Background: As Georgia's Emergency Medical Services (EMS) system approaches 50 years in operation, the Georgia EMS Association and Georgia Southern University's Center for Public Health Practice and Research began an evaluation of the strengths, weaknesses, opportunities, and threats facing Georgia's EMS system.

Methods: During the first year of the study, eight meetings were held across Georgia involving EMTs, physicians, hospital administrators, emergency planners, and state policy makers to identify strengths, weaknesses, opportunities, and threats facing the system.

Results: Results obtained during the first year of this study offered valuable insight into current and future factors affecting the ability of Georgia's EMS system to provide effective care to an expanding population.

Conclusions: Quality of care, financial solvency, community paramedicine models, and reimbursement strategies were discussed and numerous strategies were evaluated to improve EMS operations in both urban and rural populations.