Quantifying Truth: How Allegiance Mobile Health Scaled Airway CQI Across 30 Counties
An analysis of Dr. Brian Everett's deployment of IntuBlade to eliminate clinical blind spots, reduce capital expenditures, and implement film-room style paramedic coaching.
Texas Counties
Field Providers
Ambulances
Calls / Month
From Random Chart Sampling to Targeted High-Risk Review
Allegiance Mobile Health operates across more than 30 counties in Texas with a roster of 1,400+ paramedics and EMTs running over 12,000 calls per month. At that scale, the clinical quality assurance program inherited a structural limitation common to every large EMS system: there was no efficient way to observe what actually happened on the highest-risk interventions.
Under the direction of Dr. Brian Everett, the organization moved from unstructured, chart-based QA toward a targeted review model focused on the procedures that drive patient outcomes, rapid sequence intubation, cardioversion, and other defining airway and resuscitation events.
Capital Expense and Workflow Friction
Standard reusable video laryngoscopes carry significant capital expenditures when multiplied across a fleet of 200+ ambulances. Procurement, charging infrastructure, firmware management, and device replacement cycles all compound at scale.
Equally limiting was the workflow tax. Retrieving video from device-bound storage required manual offload, creating bottlenecks that effectively prevented routine case review and made structured coaching impractical.
A Consumable Blade, an iPad Already on the Rig
Allegiance deployed IntuBlade at a $95 consumable unit price point, paired with the iPads already present in their vehicles. The model eliminated per-device capital outlay and removed the charging and firmware burden tied to reusable hardware.
Footage from each intubation uploads to the cloud repository within minutes of the procedure, without paramedic intervention. Cases are indexed and available for medical director review before the crew has completed their post-call paperwork.
Just Culture, Frame by Frame
With consistent video evidence in hand, Allegiance shifted into a structured, just culture coaching cadence modeled on athletic film review. Medical directors meet with field providers in virtual sessions to walk through real cases frame by frame, examining anatomical landmarks, patient positioning, suctioning technique, and decision-making at each step of the procedure.
The result is a feedback loop grounded in the same footage the provider remembers, removing ambiguity from coaching conversations and turning each high-risk intervention into a teaching artifact for the broader fleet.
The Anatomy of Ambiguity
A founder's reflection on institutional inertia, systemic failure, and the personal responsibility of building for those on the ground.
Read the Reflection