During the past 30 years, emergency medical services (EMS) in the Unit
ed States have experienced explosive growth. The American health care
system is now transforming, providing an opportune time to examine wha
t we have learned over the past three decades in order to create a vis
ion for the future of EMS. Over the course of several months, a multid
isciplinary steering committee collaborated with hundreds of EMS-inter
ested individuals, organizations, and agencies to develop the ''EMS Ag
enda for the Future. Fourteen EMS attributes were identified as requir
ing continued development in order to realize the vision established w
ithin the Agenda. They are Integration of Health Services, EMS Researc
h, Legislation and Regulation, System Finance, Human Resources, Medica
l Direction, Education Systems, Public Education, Prevention, Public A
ccess, Communication Systems, Clinical Care, Information Systems, and
Evaluation. Discussion of these attributes provides important guidance
for achieving a vision for the future of EMS that emphasizes its crit
ical role in American health care.