The current situation around the new coronavirus is developing rapidly. As we begin to map more cases in new areas along with tracking the shortages of PPE supplies we are also hearing the CDC update guidance for healthcare providers with constantly changing advice. Even the stock market is falling as investors try to make sense of the extent of the impact of cancelled public gatherings and increased social distancing.
While there are significant new challenges around exacerbated staffing shortages created by potential quarantines of first responders, it is still, at least to some degree, business as usual for EMS. Panic over the declared pandemic is not eliminating the “normal” calls to which we must respond. Medical emergencies including cardiac arrests, cerebrovascular events like strokes, diabetic emergencies, and acute respiratory attacks (including COPD, bronchitis, emphysema, and asthma) in addition to common influenza and pneumonia occurrences in this season are all still happening just as before. Similarly, traumatic events are also continuing to happen as a result of motor vehicle collisions or by trip hazards in the homes of the elderly. It is these “routine” calls that are the very reason the most high-performing EMS agencies across Amercia began using MARVLIS in the first place. Now, the added pressures of concern over COVID-19 are requiring additional precautions that can delay care and increase the costs of delivering service to our communities, it may even cause an increase in call volume soon.
The need for efficiency in operations is never greater than during a time of emergency or crisis.
While the vast majority of EMS calls have not changed significantly in response the crisis so far, it is likely to have an impact as the pandemic grows in extent across time and jurisdictional borders. As that happens, the query used in MARVLIS Demand Monitor can be modified to highlight past respiratory emergencies to help prioritize nursing homes or the residences of the most vulnerable elderly populations. On the other hand, if the concern is that this population cannot be so easily identified, MARVLIS Deployment Planner can be used to create a geographically balanced plan that position ambulances throughout the service area based on the best ability to respond anywhere given any potential service level. MARVLIS Deployment Monitor has settings to provide automated recommendations for unit movements to match the plan according rules you can control to either minimize the time to reach that optimal configuration or limit the number post moves that crews experience. The most recent releases of MARVLIS include a “hotspot accuracy report” that allows MARVLIS Demand Monitor to grade the ability of competing queries in making the most appropriate forecasts and MARVLIS PSAP Monitor can allow neighboring mutual aid resources to be seen live on a map.
As the current crisis evolves, it is good to know that experienced advisers are available at Bradshaw Consulting Services to help MARVLIS users modify their application configuration to assist agencies in meeting their changing business objectives. As resources become more constrained, the flexibility of MARVLIS becomes more apparent.
I know there are probably agencies out there with some real control issues, but the use of technology that monitors your EMS system are not really about employee surveillance. Sometimes this monitoring is actually about your protection, but most often I believe it is about creating a competitive advantage that will help your agency survive in a bad economy and within an industry that is currently favoring consolidation. Increasing demand for emergency services is not enough to ensure that there will always be the funds needed to keep it operating at the level the community expects – especially under the same operations strategies in place since before the financial crisis of 2008 or the Patient Protection and Affordable Care Act of 2010. The world, and more importantly prehospital health care, is fundamentally different today and your job depends on your system adapting to it.
System monitoring typically starts by knowing where your vehicles are. GPS transmitters are capable of reporting location and many Computer Aided Dispatch systems are able to visualize that data and even recommend vehicles to incidents based on actual proximity and drive-time instead of a simple reported location. And that recommendation can even be based on the type of vehicle or skills of the team weighed against travel time. One concern of providers, however, is the employer always knowing where they are. But relax, the only way a monitor will see you somewhere you shouldn’t be is if you are somewhere you shouldn’t be. But again, monitoring your habits is not the important application for dispatchers knowing where available units are right now. Better response equals better service and can also improve safety. These are the keys to system survival.
Once location begins to be used effectively, concepts of system status management actually become useful. And for those who are concerned about that idea, remember that ‘posting’ is not a dirty word (that link will allow you to register for an upcoming JEMS webcast by that name or view the recording after the fact.) If you think tracking vehicles is invasive, how about tracking people? A new product currently available is GPS equipped shoes from Aetrex (incorporating GTX Corp technology) but fortunately it is directed at Alzheimer patients, not EMTs. But before you feel too comfortable, you already carry a GPS tracking device on your body if you use a smartphone. While the US Supreme court ruled it illegal for the FBI to secretly track suspects with GPS, it has not limited the private sector employer.
Road safety systems that monitor every aspect of the ambulance operations from seat belt usage, lights and siren activation to the G forces that apply to the vehicle are fast becoming commonplace in the public safety industry. Another JEMS webcast, May the G-Force Be With You will explore the implementation of such a system at Richmond Ambulance Authority to reduce accidents involving ambulances, cut operating costs, and provide a smooth and safe ride for the patient.
Paramedics and EMTs are not being singled out for tracking since this type of technology is becoming standard practice in many industries that involve mobile service providers. The difference for us are the legal standards to which we are held accountable and the legislation (like HIPPA) that make reporting especially tricky. I personally welcome cameras in the patient compartment to protect me from spurious allegations and even help me improve my clinical and patient skills. I cannot see any difference in this from recording the 9-1-1 call that dispatched me to begin with. While I realize there is fear around the monitoring topic, a useful dialog must begin with an understanding of the facts surrounding the debate – our future depends on doing it right!