The ingredients for EMS success lie in understanding the health and medical care of populations through systems with a focus on improving access, population health, care quality, and cost. In any EMS system, it is impossible to separate operations from clinical care. An EMS information system is the one component of EMS that touches every aspect of operations, service delivery, and patient care. The last decade has been challenging. By 2030 health information systems will transition from a tool to an active member of the health care team. Devices and software will become tools or real-time assistants assuring patient safety, providing recommendations based on evidence-based guidelines, and improving operational effectiveness and efficiency. EMS information systems will integrate EMS with the entire health care system and will serve as a hub for health information exchange focusing on the patient, not the transport. Service and clinical outcomes will be optimized through data, its application, and a system of care approach.