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Feature Story

Rural Ohio Fire/EMS Department Using AI to Improve Outcomes

In a bid to improve patient outcomes, Ohio’s Malta & McConnelsville Fire Department has implemented an artificial intelligence (AI) analytical system to continuously assess the quality of its EMS patient care and improve staff responses. The system, Artificial Intelligence Quality Assurance (AQUA), does this by analyzing all departmental EMS responses. This analysis includes the type of call, the care provided, medications delivered, and the patient outcomes. Using this data, AQUA can assess if the proper care was given, if improvements could be made on similar future calls, and whether additional training is needed by the department’s EMS personnel.

morgan county ambulanceBy deploying AQUA, the Malta & McConnelsville Fire Department hopes to provide ever-improving EMS service in a very challenging jurisdiction. Headquartered in McConnelsville, Ohio, the M&M Fire Department (as it is called) serves a rural area with no emergency departments in their coverage area, with at least a one-hour transport time to the nearest trauma center of any kind.

“Using AQUA and in cooperation with our medical directors, we have essentially created a real-time EMS quality assurance office at the M&M Fire Department,” said Jacob Woodward, the department’s paramedic captain of EMS operations and EMS coordinator. “Based on AQUA’s analysis, we are able to enhance our people’s responses and performance from event to event.”

“We're doing this by analyzing all of the data that's coming in from the runs,” said Joshua Tilton, the department’s clinical quality officer and a PhD candidate in artificial intelligence. “We have great clinicians in the field already, but we analyze their case data every opportunity we get, so that we can make them even better clinicians for the next run.”

EMT using AI-enabled tabletWhen AQUA does identify opportunities for M&M’s EMS staff to improve their skills, the system assigns them four 15-minute training sessions followed by a quiz that can be done at their convenience. “Even on the most successful calls, AQUA analyzes every aspect of what was done to see what could have been done better, and then provides training to make this happen,” Tilton said. “And it isn’t just about actual calls: AQUA looks at trends within our past cases to date to identify what our people could be dealing with in the future and offers training to prepare them for those coming circumstances.”

Every time an M&M EMS staff member successfully completes an AQUA training session, they receive credit for an hour’s worth of continuing education. In this way, the system rewards M&M employees for taking these training sessions while improving their skills and responses at the same time.

Beyond its ability to process large amounts of data in an efficient manner, the AI-enabled AQUA system provides the M&M Fire Department with several analytical advantages. “For instance, AQUA allows us to take any human biasing out of quality assurance,” Tilton said. “It also looks at trends that we wouldn't normally look at and provides us with useful insights. For instance, one of the trends it identified is that one of our medic crews has a higher incidence of transportation of individuals over 75 years of age, which isn’t the case with our other crews. Using this knowledge, we can ensure that this crew has the specialized training needed to better serve a geriatric population.”

AQUA has also detected that some months have more advanced life support chest pain-related calls than others, and which M&M EMS crews are most likely to encounter these calls depending on service areas and times of day.

Thanks to AQUA’s analyses and assigned training sessions, the M&M Fire Department is seeing positive changes in its patient outcomes. “For example, we've seen a reduction in basic life support (BLS) transports dramatically,” Tilton said. “Last month we had right around a 60/40 transport/nontransport split, and then this month we're seeing more of a 50/50 split with a projected targeted drop in BLS runs to 33% in the future.”

“We want our residents, our taxpayers, to receive the best care possible and receive that level of care every time, no matter which M&M EMS crew goes out,” Woodward said. “Thanks to AQUA, we’re able to do our best to make this happen.”