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Big Data and Medical Hotspotting to Enhance Community Health and Prosperity

During election season at all levels of government, we as constituents are inundated with ideas from incumbents and their opponents on how to lift up the communities we live and work in. Job creation, government transparency, accountability and smaller federal intervention represent a snapshot of ideas posited by those seeking to lead us.

In crime-ridden cities, we also hear the proverbial statement, “If I’m hired, I’ll expand the number of police officers on the streets to thwart crime.” These so-called great ideas are ostensible strategies for enhancing the overall welfare of members in a given community.

One area of public safety that’s rarely mentioned during a campaign season is the fire department. Some of us would opine that this is a good thing; no news is good news, right? Very few communities in the 21st century have a fire problem; however, many cities do in fact have an enormous crime problem.

This author assumes that we are really not that important and have no true value in actively enhancing the overall wellbeing of the community and its population. If you ask any firefighter in the United States what his or her role is, you’ll routinely hear, “To protect life and property.” True, but what does that really mean?

If we start with the reason for our existence, you’ll better appreciate the strategy below as one way to highlight the value of our existence. Protecting life and property is what we do—we exist to ensure that individuals in our respective communities have a high quality of life (subjective)—we attempt to return it to a degree of normalcy when that high quality of life is interrupted for whatever reason (fire, medical emergency, etc.).

Of the many variables that make for a vibrant community, the health of its members is the most essential. Without healthy community members, a community can’t realize its highest potential. Sick people struggle to work and be productive contributors to the economy; additionally, they require resources that could otherwise be allocated to other areas.

The result is a high degree of inequality, destituteness, blight and a feeling of hopelessness. Those who study public health lament that these are some of the critical factors that lead to high crime rates in many areas of the country.

In our world as fire service personnel, this often leads to an overuse of the 911-system for assistance that isn’t truly life threatening in many instances—another example of misallocation of resources. When is the fire service going to move from reactionary agents to prevention agents in the realm of EMS?

With the passage of the Affordable Care Act, now is the most opportune time for us to realign our service delivery model based on consumer demand. The author isn’t advocating for the reduction of fire service personnel or purporting that we will never have major fires here in the United States. It’s all about remodeling our service to affect community prosperity and save firefighters from preventable injuries and death. Since 2003, over 200 firefighters have died in vehicle accidents.

Starting in the fall of 2016, the Merritt College (Oakland) EMT Program will introduce a concept similar to hotspotting strategies used in law enforcement organizations across the United States. Using big data collected from 9-1-1 response runs by the Oakland Fire Department, five clusters were identified using a machine-learning algorithm from an open source software program (WEKA).

The attributes that comprise the five clusters include medical call type, frequency and apparatus responding. Merritt students will canvas neighborhoods in East and West Oakland, educating community members on prevention and care of diabetic, cardiac and respiratory ailments. The goals are to

  • Prevent common ailments from increasing in the community
  • Provide those with preexisting medical conditions with strategies for reducing the side effects of their conditions
  • Reduce the reliance on the 9-1-1 system as the primary healthcare provider in these areas of Oakland

Due to many reasons, individuals in poorer communities commonly use 9-1-1 responders as their primary healthcare providers—this isn’t what the 9-1-1 system was designed for.

Other fire departments are using a similar approach to reduce the frequent use of 9-1-1 for ailments that are best dealt with aggressive, proactive education strategies and collaboration between the fire service, hospitals and private insurance organizations. In the 21st century, fire departments should recognize that the use of big data is a now-required tool for strategic planning. Your organization collects an enormous amount of data. What is your organization doing with that data?

Finally, let’s all recognize that the fire service plays a vital role in community prosperity. A sick community can’t prosper effectively!

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