Partnering Up to Make Summer Safer

The summer months bring longer days, more time spent outside, and, tragically, more accidents—drownings, children experiencing heat stroke in a hot car, pedestrian deaths and injuries, and motor vehicle crashes, to name a few. (Though the number of vehicle crashes remains higher into October, according to NHTSA statistics.) EMS clinicians and leaders are in a position to help reduce those numbers, says John Ehrhart, co-founder of Mission Critical Protocols and EMS Manager of San Diego Health Connect, by partnering with those in public safety, public health, healthcare and beyond.

“EMS is relevant to these issues because you’re responding to them, so that makes you authentic and relevant to what you're communicating,” says Ehrhart. Partnering could mean reaching out to work with, say, an existing water-safety task force or connecting with an organization or an agency to start new programming.

In San Diego, where Ehrhart lives, the county was monitoring surveillance data about drownings and saw a spiking trend. “It was pools and the ocean, but it was also things like bathtubs and buckets,” he explains. “So they reached out to the California Paramedic Foundation [where Ehrhart is a co-founder] and said, ‘hey, we’d like to put a [public service announcement] out. Can you communicate out to the community and see if we can raise awareness around drowning and hopefully trend it down?’ And that was something we were happy to do.”

It starts with data

Data, Ehrhart adds, is often an ideal place to begin a collaboration. Pretty much every city and county EMS agency submits ePCRs into the National EMS Information System (NEMSIS) dataset, which feeds into a national registry. “So you can identify an issue and maybe there's a public health partner that's already working on harm reduction for opioids, for example, and you could be integrated with them, or you could share your data and decide if there's a way you can help them,” he says.

“That's a pattern that works really well for longevity and fundability and for everything from traffic safety to water safety to environmental safety with extreme hot or cold weather, as well as community paramedicine and other big initiatives.” In rural areas and other places that typically have fewer resources, he says, “maybe that’s the call to action for EMS to step forward and build a task force.”

While ePCRs contain lots of relevant data, their narrative section is often a treasure trove, too—albeit one that can be hard to easily and quickly access. “There’s a lot of interest by EMS agencies in analyzing the full record with the free text area. A lot of really valuable data is held in the narratives,” notes Ehrhart, who participated in an Office of EMS “EMS Focus” webinar on EMS and harm reduction and substance use disorder treatment in March 2024.

Natural language processing models—a type of artificial intelligence (AI)—can take huge amounts of data from records and analyze it according to the problem you’re trying to solve or help answer key questions. “You can just feed the document to a chatbot and say, ‘is this incident related to road or pedestrian safety or not?’ and it says ‘yes,’” he explains. “We wanted to identify an opiate event and I asked it all kinds of questions like identifying senior risks and polypharmacy issues.” The chatbot responded immediately with answers he and his colleagues could use.

Using what you have

In a world of ever-increasing data, being able to sort “the signal from the noise” isn’t just critical for EMS, of course. Consider how you might apply information beyond your field, then reach out to others who’d benefit as well. (That makes it likelier, too, you can then share the cost of data analysis with a partner.) “If you come to a fire department and ask them to do traffic-safety analysis, monitor their data around it and do a public campaign, they’re going to say, ‘Who’s paying for that? I’m resource-strapped,’” Ehrhart says.

Instead, make clear to colleagues in public safety and community health what they already have to work with: “They’re sitting on really valuable data that can drive action. It’s not a huge leap to see what risk factors there are for addressable problems in your community,” he says. “Especially around traffic safety, if they can identify through their own data or in partnership [with EMS] the things that the community is seeing, there are things they could absolutely do. And if they’re not monitoring this, this summer is a great time to start monitoring it for future seasons.”

Potential partners may already be using data to help educate citizens on the dangers of speeding, distracted and impaired driving, or promoting helmet safety for bicyclists, for example. Or you could work with 911 to get more telecommunicators trained up to deliver Emergency Medical Dispatch care following a traffic crash, or work with staff at your State Highway Safety Office to pilot a QI program for high-risk, accident-prone areas. “This creates future opportunities for EMS, too, as you become integrated into your broader communities, whether it’s public health, healthcare, community health or nonprofit organizations,” says Ehrhart.

As an example, he cites San Francisco’s robust non-911 opioid addiction response teams that are well-integrated with hospitals. But he’s quick to add that this approach wouldn’t work for every community. He knows of a rural community that has identified an opiate problem and what’s achievable for their EMS response is training paramedics in administering Narcan (naloxone) and then ensuring the patient receives a referral for treatment. “So you take a small-to-big approach to everything,” recommends Ehrhart. “Scale it at a level that you can maintain, either within your system or reaching out externally, and if you have the ability to scale it beyond what you’ve already done, then you take that step.”

Put another way, any efforts you make don’t have to be huge, costly or even long-lasting. Once you find a “signal”—something in your data telling you there’s a problem that needs to be fixed—think first about what might work to address it. “Is it something where we can just go on our social media accounts and raise awareness? Are there specific at-risk communities that we can distribute resources to? Or is this something that requires going above and beyond, like getting outside the 911 system and partnering on a task to try to mitigate risk?” Ehrhart asks.

“EMS has spent a lot of time looking inward and trying to improve its systems, the quality of the care it delivers, trying to make that care evidence-based, collecting data on the care that it gives, and standardizing the data. An immense amount of work has been accomplished there,” explains Ehrhart, who has been a paramedic for nearly 15 years. “Today, I think they are starting to look outward and realizing more and more that there are a lot of external partners that see the value in the very complex, robust, well-established 911 system that’s been built.”