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The Intersection of Need and Demand Equals Opportunity

Innovation, change agents, modernization, relevancy—all words that can often bring weariness to the listener. These words become almost clichés and lose their value and importance. However, now is not the time to give up on these concepts. Many things have changed in part due to COVID-19, social justice, rioting, and budget cuts. These have changed our environments. 

Ignoring it will not make it go away. 

Some say that change management is all about timing. More specifically, it's about watching for the intersection of need and new demand. That could not be truer today. For instance, for years, the International Association of Fire Chiefs has been engaged in convincing Medicare and Medicaid to compensate 911 providers for care and transport to non-emergency room alternatives. Due to the expected COVID impacts on emergency rooms and transportation resources, Medicare and Medicaid have agreed to pay for these services almost overnight! 

Telemedicine has been looked down upon by many, yet during the fog of COVID, it is now acceptable and paid for in most cases. In fact, according to an IAFC Knowledge Net post on August 26th by Dr. James Augustine and Chief Mike McEvoy, emergency room visits have decreased by 15% over last year's volumes. In many communities, the volume may never return to "normal" due in part to telemedicine. These were opportunities that forward-thinking providers adopted because, in part, the timing was right. COVID caused the intersection of need and demand. 

We, as leaders, must think strategically. To frame the approach to strategic thinking and planning, we often use the acronym called SWOT. Strengths and Weaknesses (internal to the organization) and Opportunities and Threats (external to the organization). We have had the threat of ever-increasing 911 call loads for years, and our industry has spent an inordinate amount of time trying to find solutions. And now, in part due to COVID, the opportunity for home care and transport to clinics has been dropped in our laps. The need has always been there. Now there is a demand to implement due to COVID. 

In 2018, I wrote an article for IAFC's On Scene magazine titled "What do Blockbuster, Borders, Yellow Cab, and Kodak Have in Common? 

They Never Saw it Coming!" I want to bring back some thoughts from that piece that are even more relevant for today. 

Many economists will say what destroyed or crippled Blockbuster, Borders, Yellow Cab, and Kodak was a concept called Disruptive Innovation. This concept was defined by Clayton Christensen, a business administration professor at Harvard Business School, "as a process by which a product or service takes root initially in simple applications at the bottom of a market and then relentlessly moves upmarket, eventually displacing established competitors.[1]  

In the case of Blockbuster, they failed to recognize the significance of online movies. Netflix understood!

Borders did not see Disruptive Innovation coming when the concept of online purchasing of books was developed, but Amazon understood!

Yellow Cab thought this new concept called Uber would never grab hold, but millions now have the Uber App on their phones. 

Kodak did not see the significance of digital media storage for pictures. Many other startups certainly noticed it.

Brick and mortar stores have stood the test of time until Amazon began to deliver much of what we needed by ordering it from the comfort of our easy chair. 

The result was when these new solutions took over; they replaced those historic, celebrated, and venerable leaders. An interesting question is: did they see these disrupters coming, and if they did, did they fail to see the significance of those change agents?   

With all the tidal wave changes occurring around us, it may be a little easier to see what is coming. A partial list is:

  • Telemedicine
  • Mobile Integrated Health Care
  • Alternative 911 transport destinations. 
  • Alternative response vehicles

In the August 2018 edition of Trends Magazine[2], a statement was made that "aside from education, no sector of the U.S. economy is more in need of revolutionary transformation than healthcare." 

One can deduce that Disruptive Innovation is coming to health care, and that is where the Fire Service will undoubtedly be impacted.

So what are the takeaways? 

  1. We must identify our strengths, our weaknesses, our opportunities, and threats. Most importantly, we must be painfully honest about these.  
  2. Pay attention to the changes to fire and public safety that are happening around us. What can you learn from these, and what can be applied to your organization that will address a weakness or threat?  
  3. In July of 2020, the International City/County Managers Association (ICMA) and the Center for Public Safety Excellence (CPSE) released a report entitled 21st Century Fire and Emergency Service.  Read and study it, for it provides a view of what the Fire and EMS services will need to look like in 20 years. 

My closing statement from my 2018 article was: "Things are changing, and the fire service must pay attention. We must see what is on the horizon and not ignore the significance of developing Disruptive Innovators lest we or a portion of the services we provide go the way of Blockbuster."

This is still true today.    


Chief Deputy Mike Metro (retired) Los Angeles County Fire Department, was the Chief Deputy for the Los Angeles County Fire Department until he retired in January of 2015. In his last role with the Los Angeles County Fire Department, he provided executive oversight for the Department's 170 fire stations' emergency operations protecting 58 cities and 4.5 million citizens. He served on the Executive Board of the International Association of Fire Chiefs EMS Section for 14 years until he stepped down in August of 2019. He also served as the Chair of the IAFC's Affordable Care Act Task Force.  In 2020, he served on the IAFC's COVID-19 Task Force. 

[1]  http://www.claytonchristensen.com/key-concepts/
[2] Trends Magazine, "Value-Based Business Models Disrupt Global Heath Care," August 2018


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