The Inevitable Intersection of EMS and Autonomous Technologies: A Colorado Perspective

Over the past couple of years, I’ve had the privilege of delivering keynote addresses nationwide on the future of EMS. Each time I step onto a stage, I’m struck by how quickly technology is evolving and how dramatically the conversation has shifted. What felt like a distant, theoretical discussion about autonomous vehicles, aerial mobility, and machine-assisted response just two years ago has now become a practical, near-term reality. From my perspective, the intersection of these technologies with EMS is no longer a sci-fi dream, but it is now a foregone conclusion. The only questions left are when, and how ready we will be when they arrive.

While this is an intriguing national EMS discussion, it must also be a Colorado discussion. We live in a state where mobility innovation, aerospace engineering, and public safety are overlapping in a meaningful way. The decisions we make in the coming months and years will shape how EMS evolves in mountain communities, frontier regions, and the rapidly growing Front Range corridor.

Autonomous Ground Vehicles Are Here, not “Coming Someday”

In September 2025, Waymo (the driverless taxi-like service owned by Alphabet, the parent company of Google) announced their expansion into Denver, and today their test fleet is already operational and actively mapping our city’s streets. Nationally, Waymo completes more than 250,000 paid rides every week in Phoenix, San Francisco, Los Angeles, and Austin. Additional cities including Atlanta, Miami, and Washington D.C. are preparing for full deployment in 2026. While many in our state may not yet be familiar with Waymo, let me be clear: this is not a pilot project to test the technology. The pilot phase happened years ago, and this expansion is part of their rapid, nationwide commercial rollout. It’s important to understand that Waymo is not a vehicle manufacturer; their autonomous system is a technology platform integrated onto traditional production vehicles such as Jaguars and other standard automotive platforms. This is precisely why similar autonomous technology could eventually be adapted onto an ambulance chassis.

But the safety data is what truly forces EMS to pay attention.

The human-driven vehicle accident rate in the United States is roughly 4.1 to 4.3 crashes per 1 million miles driven. However, for ambulances, the numbers become even more concerning. Federal data estimates 32 ambulance crashes per 1 million miles. This is approximately eight times higher than cars and light trucks, and the fatal crash rate is about 1.78 per 1 million miles.

For EMS Clinicians, driving to scenes, returning from calls, and transporting patients is one of the most dangerous parts of our profession.

Now compare that to Waymo’s performance. Their autonomous fleet has now surpassed 96 million miles without a single at-fault collision, and this forces us to confront a simple, uncomfortable question: What happens when the safest driver on Colorado roads isn’t a person?

And that leads directly to another question I believe every EMS leader should be asking:

Why would we not embrace technology that directly addresses one of the most dangerous aspects of our work as EMTs and paramedics?

I’m not arguing that autonomous ambulances will replace every human-driven response. That is not the goal. But, I believe the real opportunity is for EMS agencies to augment traditional fleets with some autonomous ambulances, or hybrid-autonomous ambulances that can be switched at the scene or hospital from human-driven to fully autonomous mode.

For Colorado’s rural and frontier agencies wrestling with shrinking volunteer pools and recruitment challenges, even modest adoption could be a lifeline. If technology can return a fraction of operational hours back to strained systems, reduce fatigue, or prevent crashes, the value becomes clear quickly.

Aviation Is Advancing Even Faster Than Ground Transport

While autonomous ground vehicles are progressing rapidly, innovation in aviation is also rapidly evolving, and Colorado is in the middle of it!

XTI Aerospace, a publicly traded company based at Centennial Airport, is developing the TriFan 600, a hybrid vertical-lift aircraft that blends the capabilities of both a helicopter and a fixed-wing airplane. Unlike the fully electric Vertical Take Off and Landing (VTOL) platforms currently being tested across the United States, the TriFan is being designed to use turbine power, giving it significantly greater range, speed, and payload capacity while still retaining true vertical takeoff and landing performance.

According to XTI’s published specifications, the TriFan 600 (still in the design and testing phase) will feature VTOL capability and it is projected to carry a pilot plus up to six passengers, cruise at over 300 mph, operate at altitudes up to 25,000 feet, and provide a VTOL range of approximately 1,000 miles. In practical terms, that means helipad-to-helipad from Grand Junction to Kansas City without refueling, or in-state medical transfers that begin at the scene of a crash in Durango and end at a Level I Trauma Center in Denver, in full IFR conditions, in a fraction of the time required by current ground or helicopter options.

This combination of vertical access, fixed-wing speed, and long-range capability is something no conventional helicopter or electric VTOL aircraft can match today.

What caught my attention even more is that XTI already has an EMS mock-up design displayed on their website. This tells me that the company isn’t just building a corporate transport aircraft and hoping EMS might adapt it someday. They are intentionally exploring how their platform could serve medical transport, critical care missions, and rural hospital connectivity. When aerospace manufacturers start thinking about EMS use cases this early, before the prototype has even flown, it signals a significant shift in how the aviation industry views our sector.

For Colorado’s geography, a VTOL aircraft capable of high-altitude performance, long-distance range, and true helipad access could fundamentally change interfacility transport, specialty care access, and the speed at which critical patients move across the state.

On the other end of the spectrum, Pivotal Aerospace, based on the West Coast, is advancing small, lightweight personal VTOL aircraft. Their recently certified Helix platform demonstrates just how quickly compact aerial vehicles can move from prototype to full production. Many of my Colorado EMS colleagues saw this aircraft on display at EMS World Expo in Indianapolis just a few weeks ago, and the reaction was universal: the technology is no longer conceptual; it is real, tangible, and far closer to operational use than most people expected.

Pivotal even features a video of a paramedic using the Helix to rapidly deploy to an emergency, bypassing traffic, terrain, and other barriers that traditionally slow down response in congested or remote areas. This aircraft is available for purchase today, although its current service ceiling is limited to 9,000 feet. Even so, it represents a meaningful step forward for rapid-access response. And as the platform evolves, future models will almost certainly offer higher altitude capability, greater range, and expanded EMS utility.

Both XTI Aerospace and Pivotal Aerospace have explicitly identified EMS as a core market and growth opportunity, signaling that emergency medical transport and rapid-response operations are no longer an afterthought in aviation innovation. The future of EMS is at the center of aviation innovation.

Together, these innovations show that both ends of the aviation spectrum—large hybrid vertical-lift aircraft like the TriFan 600 and small personal VTOL craft like the Helix—are advancing concurrently, supported by evolving FAA regulatory pathways. The momentum, and future disruption of traditional EMS, is unmistakable.

What This Means for EMS in Colorado

Colorado’s geography makes this conversation more urgent than in many other states. Mountain passes, remote frontier regions, population growth, and surging tourism visitors, combined with long distances between critical access hospitals and trauma centers, are  already pushing our EMS systems to the limit. We work in unpredictable weather, high-altitude environments, and areas where travel times can extend to multiple hours.

While I do not believe that autonomous ground vehicles and advanced vertical mobility platforms will completely replace traditional EMS operations anytime soon, but am convinced these technologies will start to supplement our existing fleet in the next few years.

Consider three realistic, near-term scenarios:

1. Long-distance interfacility transports

A vertical-lift aircraft could move patients between rural hospitals and urban specialty centers far faster than current ground or helicopter options. The TriFan’s projected 25,000-foot ceiling and pressurized cabin create new operational flexibility, especially during deteriorating weather or IFR conditions that routinely challenge Colorado aviation. This would allow rural clinicians to stabilize patients and hand them directly to a receiving team in Denver, Colorado Springs, or Grand Junction hours sooner than most current transport methods allow.

2. Rapid deployment of clinicians or critical supplies

Small VTOL aircraft could deliver blood products, medications, or specialized personnel into communities cut off by snow, wildfire, landslides, or seasonal isolation. They could even change how we think about personnel movement to and from stations; anyone who has battled I-70 traffic during ski season understands the potential value of bypassing congestion and terrain entirely. A paramedic or EMT arriving over the top of a traffic jam in minutes, rather than hours, is a logistical solution enabled by technology that already exists.

3. Non-emergent autonomous ground transport

Driverless vehicles could safely manage scheduled interfacility transports, returning valuable EMT and paramedic resources back to emergency response. For volunteer-based systems, this could be transformative. Once the patient is stabilized and safely loaded, the volunteer EMT/Paramedic that has to drive the ambulance today, could remain in the community—available for the next 911 call or free to return to their home or workplace—while the autonomous vehicle completes the transport.

Some of these scenarios could become reality within the next 48 months.

Why We Cannot Wait to Engage

The greatest risk to EMS is not choosing the wrong technology. I believe our single greatest risk today is failing to engage early enough to shape how these systems integrate into our world.

Historically, EMS has adopted technology after other sectors have already defined the rules. We cannot let that happen here. Autonomous mobility and advanced aviation will influence patient safety standards, road usage, regulatory frameworks, dispatch protocols, and reimbursement models.

If EMS leaders don’t participate in these early conversations, decisions will be made without us. I encourage my Colorado EMS colleagues to consider:

What I am advocating for is a practical acknowledgment of where technology is heading and how EMS can benefit from being proactive rather than reactive. If a tool increases safety, reduces response times, preserves rural access, or returns staffing hours to strained agencies, we need to take it seriously.

The future will not arrive all at once. It will come in phases. But the phases are now close enough that planning can no longer be optional. I encourage every agency—from the smallest volunteer service to the largest metropolitan department—to begin talking seriously about how these technologies can serve their communities.

The intersection between EMS and autonomous mobility is inevitable. The only variable left is the timeline. And the agencies that think ahead will be the ones shaping the future rather than being shaped by it.

About the Author

Donnie Woodyard, Jr., is a paramedic and pilot who previously served as Colorado’s State EMS Director. He has spent much of his career focused on EMS system design and the intersection of public safety and innovation. Donnie has presented more than 30 national sessions on the future of EMS and remains deeply committed to helping Colorado agencies prepare for the technological changes already reshaping healthcare and emergency response. Colorado is home for Donnie, and he continues to work alongside colleagues across the state and the nation to strengthen EMS for the next generation. He is currently the Executive Director of the United States EMS Compact.