Wow! It's much different up here. I work in British Columbia (BC), Canada. For the past two summers, I've worked in an extremely rural area, and had several patients medevaced by plane to a larger city due to critical illness/injury. The way it works in this province is that the physician caring for the patient calls BC Bedline, which is a program/organization that co-ordinates transfers between hospitals in BC. BC Bedline calls us back when they find a hospital with a bed in the appropriate hospital and ward (e.g. a Children's hospital, or a major trauma centre, or ...). Then BC Bedline co-ordinates a physician-to-physician report, so the information isn't diluted or mixed up, as you mentioned happens with your patients. BC Bedline also co-ordinates the transportation, getting the appropriate paramedics (even physicians if needed) on the appropriate medevac plane, and sends them up to us to collect the patient.