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Quick thoughts from TriCON 2012

The theme for the TriCON 2012 conference in San Diego was “Breaking Barriers” and that is certainly what TriTech presented during the plenary yesterday regarding their next generation dispatch system and their consolidation of recent business acquisitions.  The crowd was clearly the biggest ever for this conference at about 430 users.  A show of hands made it clear that the majority of these attendees were VisionAIR clients with VisiCAD users a clear runner up in representation.  However the future direction for TriTech was definitely a merger of several systems, both internal and external to the business, as explained during the opening session called “TriTech Update: One Company.”  It was explained that the products would be simplified into a family under the names of “Inform”, “Perform”, and “Respond.”  While the names were beginning to be used this week, it was admitted that it will take some time for the actual rebranding to be complete.   Attendees at this conference would almost exclusively fall under the “Inform” name reserved for the larger volume clients using applications now called VisiCAD or VisionAIR.  Smaller dispatch clients would be in the “Perform” category and “Respond” will include EMS and billing systems.

This type of re-categorization even extended into a restructuring of the organization around functional “centers of excellence” that would be geographically recognized.  San Diego, for instance, will become the center including GIS integration and Castle Hayne will host law enforcement functions.  Darrin Reilly, the new COO, explained the need to reorganize the company allowing them to take advantage of future trends given that fact that “IT evolution will be greater in the next 12-60 months than ever before.” (more…)

Posted in Conferences, Dispatch & Communications, Emergency Communications, Technology & Communications

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No comments Posted by on September 27, 2012

Measured Response to Response Measures

In conversations lately I have been hearing more diverging opinions on measuring EMS response ranging all the way from it being a definitive criteria to saying  it shouldn’t be considered at all. A recorded example of such a discussion is a recent blogtalkradio episode by “EMS Office Hours”.  While certainly appearing to be diametrically opposing opinions on the surface, I believe that there is more in common between these positions than actual difference.  Everyone agrees that responder safety is paramount and also that speeding ambulances endanger not only the medics, but the public as well.  However, to assume that the “observer effect” of simply measuring the response time is a casual factor in promoting unsafe practice is not always justified.

To clarify the commonality, it is worthwhile to first discuss the measurement itself.  When does the clock measuring response performance actually start and when does it stop?  The answer likely depends on your perspective.  As a patient in cardiac or pulmonary distress, rescuer performance is rightfully measured from symptomatic onset to relief.  For a dispatcher, it can be from the point of answering the call for service to the paramedic greeting the patient.  For the responding agency, it can be from the initial dispatch time to the time of “wheels on the curb” at the scene.

In reality, it doesn’t matter what you choose measure, the point is ultimately how efficiently can service safely be rendered to achieve a positive clinical outcome.  Opponents to time response measures will say that the focus is brought to the wrong objective.  That only (more…)

Posted in ems

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No comments Posted by on August 27, 2011

Dynamic System Status Management

System Status Management (SSM) is the fluid deployment of ambulances based on the hour-of-the-day and day-of-the-week in order to match supply, defined as Unit Hours of Utilization (UHU), with expected demand, expressed as calls for service, in the attempt to provide faster response by locating ambulances at “posts” nearer their next calls.  While the practice is still not unanimously embraced by all services, it has a sound foundation both in the research literature dating back to the 1980′s as well as in practice today.  Experience has shown that ambulance response times can be dramatically decreased using this type of dynamic deployment, but it is also recognized that it is possible to reduce performance when these techniques are not applied properly.  The direction of the results of a system implementation are typically influenced by the system design, competence of the managers creating the plan, and commitment of the workforce in implementing it.  Therefore the best practice is a simple and straightforward implementation that will show positive results quickly.  This methodology ensures a positive return on investment along with garnering the necessary buy-in from staff to make the project a success.

In his article, “System Status Management – The Fact is, It’s Everywhere“,  published in the Journal of EMS (JEMS) magazine back in 1989, Jack Stout explained the concept of SSM and tried to dispel certain myths.  Based on foreseen Geographic Information System (GIS) technology and even general computing capabilities of that time, it was quite logical to assume in his Myth #2 that “no matter how thoroughly the response zone concept is fine-tuned in practice, it cannot be made to cope effectively with the dynamic realties of the EMS environment.”  But systems implemented today around the US are capable of calculating dynamic response zones in a small fraction of a second while even being based on time-aware historic driving patterns making a truly dynamic system status management process a reality.  A practical and proven example of a dynamically functioning system status management application is the Mobile Area Vehicle Routing and Location Information System, or simply MARVLIS.

The following Slideshare presentation does an excellent job of telling the story of why and how the system works:

High Performance EMS is MARVLIS[slideshare id=8765718&w=425&h=355&sc=no]

View more presentations from hp_ems

Posted in ems, Technology

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7 comments Posted by on August 8, 2011

Addressing Geovalidation

The most fundamental aspect of an E-911 emergency dispatch center is to be able to locate a call for service and communicate that location to the closest appropriate vehicle to be dispatched.  In nearly every case, that location description is eventually an address.  The back-end process starts when a call is placed to 9-1-1 from a traditional wired land-line and its Automatic Number Identification (ANI) is compared to phone company records to find the Automatic Location Identification (ALI) address which is then compared to the Master Street Address Guide (MSAG) database to determine which Public Safety Answering Point (PSAP) or “call center” will receive that call.  It is the dispatcher at the PSAP who will determine the required resources and ultimately dispatch the requested assistance.  For cellular phones, VOIP, or telematics, the process is a little more complex to return a current latitude/longitude coordinate rather than a pre-determined address.  In those cases, the PSAP will interpret the caller position to a nearest address using Geographic Information System (GIS) technology.  The process of turning an address into a latitude/longitude value is called “geocoding” by GIS people and “geovalidation” by EMS staff.  The inverse of that process, finding the address of a specified point, is preceded with the term “reverse” by either crowd.  So, regardless of how the location information is presented to the PSAP, the closest resources can be found by comparing points and, in return, an understandable location descriptor can be provided for any point – at least in theory.

(more…)

Posted in Technology

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1 comment Posted by on June 21, 2011

HP-EMS Profile: MEDIC

Each month we will feature a profile of another High Performance EMS to show the variation in these services and inspire others to reach beyond just the basic services to provide advanced pre-hospital care with a focus on high economic efficiency.

In 1996, the Mecklenburg EMS agency was one of the slowest in the US with an average call response time of about 16 minutes.  Today, calls average around 7 minutes.  That incredible transformation began when two competing hospital services joined together to create MEDIC which now contracts to serve the county of 540 square miles with a fixed population of 850,000 that swells to a routine daytime total of around 1 million people.

MEDIC Emergency Dispatch Center

Barry Bagwell, Deputy Director of Operations, is proud to state that MEDIC has been compliant regarding performance every month since 1998.  “While there is no ‘silver bullet’, all of the pieces must work together,” says Barry, “it requires technology plus the people to run it.”  But a truly High Performance EMS must not be tempted to over-utilize response times as the only measure of success. The original focus for system improvement was on routing, but the partnership with Bradshaw Consulting Services has led to many operational (more…)

Posted in Profiles

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No comments Posted by on June 2, 2011