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San Francisco EMS reports improved offload times, high cardiac arrest survival and paramedic buprenorphine use
Summary
San Francisco EMS reported a year-over-year improvement in ambulance patient offload times and a 35% cardiac arrest survival rate; the agency highlighted ImageTrend implementation, RediNet upgrades, PulsePoint outreach and paramedic-initiated buprenorphine (179 doses since April 2023).
San Francisco’s EMS Agency presented its 2025 priorities and data to the Health Commission, reporting incremental improvements in ambulance patient offload times (APOT) and strong cardiac arrest outcomes while outlining system upgrades and public‑facing outreach.
EMS Director Andrew Holcomb and Medical Director Dr. Amelia Breyer described a shift to a single digital platform (ImageTrend) to consolidate ambulance permitting, complaints, inspections and fiscal activities, funded in part through grant support. Holcomb highlighted an updated RediNet platform that gives hospitals earlier visibility into incoming ambulances and supports automatic EMS alert routing to distribute ambulance loads across facilities.
On performance metrics, the agency reported a 90th‑percentile APOT improvement from 44 minutes in April 2024 to 39 minutes in April 2025. ‘‘We continue to see some small signs of progress,’’ Holcomb said, while noting that the state standard under AB 40 is a 30‑minute target and that further work remains.
Dr. Breyer focused on clinical initiatives. San Francisco’s 2024 CARES Registry cardiac arrest survival rate was 35%, she said, above the state (23%) and national (26%) averages, and the agency is working to raise bystander CPR and AED usage. ‘‘This week’s national theme is We Care for Everyone,’’ Dr. Breyer said during the presentation as she invited commissioners to EMS award events and outreach activities.
The commission also heard about overdose‑prevention and treatment innovations. A paramedic‑initiated buprenorphine program that began in April 2023 has delivered 179 doses, among the highest counts in California, according to Dr. Breyer. The agency described naloxone distribution, ketamine for pain alternatives and cross‑agency work to implement SB 43 guidance for patients with grave disability due to severe substance use.
Commissioners asked about data integration, event planning for large gatherings (Super Bowl, FIFA) and how lessons from San Francisco General’s diversion improvements will spread across other hospital campuses. Holcomb said tighter data integration between EMS and hospital systems would allow better ambulance routing and outcome research and that the new platforms and monthly APOT/diversion workgroups are being used to share best practices and daily hospital‑level performance data.
The commission did not take a formal action on the EMS presentation; commissioners thanked the agency and requested periodic updates on APOT, ImageTrend rollout and community outreach metrics.
