Case Summary
Loma Linda University Medical Center (LLUMC) is a level-one trauma center serving a population of more than 3.3 million. Recognizing the fragmentation of a massive emergency response operation that included fire and police departments, local hospitals, ambulances and rescue helicopters, LLUMC CEO Ruthita Fike in 2005 proposed building a situational awareness tool linking patients with emergency assets.
Partnering with the software firm ESRI, LLUMC developed the Advanced Emergency Geographic Information System (AEGIS,) which is an interface that graphically maps the real-time location of victims, emergency response assets and traffic information and other pertinent data. AEGIS has proven successful in reducing the time needed to route patients expediently to hospitals, and has even sparked new academic initiatives at the Medical Center.
Business Challenge
Loma Linda University Medical Center
(LLUMC) is a level-one trauma center in Southern California's San Bernardino County, representing 25% of the state and serving a population of more than 3.3 million.1 Recognizing the fragmentation of the massive emergency service apparatus created by this large service area, LLUMC CEO Ruthita Fike in 2005 formulated a compelling strategic vision for this teaching hospital. Embracing the fledgling academic discipline of health geoinformatics , Fike argued that linking emergency resources with victims is in essence a geographic challenge. Consequently, she proposed building a communications clearinghouse that would ensure a common operating picture for relevant hospital personnel, fire and police departments, ambulance companies and other stakeholders.2
At the same time Fike was laying the groundwork for LLUMC's new organizational initiative, Dr. Jeff Grange, Emergency Medical Services (EMS) Director for the hospital, endured a deeply frustrating and memorable emergency response experience during a shift with the San Bernardino County Sheriff's Air Rescue. He recalls: "I was on the helicopter one day when we had just dropped off a patient. As we were flying back, a little six year-old girl got run over by a car and we were only about 30 seconds away. But the County Communications Center didn't know we were right there, so they dispatched a helicopter from Anaheim that was more like 30 minutes away. It became clear that we weren't getting the right information to the right people to make the right decisions in a timely manner."3 This experience would lead Grange to become actively engaged in tackling the challenge presented by Ruthita Fike to coordinate geographic and public health information in a revolutionary new way.
Approach Taken
In 2005 Loma Linda University Medical Center approached the software firm ESRI about developing a Web-based situational awareness geographic information system to achieve the strategic goal outlined by Ruthita Fike of obtaining a common operating picture for all emergency response stakeholders. Launched a year later, the Advanced Emergency Geographic Information System (AEGIS) graphically maps the real-time location of an emergency and its victims as well as emergency response assets.4
Specific items incorporated into the digital display include ambulances, rescue helicopters, and other emergency vehicles as well as the locations of all fire departments, rescue workers, and law enforcement officers. Additionally, the AEGIS overlays traffic congestion and accidents on freeways to plot the fastest routes to area trauma centers. This is achieved through the harvesting of data feeds provided by the California Highway Patrol and California Department of Transportation which offer both the pertinent accident information as well as camera monitoring of freeway traffic. When a user needs to check highway traffic or evaluate available hospital resources, he or she simply clicks on its corresponding icon.5 Consequently, the AEGIS system allows all relevant stakeholders including the local county communication center, law enforcement agencies, fire departments, and EMS a near-real time resource management tool for strategic decision-making during emergency situations. In practical terms, this tool assists a dispatcher sitting at a computer to see in real time, nearly all the relevant data for deciding how best to get emergency medical help to those who need it, and how to get such patients to the hospital as quickly as possible.6
Results Achieved
For Loma Linda Medical Center, AEGIS has been instrumental in establishing a common operating picture for all pertinent emergency stakeholders. According to EMS Director Dr. Jeff Grange: "Previously an ambulance might have been directed through bad traffic or even through another accident scene. Now, with the situational awareness geographic information system, the base hospital can see everything in real time. When someone makes a 911 call on a cell phone, it shows up on the map, and the team can respond accordingly."7
Just as importantly, LLUMC's implementation of AEGIS has impacted the academic curriculum of this teaching hospital. In line with CEO Ruthita Fike's strategic vision to integrate public health and geography, this technology has been leveraged to allow Loma Linda University to become the first educational institution to offer a certificate in health geographics.8
Lessons Learned
The central conclusion to be drawn from LLUMC's implementation of AEGIS is that the success of this tool has confirmed that "place matters," and by bringing personnel, equipment and information technology together lives can be saved.9 In terms of the potential for exporting AEGIS to other organizations, Dr. Grange notes that "this is basically current, off-the-shelf technology, so someone can take this system today and start using it anywhere in the country."10 Another critical point is that LLUMC's early experiences with AEGIS have indicated that interoperability is critical if the technology is going to continue to be successful at connecting all relevant stakeholders. Consequently while today AEGIS only works with a map viewer developed by ESRI, there are already plans to build a next generation of AEIGIS that will allow the tool to run on standard desktop PCs, laptops and cell phones.11
References
1. Joe Francica, 'A Governor and a Geologist Meet an Environmentalist and a Hospital Administrator - Result: Executive Champions', Directions Magazine, June 21, 2007.
2. Ruthita Fike, 'How GIS is Changing Loma Linda University Medical Center's View of the World', ESRI ArcWatch, August 2007.
3. Case Study: Loma Linda University Medical Center
4. Ruthita Fike, 'How GIS is Changing Loma Linda University Medical Center's View of the World.'
5. Rod Brouhard, 'Using Geographic Information To Aid Patient Care,' EMS Product News, April 16th, 2008.
6. Mark Muckenfuss, 'A Rescue Mission: Loma Linda doctor helps develop an emergency system,' The Press-Enterprise, December 18, 2006.
7. Case Study: Loma Linda University Medical Center
8. Joe Francica, A Governor and a Geologist Meet an Environmentalist and a Hospital Administrator - Result: Executive Champions'.
9. Ruthita Fike, 'How GIS is Changing Loma Linda University Medical Center's View of the World.'
10. Case Study: Loma Linda University Medical Center
11. Rod Brouhard, 'Using Geographic Information To Aid Patient Care'
