Since the U.S. Department of Transportation’s National Highway Traffic Safety Administration released the National Standard Curriculum in 1985, EMS has been irrevocably connected with transportation and public safety. Automobile technology has developed at a breakneck pace and has brought changes in emergency medical care along with it. From improvements in manufacturing processes and materials fabrication that afford more room and improved work areas in the rig, to advances in lighting and electrical technology that allow for more efficient patient care during transport, today’s ambulances are significantly different machines than those of the past.

That trend of fast improvements isn’t slowing down. In fact, radical changes are on the horizon, and many sources suggest the future points to driverless vehicles. Automotive leaders like Audi and Mercedez Benz are investing heavily in autonomous driving technology. Even General Motors has unveiled a driverless concept car. Tech giants like Google and Uber are putting significant dollars behind this exciting technology, with Google’s Self Driving Car Project and Uber’s partnership with Carnegie Mellon University.

As with all dramatic shifts from the status quo, many thought leaders are quick to point out risks. The risks for driverless technologies include a predicted loss of transit-centered jobs. The risk is real when driving is the skill (e.g., taxi and bus drivers), but how will this technology affect jobs in which driving supports the employee’s primary skill, such as prehospital care? For EMTs, advanced EMTs and paramedics, how will driverless ambulances affect their day-to-day jobs? It’s not just losing the moniker “Ambulance Driver” (though who could complain about that?); driverless ambulances will also impact the landscape of EMS in subtler ways.

Potentially the biggest change will be in patient care: during transit in a driverless ambulance, two EMS professionals could be available for treatment the entire time from scene to hospital instead of the current practice of one in the back and the other behind the wheel. This could move some on-scene care into the ambulance and lead to a decreased time on scene. Most importantly, it could lead to improved patient outcomes, both because time on scene has been demonstrated to affect results in high acuity calls, and because two sets of hands often are better than one, such as with bag-valve mask ventilation.

Dispatch may also gain substantial efficiency through the combination of system status management and autonomous driving. The two could allow dispatchers to move a service’s active ambulances into position in their dispatch area between calls while the EMS professionals on the ambulance are able to rest, alerting providers only when they are on route to a patient. Some driverless concept cars remove the driver’s seat completely. In that future, we can hope that an ambulance might have room for a bunk, a toilet, and even a fridge for the use of the practitioners on board.

There will also be some downsides. For individuals who are unable to drive for health reasons, an automated vehicle could help them get to a doctor or hospital on their own when they have a non-emergent health concern. This could translate to a decrease in overall call volume, and an increase in the proportion of emergent calls requiring ALS skills. It is possible that this shift would impact overall employment in EMS.

We may also lose the glamour (and risks) of “lights and sirens” to speed transit, and instead gain a “priority” transit status that could communicate to other vehicles on the road to clear a lane for ambulances in transit. Ambulance services in Britain are already piloting a form of “priority” transit status technology. It also couldn’t hurt transport time that traffic will likely be more efficient when all cars are fully automated, as demonstrated in this virtual model from CityLab.

EMS has always had roots in both transportation and healthcare. In fact, automotive technology and prehospital care have been tightly bound together for decades, with patient care benefiting from each step forward in both arenas. Automobile technology may not impact hospitals or clinics, but it will certainly affect EMS, and with the growing notion that EMS is the first part of a continuum of care, it will certainly affect patients. We should make sure that effect is a positive one.