911 systems have served the public for the last 40 years. They were originally designed to take calls from landlines; the data collection technology available under old systems was based on gathering location information from landline numbers to localize an emergency to a particular address. But in the last decade, the percentage of 911 calls made from cell phones has skyrocketed. This has led to challenging times for 911 call centers as the technology underpinning the old systems no longer works in an increasingly mobile world. Operators’ inability to locate cell phone calls has proven deadly when callers are unaware of their precise location.
Over the past decade, governments have sought to transform the 911 system from one designed to provide basic emergency communication for landline users to one that can also handle cellular and VoIP technologies and enable better emergency response. In 2015, the FCC introduced updated indoor location accuracy benchmarks. Their changes included reducing location data delivery time from wireless companies, improving accuracy levels, standardizing across 911 centers, and increasing reliability. The update dictates that by 2020, 70% of all wireless calls made by national providers must provide a dispatchable location or have a horizontal location accuracy of 50 meters. By 2024, all national and non-national providers will have to provide either a dispatchable location or a vertical (z-axis) location to help responders determine an exact indoor location, a particularly useful feature in high-rise apartments and offices.
911 updates include text-to-911, Voice over Internet Protocol (VoIP), and Multi-Line Telephone Systems (MLTS) technologies. Even with the FCC’s guidelines, anticipating the uptake of these technologies can prove difficult. For example, VoIP technologies such as Skype currently only account for 3% of 911 calls, but that percentage is expected to grow as they become increasingly popular. For call centers, updating regulation and policy to respond to new technology takes investment of time and money, which means 911 upgrades have been slow to roll out across the country.
Innovations pioneered by third parties that build on enhanced 911 capabilities have the potential to improve services assisting citizens in danger. One of the best examples is PulsePoint, an app that enables CPR-trained citizens to be the first responders to life-threatening cardiac arrests. A report from the Institute of Medicine indicates only 6% of the 395,000 people each year who have cardiac arrests survive. Inspiration for a CPR app came to PulsePoint’s president, former fire chief Rich Price, after a tragic incident: “Someone had a cardiac arrest right next door when I was on duty, in uniform, and had an AED in the car. But I wasn’t aware the cardiac arrest had happened.” Price realized that a mobile force of CPR-trained responders could be created using a smartphone app.
Working with a jurisdiction’s Computer-Aided Dispatch (CAD) system, PulsePoint alerts all users within a quarter-mile radius when a cardiac arrest is reported. CPR-trained citizens who are nearby can respond to the emergency and begin administering CPR until emergency personnel arrive. Survival rates in the incidence of a sudden cardiac arrest are less than 8%, but effective bystander CPR can double or triple the likelihood of survival. Studies published in the New England Journal of Medicine and the Institute of Medicine show that the use of a mobile app increases the rate of bystander-initiated CPR by 14 percentage points, significantly reduces response times, and massively boosts cardiac arrest victims’ chances of survival.
PulsePoint has also been endorsed by fire rescue teams, the American Heart Association, and local government. The coverage map shows that 1204 agencies are currently connected across 24 states. More than 500,000 people have already downloaded the app, and they have been alerted to more than 16,500 cardiac arrests. Finally, PulsePoint is relatively cheap: a one-time fixed fee of $10,000 covers the cost of launch, and the annual service fee (dependent upon the population served) does not exceed $28,000.
Technology watchers should be cautiously optimistic about the ability of apps like PulsePoint to make emergency services quicker and more responsive. Good emergency services require nimble and informed responses to emergency calls as they arise. PulsePoint cleverly combines emerging technologies with existing capacities and resources, and widens the range of potential responders by integrating with 911 systems.
Emergency service operators can continue to harness the creative powers of third party efforts like PulsePoint by collaborating to improve services. The White House identified public safety as an area where the apps, products, and services created have added significant public value, protecting citizens. In the case of PulsePoint, this was achieved by enabling citizen response to emergencies and crowdsourcing information on AED locations.
Other third parties contribute to the operation of emergency services by making apps from open data released by cities. In Boston, Adopt-a-Hydrant uses the city’s published inventory of fire hydrants to allow residents to volunteer to dig them out during snowstorms, ensuring that firefighters can access them when responding to calls. Collaborating across public-private boundaries through programs like this empowers other parties to see the possibilities to transform services and unlock public value.
Nevertheless, it is critical that optimism about the ability of third-party technologies to solve 911’s problems is cautious. Ultimately, the success of programs like PulsePoint depends on the efficacy of 911. Unless the systems are able to cope with calls from mobile phones and obtain accurate information about location, PulsePoint and other apps cannot work effectively. PulsePoint citizen responders are alerted at the same time, and with the same information, as emergency services. Therefore, any limitations in the dispatch system will affect both emergency services response and the effectiveness of third party apps.
The timely adoption of new technology will help citizens in crisis by ensuring 911 systems are up to date. Unless 911 systems are equipped to handle changes in cellular technology use, innovations in emergency response cannot function properly. To achieve this, government must closely track trends, and anticipate when further 911 updates are necessary. By monitoring public demand in this way, governments can make the most of the core services to save lives.