What Limits,
It is not always about just saving a life. A limb saved from amputation, a burn trated early, a premature baby flown to NICU, a stroke reversed in time. These are all good reasons to have HEMS in far flung rural areas where the nearest metro hospital is a three hour ambulance ride away.Such is the quality of life taken for granted by the world today.
Technology certainly assists but has to be applied judiciously. For instance, to run a full fledged, two pilot full IFR certified aircraft in an area where there are no approaches to hospitals in the IFR system would be extravagant. But to run an IFR capable aircraft and pilot for a VFR only program would be reasonable.The trick is to find the happy medium between one and the other without too much impact on the bottom line.
Alt3.