Faster Highways, Faster Care? How Road Improvements Affect Emergency Medical Response Times

Faster highways, faster care? Why patients and caregivers should care about I‑75 and other chokepoints

Traffic congestion is not just an annoyance — it is a public health problem. For people calling 911 with chest pain, severe trauma, stroke symptoms or childbirth complications, every minute from dispatch to hospital arrival matters. As states like Georgia move in 2026 to spend billions to unclog interstate bottlenecks — most recently a proposed $1.8 billion to add express lanes on I‑75 through Atlanta’s southern suburbs — a practical question arises: will highway widening and toll lanes translate into faster emergency medical services (EMS) response, shorter trauma transport times and measurable survival gains?

Bottom line up front (inverted pyramid)

Short answer: Highway capacity improvements can reduce some delays that affect ambulance travel, but the effect on clinical outcomes is mixed and depends on design choices, congestion dynamics (including induced demand), coordination with EMS, and equity considerations. Infrastructure alone is rarely a silver bullet; integrated planning that prioritizes emergency access, smart traffic management, and prehospital system redesign is essential to convert roadway gains into lives saved.

Key takeaways

• Improvements can help — removing chokepoints, providing consistent travel lanes, and reducing stop-and-go congestion can lower ambulance transport times in many corridors.
• But time-to-treatment improvements are conditional — construction disruption, induced demand, tolling rules, and lane access determine whether benefits accrue to EMS.
• Design choices matter — designate emergency vehicle access, integrate traffic signal preemption, share real-time traffic data with 911 systems, and exempt ambulances from tolls.
• Monitor outcomes — measure EMS response time percentiles, scene-to-hospital transport time, trauma mortality, ROSC and survival-to-discharge for cardiac arrest, and stroke reperfusion intervals before and after projects.
• Complementary strategies — ambulance deployment optimization, aerial medevac, community paramedicine, and telemedicine can multiply benefits.

Why EMS time matters: a clinical primer

For time-sensitive conditions, delays translate to worse outcomes. Rapid reperfusion for acute myocardial infarction and ischemic stroke, rapid hemorrhage control for major trauma, and early airway and resuscitation care for cardiac arrest are all time-dependent. While the exact minute-to-outcome relationships vary by condition, clinical practice and trauma systems emphasize minimizing prehospital time and rapid access to definitive care. Emergency medical systems therefore track response interval metrics — dispatch-to-arrival, on-scene time, and scene-to-hospital transport — because they are proximal determinants of survival and neurologic outcome.

How highways interact with EMS operations

Roadways affect EMS in three main ways:

1. Response time to the scene. Congested arterials and clogged interstates can delay ambulances reaching patients, especially when freeway incidents block arterial cross-connections and local streets become oversaturated.
2. Transport time to definitive care. Even after stabilizing the patient, transport to a trauma center, stroke thrombectomy-capable hospital or PCI-capable center can be prolonged if highways and surface streets are congested.
3. Reliability and predictability. Variability matters as much as average speed. Long tails — rare but extreme delays — challenge hospital capacity planning and can force detours to less-optimal facilities.

Mechanisms that reduce EMS times

• Higher throughput on mainlines reduces stop‑and‑go and incident-induced backups on feeder roads.
• Express lanes with limited access points can produce predictable travel times.
• Intelligent transportation systems (ITS) — traffic signal preemption and live traffic feeds — let EMS optimize routing and safely speed response.

What the evidence and real-world experience show

Research on whether road widening directly improves patient outcomes is limited and context-specific. Studies consistently show that traffic congestion increases EMS response intervals. When congestion is reduced in predictable ways, EMS travel times fall — but the translation to improved survival depends on how much time is saved, which patients are affected, and whether downstream care is timely.

Important caveats from prior evaluations:

• Highway widening often triggers induced demand — more people driving, trips shifting from transit, and congestion returning over months to years — potentially eroding initial gains for EMS unless coupled with multimodal planning.
• Construction phases frequently cause temporary increases in delays and crash risk, producing short-term harm if not mitigated with EMS route planning.
• Tolling regimes can affect EMS access. If emergency vehicles are restricted from express lanes or face administrative barriers, potential benefits are lost.

Case focus: I‑75 in Atlanta (2026 proposal) — opportunity and risk

In January 2026, Georgia’s governor proposed a $1.8 billion plan to add toll express lanes to a 12‑mile chokepoint on I‑75 through Henry and Clayton counties. That corridor is a major freight and passenger artery connecting the Midwest and Florida, with heavy peak congestion. The proposal frames lanes as economic development and mobility investments — but the public health implications deserve explicit attention.

Potential positive effects for EMS:

• Added capacity may reduce recurrent backups that spill onto local roads used by ambulances.
• Express lanes can provide consistent, higher‑speed options for long‑distance interfacility transfers (for example, trauma transfers to a Level I center).
• Modern toll projects typically include ITS infrastructure (sensors, cameras, communication backbones) that can be integrated with EMS dispatch for real‑time routing.

Risks and pitfalls:

• If express lanes are gated by tolling equipment or have limited shoulder access, ambulances may be unable to use them freely.
• Without exemptions or clear protocols, ambulances could be diverted onto congested local streets to avoid toll lanes, worsening scene-to-hospital times.
• Induced demand could wash out initial time savings after a few years if transit and demand-management are not part of the plan.

“Infrastructure is necessary but not sufficient — design rules and operational integration determine whether patients benefit,”

Design principles to ensure infrastructure benefits EMS and health outcomes

When planning highway upgrades, policymakers should bake in EMS performance objectives from day one. Practical design and operational strategies include:

1. Guarantee express-lane access and toll exemptions for emergency vehicles

Explicitly allow ambulances, fire apparatus and police to use express lanes and shoulders as needed during responses and transports. Wherever electronic tolling applies, create an administrative exception that does not require time-consuming paperwork for front-line crews.

2. Integrate ITS with 911 dispatch systems

Share real-time traffic feeds, camera views and incident alerts with EMS dispatch centers so computer-aided dispatch (CAD) can choose the fastest corridor. Install dedicated data links and standard APIs (Application Programming Interfaces) during construction.

3. Offer protected shoulders or emergency pullouts

When possible, maintain a safe emergency lane or wider shoulders that allow ambulances to pass stopped traffic and provide safe spots for multi‑unit response staging.

4. Plan for construction-phase continuity

Large rebuilds can degrade travel times for months. Require contractors to prepare EMS contingency plans, maintain alternate corridors, and provide advance notifications to county 911 centers and hospital systems.

5. Pair investments with demand management and multimodal options

Because induced demand can erode EMS gains, pair widening with transit expansion, mobility pricing, carpool incentives and land-use changes that reduce rush-hour overload.

6. Use equity filters in toll-lane policy

Toll lanes can create two-tier mobility unless revenue and access are structured to reduce inequities. Consider using toll revenues to subsidize EMS readiness, fund first-responder staging, or expand public transit that reduces rush-hour car volumes.

EMS and health system strategies to leverage roadway improvements

Even well-designed roads require EMS system changes to capture health gains:

• Dynamic deployment: Use predictive analytics and heat maps to preposition ambulances ahead of peak congestion or near known chokepoints.
• Interfacility routing agreements: Define preferred routes for time-sensitive transfers (trauma, stroke, STEMI) using express lanes where safe and permitted.
• Helicopter coordination: For regions where roadway time savings are marginal, strengthen medevac protocols and landing zones to bypass ground constraints.
• Tele-EMS: Equip paramedic crews with teleconsultation to expedite triage and reduce unnecessary transports, freeing ambulances for high-acuity missions.

Measuring success: recommended metrics for projects

To determine whether highway projects improve emergency care, measure both transport metrics and clinical outcomes before and after implementation. Recommended indicators:

• Operational metrics: median and 90th‑percentile dispatch‑to‑arrival, on‑scene time, scene‑to‑hospital transport time, total prehospital interval.
• Clinical process metrics: time-to-reperfusion for STEMI, door‑to‑needle for ischemic stroke, time-to-operating-room for major hemorrhage, time to definitive hemorrhage control for trauma.
• Outcome metrics: trauma mortality (30‑day), return of spontaneous circulation (ROSC) and survival-to-discharge for out‑of‑hospital cardiac arrest, functional outcomes at discharge for stroke.
• Equity metrics: changes in response times by zip code, socioeconomic status, and insurance status to spot disparate impacts.

Future trends (2026 and beyond): technology that multiplies infrastructure value

Late 2025 and early 2026 saw accelerated deployment of connected vehicle infrastructure, low-latency traffic data platforms and pilot programs tying ITS to emergency dispatch. These trends point toward practical gains:

• Connected vehicle routing: Vehicles and roadside units sharing trajectory data can create virtual corridors allowing ambulances to navigate safely through complex traffic.
• Autonomous and semi-autonomous public fleets: When linked to traffic management, these fleets can help smooth congestion curves and reduce sudden slowdowns that block ambulances.
• Drones for initial response: Medical drone pilots (e.g., AED delivery) can begin care before ground EMS arrives, reducing time-to-first intervention in high-delay corridors.

Policy checklist for state and local leaders

If your jurisdiction is evaluating highway investments (like I‑75), insist on these items before final approval:

1. Formal EMS access language in project contracts, including toll exemptions and emergency access rights.
2. Commitment to CTS (communications, traffic signals, sensors) integration with regional 911/CAD systems.
3. Construction-phase EMS continuity plans and a point-of-contact for first responders.
4. Predefined monitoring plan with baseline data and timelines for reporting transport and clinical metrics.
5. Revenue allocation that supports EMS readiness, equity-mitigating programs, and transit alternatives.

Practical advice for clinicians, EMS chiefs and caregivers

Whether you are a medical director, a paramedic captain, a hospital emergency director or a caregiver whose family member relies on time-sensitive care, here’s what you can do now:

• For EMS leaders: Negotiate express-lane access and create direct data links between DOT and dispatch. Update deployment plans to reflect new capacity corridors.
• For hospital systems: Participate in project planning, share transfer protocols, and coordinate landing zones and interfacility transfer agreements early.
• For clinicians: Advocate for measuring clinical endpoints tied to transport time to build a clear case for integrated investments.
• For caregivers and community advocates: Ask elected officials how projects will protect EMS access, what toll policies will be, and how revenues will support public-health priorities.

Limitations and open questions

Evidence gaps remain. Few large-scale, controlled studies have directly linked highway widening to patient-level outcomes across diverse systems. Long-term follow-up is also needed to determine whether induced demand negates initial EMS time gains. Rigorous before-and-after studies with control corridors, and randomized or phased rollouts where feasible, can strengthen causal inference.

Conclusion: Faster pavements are a start — systems thinking turns them into faster care

Highway upgrades such as the proposed I‑75 express lanes offer potential to reduce some EMS delays — but only when projects are designed and operated with emergency access and public-health objectives in mind. To convert asphalt into saved minutes and improved survival, states must pair infrastructure work with operational integration, clear tolling and access rules for emergency services, demand-management policies, and rigorous monitoring of both EMS performance and clinical outcomes. In short: faster highways can contribute to faster care, but only as part of a coordinated system.

Actionable next steps

• Policymakers: Require EMS access clauses and an outcomes monitoring plan for any major highway project.
• EMS agencies: Secure real‑time data feeds from DOT and negotiate toll exemptions now — don’t wait until lanes open.
• Hospitals and trauma systems: Predefine preferred transfer routes and simulate scenarios during construction.
• Community advocates: Demand transparency on how revenue will fund equitable mobility and emergency care preparedness.

Call to action

If you care about whether a proposed road project in your region will actually improve emergency care, ask three pointed questions of planners and elected officials: (1) Will emergency vehicles be allowed to use new lanes without delay? (2) How will traffic data be shared with 911 dispatch? (3) What metrics will be reported to show impact on EMS response and patient outcomes? Send your questions to your state DOT, county EMS director and your elected representative — and insist that public health metrics be part of the project’s success criteria.

Want help translating a local road plan into EMS‑ready policy? Share your jurisdiction and project details with us at clinical.news; we compile evidence-based checklists and can help you prepare a focused public‑comment or advocacy brief.

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