Meet the Leaders Behind Nassau County’s Success
In Nassau County, NY, transforming emergency communications has become a true team effort. Many dedicated leaders, physicians, and EMS professionals have helped guide this regional project from its initial development through its continued success including the long-term efforts of Dr. Josh and David Kugler, hospital partners, and regional EMS leadership.
Among those who help to advance this initiative are Dr. David Silver, Medical Director for multiple EMS agencies and Chair of the Nassau REMAC QA/QI Committee, and Don Hudson, EMS Academy Administrator and REMSCO Council Member.
Dr. Silver, an emergency medicine physician with Northwell Health, began his career as a firefighter and EMT before returning to his EMS roots as a medical director and instructor.
“I was a volunteer for seven or eight years, so I was there for a while,” he shared. “I’m an emergency physician by profession. I’ve been a resident for 14 years, here on Long Island with Northwell Health.”
Hudson’s path began when he was just 18 years old in his local volunteer fire department. “I started at 18, I joined my volunteer fire department … I went to EMT school, then medical school, and I was hired by the City of New York. I worked there for 19 years as an EMS paramedic, Instructor and Paramedic Lieutenant”, he said. Now, as Administrator of Nassau County’s EMS Academy, Hudson oversees education and training while helping to coordinate communication programs across the county.
Together with a network of regional partners, Dr. Silver and Hudson help drive a culture of innovation, communication, and collaboration that is reshaping the way Nassau connects care from the field to the hospital.
Regional Communication Model
Nassau’s success is more than the release of a new tool. It shows what happens when the entire region agrees that communication cannot be cut across legal lines. Emergency care is fast-paced, complex, and rarely fits neatly within the boundaries of a single organization. Patients are moving. The severity of the incident changes. Hospital availability is variable. When EMS and hospitals operate with different protocols, platforms, or expectations, even a minute of communication delay can set back patient care.
Regional standardization gives every provider, dispatcher, and physician the same playbook. It means that doctors don’t just trust that their message will get where it needs to go. They know it will happen.
Nassau County was an early adopter of this belief. Leaders realized that if EMS teams could reliably share real-time data and images with hospitals before arrival, patient care could be accelerated from the very first mile of transport. With e-Bridge, agencies are no longer dependent on explanations that go through layers of intermediaries. They deliver first-hand information quickly.
As Hudson points out:
“Since the 70s, we’ve been trying to train people to ‘paint a picture with your words.’
The regional approach creates an integrated ecosystem: one regional network, one level of communication, many hands working together. The result is one of the largest and most connected mobile health deployments in New York State and regional models across the country.
Fast Facts: Nassau County’s e-Bridge Program
Need for e-Bridge in Every State
Before the e-Bridge, EMS communication to the Nassau hospital relied heavily on radio transmissions. It worked, but only up to a point. Information often passes through many hands before reaching the emergency department, and during that time, good information may be diluted, delayed, or lost altogether. As Hudson explains:
“Our radio-based medical control wasn’t directly in the hospital. So, when Dr. Silver said we had teleported, it was the second or third information the hospitals were getting.”
In a situation where minutes meant the difference between getting out of the hospital or being disabled for life, uncertainty was unacceptable. Important data such as suspected stroke, changes in vital signs, or emerging concerns about trauma are needed for immediate intervention.
Hospitals needed a clear picture up front. And EMS needed a way to communicate without throwing around equipment or hoping someone on the other end caught all the words.
Across all local agencies, leaders saw common frustrations:
- Communication delays when hospitals were busy or radio traffic was heavy
- Difficulty ensuring that messages are heard and understood
- There is no ability to share photos, video, or diagnostic information
- Limited visibility of what patients are coming to and when
The district was ready for a system that not only notified hospitals but connected them in real time.
That desire for a stronger, more unified partnership brought together the leadership of Nassau EMS (REMSCO/REMAC), as well as all hospitals in the Region. Their shared goal: to eliminate fragmentation and create a connected digital communication network that puts the patient at the center of all changes.
Through this combined effort, the region has successfully connected all 84 EMS agencies and 13 hospitals through the Bridge platform, making the region’s most comprehensive deployment in the state. More than 700 providers across the region now use the Bridge, along with Northwell EMS’s 865 individual user infrastructure, each equipped to communicate directly and consistently.
Hudson highlighted the change simply:
“Every hospital uses it, every EMS agency uses it in one way, shape, and form.”
The game of telephone is over. In your place: real-time, visual, and collaborative communication that ensures every patient story comes through without interruption.
