products than the model or the interface ever will.
- Buyers are several thousand agencies with no shared procurement, no common contract vehicle, and wide variation in what they are legally permitted to do.
- A medical director has to approve the clinical workflow before anyone can use it. That is a different sale from the one most founders plan for.
- Rural, frontier, Tribal and austere systems break assumptions about connectivity, staffing and transport time that hold everywhere else. These are not edge cases in paramedicine. In much of the country they are the case.
There is also a convening problem. Separate founding teams have approached TPF recently about the same narrow thing: turning a paramedic’s spoken account of a call into a usable patient care report. None knew the others existed. That is one problem being solved several times over, with no shared data layer under any of it. Put those teams in a room with the paramedics who would use the result and something better comes out, whether that is a common standard, sharper competition on the part that matters, or one team going to work on something nobody has touched.
Three relationships
Which one fits you
Not three sizes of the same product. They differ in what TPF does, what it is paid, and whether TPF holds a stake in your success.
Independent cohort panel
A focused, independent product and market review. One hour in front of the whole panel at once, plus adviser time before and after. TPF holds no interest in the product, and neither do the panel members reviewing it. For a company that has something to show and needs to know whether the workflow and the market case hold up.
Vested partnership
A negotiated partnership in which TPF may become fully vested in the success of a product, system or body of shared work. Not consulting bought under a statement of work. Shared risk, shared responsibility, and potentially shared ownership and return, structured case by case and set down in writing.
Hub membership
Sustained participation in shaping what gets built next. Two-sided by design: paramedics, service leaders, medical directors, educators and researchers on one side, founders, companies, health systems and other organizations on the other. The part of this that is a profession rather than a transaction.
| Tier 1 · Independent panel | Tier 2 · Vested partnership | Tier 3 · Hub membership | |
|---|---|---|---|
| What TPF does | Assembles a panel matched to your product and reviews it, once, in depth | Works on the product or system alongside you, contributing intellectual property, expertise, field knowledge, implementation capacity, evaluation capability or relationships | Convenes the field, runs working groups, and maintains open reference standards |
| What you pay | A participation fee per place. Not yet set, not published | Negotiated. May include fees, and may also or instead involve licensing, royalties, revenue share, equity or another agreed structure | $50 a year for individuals. Commercial dues in five bands, $500 to $15,000, by organization size. Sponsorship separate |
| Does TPF hold a financial or ownership interest? | No. None in the product, and no panel member with an interest in the company or product may sit on its review | Possibly, by agreement. Licensing, joint or co-ownership, royalties, revenue share, equity or shares, and intellectual-property or commercialization rights are all negotiable. Nothing is standard or automatic | No. Membership is support and participation, not investment |
| Can TPF evaluate the product independently? | Not the purpose of Tier 1. A panel review is expert opinion, not an evaluation | Only with the interest disclosed and the limits stated. Where genuine independence is required, TPF says so and recommends an independent third-party evaluator | Not applicable |
| How you start | Written submission, then selection on the merit of the work and fit with the field | A conversation about what each side would bring and what a fair structure looks like | Ask. Hub contributors are invited or apply; commercial and institutional members enquire |
| What it does not include | Original research, a market study built from sources, engineering work, or validation of your product | Any claim that TPF endorses or approves the product, and any suggestion that TPF is an independent evaluator of work it has a stake in | Procurement access, customer leads, endorsement, preferential treatment, influence over TPF’s advice to agencies, control of an open standard, a softer panel review, or exclusive access to profession-wide work |
Tier 1. The independent panel review
The closest reference most founders have is a televised pitch panel with the investment taken out. You present, a panel of paramedics and operators pushes back in real time, and you leave with suggestions, ideas and information rather than a cheque.
The panel is built for your product. After your submission, TPF maps what the product touches onto the disciplines on its bench, runs a conflict screen, and assembles a panel. You are told who is on it, by discipline and role, before the session.
The hour is concurrent. Every adviser is in the same hour, hearing the same answers, able to disagree with each other in front of you. Five sequential calls give you five opinions with no friction between them, and the friction is where the useful information is.
Each adviser commits up to one further hour to read what you sent, check a specific question against what they know of the market or the regulatory position, and write back. It is bounded on purpose.
The fee buys the panel’s time and attention. It does not buy a favourable opinion. It also does not buy selection into a cohort, which is decided on the merit of the work and the fit with the field.
TPF takes no equity, warrants, options, royalties, revenue share, referral fees, advisory shares or any other financial interest as part of Tier 1, and no panel member may hold a financial interest in the company or product being reviewed. That is the whole reason a Tier 1 adviser can tell you the workflow will not survive a real call. Nobody in the room has anything riding on whether you ship it.
What Tier 1 is not. Not a research engagement, not a market study built from sources, not a validation. It is market and product management input aimed at the presentation, the roadmap and the go-to-market assumptions you already have. Bring the deck you would show a customer, not the one for an investor. The panel is closer to the customer.
Tier 2. The vested partnership
Sometimes the right answer is not a review or a contract. It is a partnership where both sides carry risk and both sides share what comes of it.
Tier 2 is that, and it is not consulting purchased under a statement of work. TPF may contribute intellectual property, subject-matter expertise, field knowledge, implementation capacity, evaluation capability or professional relationships, and may take a share of the risk, the responsibilities, the ownership and the return.
Depending on the engagement, the parties may discuss and negotiate:
- Licensing
- Joint ownership or co-ownership
- Royalties
- Revenue sharing
- Equity or shares
- Intellectual-property rights
- Commercialization rights
- Governance or decision rights
- Attribution and branding
- Ongoing development responsibilities
- Implementation and evaluation roles
- Other forms of shared risk and shared return
None of that is standard or automatic. Every Tier 2 relationship is structured individually against what each side brings and documented in a written agreement before work begins. Some will look like ordinary contracted work with no TPF interest at all. Others will not.
When TPF is in, it is in. A vested partnership means TPF is working for the product to succeed, in the field, with real services, and staying honest at the same time about safety, evidence, feasibility and whether the thing is actually worth what it costs paramedicine. Those two commitments are compatible. Pretending the interest does not exist is what makes them incompatible.
How TPF handles the conflict that creates
An organization with a stake in a product is not an independent evaluator of it. TPF will not present itself as one.
- The nature of TPF’s interest is disclosed to anyone relying on TPF’s view of the product, including agencies, funders and partner services.
- Where TPF does evaluate a product it has an interest in, the interest and the limits of the evaluation are stated in the work itself, not in a footnote.
- Where genuine independence is required, and often it is, TPF will say so and recommend an independent third-party evaluator rather than take the work.
- Where TPF is advising an agency on a procurement, any interest in a bidder is disclosed to that agency before the work proceeds, and the agency decides how to handle it.
If evaluation is part of it
Design comes first: a stated primary outcome, a defined denominator, a comparison, and a pre-specified analysis, agreed before anything is deployed. Retrofitting an evaluation onto a pilot that already ran is the commonest reason a result turns out unusable. Reporting follows whichever guidance fits the claim, TRIPOD+AI for a prediction model, TRIPOD-LLM where the system is built on a large language model, CHEERS 2022 for a cost claim, the STRESS guidelines for a simulation. Plus the engineering hygiene a technical reviewer looks for: a held-out set untouched during development, calibration and not only discrimination, error analysis on the failures, and a written account of the training data and its limits. More on how TPF does this work is on the data, evaluation and research page.
Tier 2 also carries the most governance still to settle. Vested arrangements between a 501(c)(3) and a for-profit product raise tax and exempt-purpose questions that sit with TPF’s counsel and accountants, not with this page. Nothing here represents that a particular structure is available. The conversation starts with what each side brings.
Tier 3. The hub
This is the part that matters most and the easiest to underestimate. Paramedicine has no standing forum where the people who build technology and the paramedics who use it are in sustained contact. Conferences are annual and transactional. Procurement is adversarial and too late. Vendor advisory boards are chosen by the vendor.
The hub is the alternative, and it is two-sided on purpose. Paramedics, paramedic service chiefs, medical directors, educators, researchers, regulators and professional leaders on one side. Founders, technology companies, established vendors, investors, health systems and other organizations on the other. They join for different reasons and neither side gets what it needs from the other side’s absence.
- For paramedics and professional leaders: a real voice in what gets built next, working groups and standards work, early visibility into emerging tools, and direct conversation with builders while the product can still change. Individual membership is $50 a year, which is professional dues rather than a price on access.
- For companies: continuous structured conversation with the field instead of one feedback session and a guess, earlier signal on standards and evaluation expectations, a seat on precompetitive problems, and materially lower product and market risk.
- For neither: a membership fee buys no procurement access, no leads, no endorsement, no preferential treatment, no influence over TPF’s advice to an agency, no control of an open standard, and no exclusive access to work that belongs to the profession.
Commercial dues run in five bands from $500 a year for an unfunded startup to $15,000 for an organization above $10 million, set on size so a two-person team can afford to be in the room. Sponsorship of the hub is offered separately at five levels. The full picture, including what varies by band and what deliberately does not, is on the Paramedic Futures hub page.
Where the money and the interests sit
The financial relationship depends on the tier. Tier 1 is independent: the fee pays for the panel’s time and attention, and neither TPF nor its advisers hold an interest in the product under review. Tier 2 is different. It may be structured as a vested partnership involving licensing, co-ownership, royalties, revenue sharing, equity, shares or another negotiated interest. Tier 3 membership supports the hub and its shared work; it does not buy endorsement, procurement access, control over standards or favourable treatment. TPF discloses and manages financial interests wherever they could affect, or reasonably appear to affect, its advice.
The safeguards behind that, in full:
- Everything is logged. Every submission, panel place, membership and partnership goes in a register.
- Interests are disclosed before reliance, not after. Where a relationship could reasonably affect or appear to affect TPF’s advice, evaluation, or role in a procurement, it is disclosed to whoever is relying on TPF.
- Individuals disclose and recuse. Anyone reviewing a product independently discloses relevant interests and steps aside where one exists. No panel member reviews a company or product they have a financial interest in.
- TPF does not write specifications that favour a product it has worked with, and does not recommend named vendors in agency deliverables. Requirements come from the agency’s own needs assessment.
- Independence is not claimed where it does not exist. Where TPF holds an interest in a product, it says so and recommends an independent third-party evaluator when independence is what the situation requires.
- Nothing you send is confidential unless an agreement is executed first. Send what you can send openly, and raise a confidentiality agreement when a review genuinely needs more. Agreements go through counsel, which takes time an initial enquiry does not warrant.
TPF advises the state agencies, hospital systems and paramedic services that buy technology in this market. Convening the companies that sell it is a real conflict, not a theoretical one, and it is managed in the open because the alternative costs TPF the relationships that make the room worth being in.
What you may say about working with TPF
- You may say you took part. A panel participant may state that it took part in the Paramedic Futures program at The Paramedic Foundation, and when. TPF will confirm it.
- You may name TPF as your partner on a named engagement, describing TPF’s role, in wording agreed in advance.
- You may quote written feedback in full rather than selectively, with TPF’s agreement to the wording.
- You may not claim endorsement, certification, accreditation, validation or approval. TPF does not issue those for products, and participation carries no licence to use the TPF name, marks or logo in marketing, on a pricing page or in an investor deck. Co-branding is separate written permission.
TPF vouches for its own work with you. It does not vouch for your product.
The bench
Who is on the other side of the table
TPF staffs from a standing bench rather than a consulting pool. Panels and working groups are assembled from the disciplines below and matched to the work. Profiles are on the team page.
- Medical direction. Physicians holding EMS medical direction across rural, frontier and Tribal systems, including oversight of more than a dozen agencies in a single state, and practice covering prolonged field care and prehospital blood programs. If your product touches a clinical decision, they decide whether a service may use it at all.
- Paramedic practice and service operations. Practising paramedics, paramedic service chiefs, and supply chain and revenue cycle leadership, including from services where evacuation is delayed and the paramedic holds the patient for hours. Products that assume connectivity meet reality here.
- Data, standards and integration. Performance measure development, patient care record systems, geospatial coverage modelling, FHIR, HL7 and admission-discharge-transfer interfaces, and dashboard and workflow platform work.
- Care model and payment. Community paramedicine and mobile integrated healthcare program design and the payment arrangements that sustain it, including value-based care operations at scale and health economics from a federally funded rural health research centre.
- Education, certification and workforce. A former chief certification officer of the national registry, certification examination item writers, and educators who have built curricula adopted at state and international level. Adoption is a training problem more often than founders expect.
Build on TPF’s open work. It is already yours to use.
TPF publishes reference work openly because a shared standard serves paramedicine better than a proprietary one, and maintaining that layer is part of what the hub is for. The current example is Paramedic-Narrative, a patient care report narrative standard released under CC BY 4.0, with source, version history and ethics statement in a public repository.
You do not need permission. The licence grants it, including for commercial use, provided you attribute the work.
Credit line: PARAMEDIC-NARRATIVE by The Paramedic Foundation.
Citation (APA 7): Nudell, N. G. (2026). Paramedic-narrative-skill: AI-assisted PCR narrative documentation for paramedics and EMTs (Version 2.0.1) [Software]. The Paramedic Foundation. https://github.com/The-Paramedic-Foundation/paramedic-narrative-skill
Attribution is a condition, not a courtesy. The licence carries no claim of approval, partnership or certification and no right to use the TPF name in marketing beyond the attribution. It transfers no interest in the international Community Paramedic curriculum, which TPF neither owns nor co-owns: copyright is held by The Paramedic Network and TPF’s role is custodial.
If you improve it, TPF would rather have the improvement than compete with it. Contributions to the repository are welcome on the terms recorded there.
Four ways to start
One message to info@paramedicfoundation.org. Use the subject line for the route you want, because it decides who reads it.
Join as a paramedic or professional contributor
Subject line: Paramedic Futures hub contributor. Tell TPF what you do, where, and what is not working in the tools you have. If there is a specific problem you would want a working group to take on, name it. No fee.
Explore commercial membership
Subject line: Paramedic Futures commercial membership. Tell TPF what your organization builds or sells into paramedicine and what you would want from sustained contact with the field. Fees and terms are not set; you will be told where that stands rather than given a number that might change.
Submit a product for independent panel review
Subject line: Paramedic Futures panel review. Six things, briefly: the problem and who has it; what the product does, described the way you would describe it to a paramedic; where the data goes, who sees it, whether it trains a model, and what happens to it when a contract ends; what evidence you have and what you have not tested; whether you build on open work and how you attribute it; and what you want the panel to focus on. No deck required.
Discuss a vested partnership
Subject line: Paramedic Futures partnership. Describe the product or the shared work, what you would want TPF to contribute, and what kind of relationship you have in mind. Expect the first conversation to be about what each side brings rather than about terms.
Start a partnership conversation
What comes back is an acknowledgement, a conflict screen, then a straight answer. TPF is a small organization with contracted obligations to public agencies, and those come first, so it gives no undertaking on timing. It does undertake to answer.
Where Paramedic Futures is going
Current state, plainly. The routes above are open. The membership architecture, the fees and the terms are in design with TPF’s advisers. Panel format is designed and no dates are set. Working group priorities have not been chosen, which is the most interesting thing on this page if you have an opinion about what they should be.
What is intended is specific: a recurring panel that gets builders in front of paramedics and service leaders early enough to change the product; a small set of maintained open standards so the foundation layer is shared rather than rebuilt by every team; real pilots in real services with evaluation attached; and a working connection into the international bodies TPF already convenes, including the International Roundtable on Community Paramedicine and the International Rural and Remote Prehospital Collaborative.
Straight answers
Questions people ask
Does TPF take equity or a financial stake in companies?
It depends on the tier. Tier 1, no: no equity, warrants, options, royalties, revenue share, referral fees or advisory shares, and no panel member may hold an interest in what they review. Tier 2, possibly: a vested partnership may be negotiated to include licensing, co-ownership, royalties, revenue sharing, equity or other rights, case by case and in writing. Tier 3, no. Wherever an interest exists, TPF discloses it to anyone relying on its view.
If TPF has a stake in a product, can it still evaluate it?
Not independently, and TPF will not claim otherwise. Where TPF holds an interest, that interest and the limits of any evaluation are stated in the work itself. Where genuine independence is required, TPF recommends an independent third-party evaluator rather than take the work.
What does the Tier 1 fee cost, and what does it buy?
Not set yet. It is being worked out with TPF’s advisers alongside the tax questions a fee raises for a 501(c)(3), and no number will be published before those are answered. It buys the panel’s time: one concurrent hour, plus up to one further hour per adviser of reading and written response. It does not buy selection, a favourable opinion, or a softer review.
I am a paramedic, not a founder. What is in this for me?
A say in what gets built, before it is built. Contributors sit in working groups, name the problems worth solving, see emerging tools early, and talk directly to the people building them. No fee. The difference between this and a vendor advisory board is that the field sets the agenda.
Will membership get my company into TPF’s client agencies?
No. Membership buys no procurement access, no leads, no endorsement, no preferential treatment, and no influence over TPF’s advice to an agency. Getting a product into real services happens through a partnership that puts it in the field and measures what happens. Even then TPF will not broker a sale, recommend named vendors in an agency deliverable, or write requirements favouring a product it has worked with.
Can my product say it is approved or validated by The Paramedic Foundation?
No. TPF does not certify, accredit, validate, endorse or approve products, and if it did its opinion would stop being useful to the agencies that rely on it. What you can say is factual and still useful: that you took part, that TPF is your partner on a named engagement and in what role, and what TPF wrote to you, quoted in full and in agreed wording.
Will you sign an NDA first?
Sometimes, not by default. Agreements go through counsel, which takes time an initial enquiry does not warrant. Send what you can send openly and raise an agreement when a review genuinely needs more. Anything sent beforehand is not treated as confidential.
When does this actually start?
The routes in are open now. Membership categories, fees and terms are in design and no dates are set for the first panel. Early participants shape the program rather than join a finished one, which is the honest reason to write now rather than later.
Help shape Paramedic Futures while it is still being formed
The membership model is unset and the first working group priorities have not been chosen. If you are a paramedic with a problem worth solving, a service leader tired of software that arrives finished, or a company that would rather understand this field than guess at it, this is the useful moment to say so. Pick your route and write.