SASless, you ask great questions!
Turn your question around and tell us how to do it and get it done by the FAA and Helicopter Industry if you would?
The Frendlie Aviation Agency has a program just signed to create low altitude routes approaches and departures specifically for helos
What Role does HAI play in this quest for that change?
The Flight Operations Committee is one of the key sparks to make it happen, come to the meeting at HeliExpo and watch the sausage being made. A ppruner is the task master for this piece of the puzzle.
What Role does the individual operator play?
establishing the initial routes requires operator help - aircraft, route and approach locations, expert guidance for operations.
What Role does the helicopter manufacturers play?
Equipment installation, flight envelope, prime advocacy, selling machines that do the job
What Role does the individual pilot play?
Usually Coco the Clown, at least in your case. ;-) Seriously, the lead pilots are key in designing the routes and approaches to be productive, safe and easy to fly. Also, the pilots can help by advocating IFR operations for all offshore and onshore commercial work. I am constantly amazed at the attitude some have that equipment and procedures are too expensive and too much bother.
Interesting side note to consider.....the Canadians have not done what you suggest and they have not had an EMS fatality yet. Why can they do that without any accidents but the Americans cannot?
The typical old solution for EMS accidents is to simply sit at home and tell the patient "tough beans, old chap." I guess the Canadians are better at that.
Seriously, the issue is not to derive safety by stopping operations, it is to make those operations safer while doing them. No?