Expert witness says Aetna proposal stronger than WEMSA’s, citing experience, CAD-integrated tracking and dynamic deployment

Michael Gunderson, an EMS systems expert who testified at a continuation of an administrative hearing, told the panel he favors the town’s plan working with Aetna over the proposal from WEMSA. Gunderson cited Aetna’s operational experience, integrated vehicle-location tracking tied to computer-aided dispatch and the company’s dynamic deployment strategy as reasons the Aetna plan is more likely to meet the town’s needs.

Gunderson, who identified himself as owner and president of the Center For Systems Improvement and described decades of EMS clinical, management and system-design work, said “the experience of an ambulance service provider is one of the best predictors of its future performance.” He testified that Aetna has a long history of providing both ALS and BLS services and that WEMSA, which began as a volunteer agency, is relatively early in its transition to career staffing.

On technology, Gunderson said exhibits and testimony show Aetna’s vehicles are integrated into a CAD platform (identified in testimony as a ZOLL product). He told the panel that CAD-linked vehicle location and status data give dispatchers real-time location, availability and time-stamped records—information that, he said, “enables the whole process of processing the call, identifying what’s the closest appropriate ambulance, and deploying it ... as efficiently and quickly as possible.” By contrast, Gunderson testified that WEMSA lacks that integrated vehicle-location capability and that relying on staff phones does not provide the same CAD integration or automatic time stamps needed for efficient dispatch and medical-legal documentation.

Gunderson described the operational difference between an ‘‘island’’ model—where a community posts two dedicated ambulances locally—and a dynamic deployment model that positions a regional fleet using historical geotemporal demand patterns. He said dynamic deployment, paired with a larger regional fleet and CAD integration, reduces response times and helps cover concurrent calls or large incidents that can otherwise produce a ‘‘system overload.’’ As an example, he reviewed an amended exhibit showing a Nov. 13, 2023 motor-vehicle crash that required multiple transports and said that having only two ambulances in town could leave the jurisdiction unable to meet concurrent demand without mutual aid.

During testimony Gunderson summarized vehicle and staffing figures from exhibits: WEMSA’s license shows four vehicles (three ambulances and one non-transport EMS vehicle) and a staffing plan to keep two ambulances staffed for 911; Aetna’s exhibits reference roughly 31 licensed vehicles with about a dozen deployed at a given time; the Ambulance Service of Manchester (a sister company) was shown at 33 authorized vehicles. Gunderson also described call-volume columns in Exhibit 71 showing many incidents in which Aetna responded without WEMSA and said that, for the period reported, Aetna-alone responses represented a substantial portion of the total.

Gunderson emphasized operational complexity in running an ALS service—controlled medications, more advanced equipment and increased medical-legal risk—saying that contracting paramedics satisfies statutory staffing requirements but does not replace organizational experience in operating ALS at scale. He recommended attention to integrated tracking and deployment practices that reduced cumulative response time increments for time-sensitive emergencies such as heart attacks, strokes and cardiac arrest.

The hearing recessed for a lunch break with the panel directed to return at 1:00 p.m.; further questioning resumed after the break, with follow-up on Gunderson’s clinical licensing and earlier career roles.