This study was undertaken to determine the advantages and disadvantages of a hospital-based emergency medical service system with hospital employees serving as emergency medical technicians. This type of service is operating in thirteen hospitals in Wisconsin. A series of interviews was conducted to obtain pertinent information regarding the hospital, emergency medical vehicles, ambulance attendants, finances, communications and personal reactions to the system. The data indicate that hospital-based services using hospital employees can operate with minimal interference to regular patient care, and with apperent advantages to the emergency patients. In the rural, sparsely populated areas which were studied, response times from the hospital-based systems were comparable to other rural systems, and the financial and administrative aspects of the system were reviewed.