The ‘Uberization’ of 911

Apps like Uber or Lyft can find you easily for a ride to the airport. So why is getting help to get to a hospital in an emergency so much more complicated?

11:00 AM

Author | Haley Otman

Hand holding cell phone calling 911

The authors of a new editorial in JAMA Cardiology say technologies used by ride sharing and even pizza delivery operations are more advanced in some communities than those used in the life-and-death circumstances managed by local 911 centers. But, they point out, things are changing.

Stephen Dowker, E.M.T., a research analyst, and Brahmajee Nallamothu, M.D., M.P.H., an interventional cardiologist at the Michigan Medicine Frankel Cardiovascular Center – both with the Michigan Integrated Center for Analytics and Medical Prediction – share updates that are coming, and what patients and clinicians can expect.

What does pre-hospital communication look like presently? Why do you say the systems cannot meet modern expectations?

Dowker and Nallamothu: At present, pre-hospital communication systems don't measure up to consumer equivalents. Many 911 centers around the country are operating old technology that just can't process the same richness of data as consumer devices like location services and video streaming.

LISTEN UP: Add the new Michigan Medicine News Break to your Alexa-enabled device, or subscribe to our daily updates on iTunes, Google Play and Stitcher

Similarly, communication between pre-hospital providers like 911 call centers and ambulances is technologically lagging. We can live stream a kid's birthday party to a parent who's out of town. But livestreaming emergency medical services of a patient encounter to a hospital physician isn't as common as you might expect today.

What technological disruptions are in the works to improve the process?

Dowker and Nallamothu: Next Generation 911, or NG911, and FirstNet are two big overhauls we discuss in our article. These disruptions are leading to an "Uberization" of pre-hospital communications systems.

NG911 puts in place the infrastructure our 911 systems need to capture today's data streams. This will allow 911 centers and pre-hospital providers to leverage rich information now available from devices like smartphones that are in everyone's pockets.

FirstNet is a relatively new broadband network designed specifically for pre-hospital providers and first responders. It facilitates communications between, for example, a paramedic in the field and a physician at the hospital.

Does the COVID-19 pandemic have any impact on those changes or need for those changes?

Dowker and Nallamothu: It is a bit too early to say. But we do know that COVID-19 generally had negative financial impacts on hospitals, municipalities and private EMS organizations.

It's probably less likely that organizations have money in the coffers right now for cutting-edge technologies. Additionally, organizations have been forced to make a lot of changes recently in how they approach patients with emergencies to keep their providers safe.

With so much uncertainty in the air, changing up something as big as a communication workflow may not make a lot of sense right now. So there might be delays in reaching our idealized vision over the next year or so as we adjust to the pandemic.

What should cardiologists and patients take away from this?

Dowker and Nallamothu: To provide the best care to patients, especially those with acute cardiovascular emergencies, access to high quality, early information is key. These system overhauls are the foundations for that type of high fidelity data sharing.

Cardiologists as well as other providers who treat patients with life threatening conditions should be prepared for new data to be coming their way. One of the points we make is how cardiologists can start to think about ways to engage with and integrate these new data, such as field ECGs, vital signs and possibly even video, into their workflow.

MORE FROM MICHIGAN: Sign up for our weekly newsletter

However, this isn't without risk. Uberization can disrupt old models and also result in data privacy concerns. So we will require careful implementation of new systems with feedback from everyone involved to ensure their optimization for both the public and providers. Protecting all these data streams from privacy concerns also will be very important.

More data is usually considered a good thing, but you warn about the oversaturation of data that may result from these technological improvements. Why?

Dowker and Nallamothu: In today's medical environment with electronic health records, dozens of computer programs, pagers, cellphones, authentication tokens, etc., physicians often suffer from data overload.

As prehospital data makes its way into the hospital setting, the last thing we need is for it to just become another chirp in a chorus of alerts. Hospitals and EMS systems will have to collaborate to determine what data is valuable and how can it be presented in ways that improve care. We don't want doctors slowed down by the process of sifting through too much unnecessary information when they're trying to provide emergency care.

Paper cited: "Uberization of Prehospital Communications—Are We Ready?" JAMA Cardiology. DOI: 10.1001/jamacardio.2020.2990

More Articles About: Health Tech Cardiovascular: Diagnostics & Procedures heart attack Health Care Delivery, Policy and Economics Emergency & Trauma Care Cardiovascular: Diseases & Conditions
Health Lab word mark overlaying blue cells
Health Lab

Explore a variety of health care news & stories by visiting the Health Lab home page for more articles.

Media Contact Public Relations

Department of Communication at Michigan Medicine

[email protected]


Stay Informed

Want top health & research news weekly? Sign up for Health Lab’s newsletters today!

Featured News & Stories woman sitting at table in stripe shirt stressed seeming white background window
Health Lab
An unequal toll of financial stress
Inflation rates may have cooled off recently, but a poll shows many older adults are experiencing financial stress – especially those who say they’re in fair or poor physical health or mental health
woman laying down and sheet over going into surgery
Health Lab
Older women more likely to receive heart surgery, die at low quality hospitals
Women over the age of 65 who require complex heart surgery are more likely than men to receive care at low quality hospitals — where they also die in greater numbers following the procedure, a Michigan Medicine study finds.
sunscreen blue people outside
Health Lab
Sunscreen dispensers make skin cancer prevention easier
Medical students have worked to place dispensers at parks, pools and golf courses around Washtenaw County to give people easy access to sunscreen.
people standing in teal background with bubbles overhead
Health Lab
What can America do to make health care and health outcomes more equal?
Inequality in health care access and delivery, and in health outcomes, have changed somewhat in the past 20 years but more needs to be done to reduce racial and ethnic disparities.
10 year old in wheelchair at hospital, also posing on physical therapy mats.
Health Lab
10-year-old works to regain independence after rare brain hemorrhage
A young girl works with physical therapists and other specialists in two unique clinics to regain strength again after a rare brain hemorrhage.
pills spilling out of bottle
Health Lab
Primary care physicians are hesitant to accept chronic pain patients using opioids or cannabis
Michigan Medicine research finds that patients with chronic pain who use either substance may find it harder to find primary care physician than those who don’t.