Monthly Archives: November 2011

HP-EMS Profile: Jersey City Medical Center EMS

The High Performance EMS we examine this month is Jersey City Medical Center EMS  located just across the Hudson River from Lower Manhattan.  It is a triply accredited service, receiving the CAAS, NAED’s ACE, and CoAEMSP accreditations all in the same year.  As a part of the LibertyHealth System, it serves the residents, workers, and visitors of Hudson County, NJ by responding to nearly 90,000 calls a year.  JCMC EMS provides both Basic and Advanced Life Support as well as services for special operations, neonatal transfers, critical care inter-facility transports, regional EMS communications, and more.

Few modern ambulance services can claim over 100 years of history, but this organization has been providing prompt, professional pre-hospital care since the days of taking patients to the Medical Center in horse-drawn ambulances.  Today, however, JCMC EMS is one of the most technically advanced EMS agencies in the country with an impressive response time averaging 6:02 – well below the 7:59 city standard.

Richard Sposa, EMS Communications Coordinator at JCMC EMS, describes how they continually improve their service saying “positive patient outcomes are the goal for any EMS agency, and at Jersey City Medical Center, it is our guiding light.  The Jersey City Medical Center’s EMS Department has taken a leadership role in positive patient outcomes by examining real life scenarios.” More specifically Sposa says, “we made a self-realization in 2005 that the system as a whole was in need of improvement in a multitude of areas, and the most notable were our response time and asset deployment.  With the help of Bradshaw Consulting Services and the MARVLIS system we were able, in less than a years time, to reduce our response by over two minutes.”

The MARVLIS application forecasts demand dynamically and displays the probability of incoming calls as a colored surface.  As paramedic David Pernell describes it, they “chase the blob” likening the constantly updating application to an animated weather forecast showing upcoming need allowing resources to be better deployed when called upon.

As one of the largest and busiest EMS systems in the state, they are proud to play a vital role in domestic preparedness education, homeland security response and educating the public and healthcare providers in CPR and advanced adult and pediatric life support.

“With an in-house study we have undertaken,” said Sposa, “we have seen that the drop in response time has improved patient survivability.  With the data collected so far we hypothesize that by reducing our response time by two minutes we will have the ability to return pulses to as many as thirty more patients a year.”  What more could be said about high performance in EMS!

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EMS in the Cloud

According to the Gartner Hype Cycle for 2010, “Cloud Computing” and “Cloud/Web Platforms” have reached the infamous “Peak of Inflated Expectations” and are already sliding down like a fog into the unavoidable “Trough of Disillusionment”.  But the story doesn’t end there as the cloud is expected to rise back upward and eventually reach the ultimate “Plateau of Productivity” within the next 2 to 5 years.  What does this mean for EMS?  Well, first, it means that there is probably still plenty of confusion about what the “cloud” actually refers to and its waning excitement at the moment means the enthusiasm of its promoters is more easily dismissed as the ramblings of zealots “with their heads simply stuck in the cloud.”   However, it is the critical review and appropriate response to technology offerings in just this state that separates the industry leaders from the rest of the pack.

Notice that I did not say the “full adoption” of a new technology, but rather the “appropriate response” to its availability.  As you will see in this post, my forecast of cloud computing is that tomorrow will only be “partly cloudy”.


According to Wikipedia,  “cloud computing describes a new supplement, consumption, and delivery model for IT services based on Internet protocols” (IP).  This means that the cloud really becomes just another computing resource similar to existing enterprise servers except that these cloud-based resources are physically located (and maintained) somewhere else in the world and access is typically provided on a subscription basis that allows them to “scale” (increase or decrease available resources) more dynamically based on demand than traditional hardware installations within an agency.  Additionally, the IP nature of cloud-based resources means that these services can be accessed through a variety of distributed devices from a desktop web browser to a smart phone.  That broad availability raises legitimate questions about security, but cloud-based providers often address these concerns based on the specific security demands of an organization making the broad access more of an advantage to distributed workforces (such as EMS) than a threat.

If you send messages with a Gmail account, listen to Pandora, share your thoughts on Twitter or Facebook, check-in on FourSquare, look up addresses on MapQuest, share files using DropBox, or pay bills online – you already use cloud computing services.  Even the blog post you are reading now was written and delivered using WordPress as a hosted cloud service.  Another WordPress site recently described using the cloud service Google Calendars to create an EMS shift calendar in place of a paper schedule.  A more sophisticated online scheduling system specifically designed for EMS employees is available from Aladtec and used by Deputy Fire Chief Kris Kazian of Countryside Fire Protection District in Illinois who said, “It is one of our better decisions relating to migrating office processes into the ‘e and green’ world!”  Applications like these, or even billing systems which are not as adversely affected by potential temporary outages related to disaster events, are perfect examples for outsourcing to the web.

But not all applications should be considered for hosting off-site just yet.  Besides security, is the question of availability when internet connectivity is down.  For mission critical applications, this type of interruption can be a worst case scenario.  While applications like ArcGIS by Esri are moved to the web, an EMS agency functioning in a pure cloud model could be effectively running blind without any access to their GIS.  However, hybrid models (only partly cloudy) utilizing select web resources from the cloud can be very efficient and still remain effective.  Orthographic imagery, whether satellite or aerial photography, and oblique photography, such as Pictometry can be very resource intensive and difficult to update.  But as a cloud-based web service, they can be very fast, current, and efficient.

To say that the cloud is too confusing, or that the technology is not ready yet is clearly a misunderstanding of the resources available from the cloud.  On the other hand, it is not necessary to go overboard by planning to completely outsource everything to the cloud either.  Now is the perfect time, however, to evaluate and plan for how your agency will leverage this technology in the future.  The cloud is not coming – it is already here!

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