By: Kristine Conner
As Community Health Educator Susan Pizzi, RN, MS, wrapped up a recent session of Chester County Hospital's "Matter of Balance" fall prevention education program, she added something new: She pulled up her Smart911 profile online and showed it to the class. Smart911 is a nationwide digital service that has been available to Chester County residents since 2017. Its goal? Make sure that the local 9-1-1 center and first responders automatically receive information that can help them get the right care to the right place quickly.
When people create their profiles at Smart911.com, they can enter medical history and medications, emergency contacts, their cars' makes and models, and the names and even photos of people and pets in the household. They can include instructions about how to find and quickly access their homes or workplaces in case of emergency. And they can attach multiple phone numbers to the profile, including a cellphone. This is a key feature, as 75 percent of the 160,000 9-1-1 calls made in Chester County in 2017 came from cellphones. Unlike a landline emergency call, a cellphone call can't pinpoint your exact location.
"Let's say your phone is registered and you are unresponsive," Pizzi says. "When someone uses your phone to call 9-1-1, your medical information is right there. Maybe you have diabetes or are on a specific medication. The person who calls might not know that, but the paramedics will." Or suppose you live in a townhouse development where all of the houses look similar, she adds. Your profile can include a photo and identifying details that the 9-1-1 dispatcher can use to guide first responders.
For older adults with fall risk, like those in Pizzi's class, this added information could be life-saving. But all residents can benefit from enrolling in Smart911. This is why Chester County Hospital has been partnering with the Chester County Department of Emergency Services since early 2018 to get the word out to the community. Smart911 is now included in the hospital's educational programs on fall prevention, diabetes, and heart failure. Promotional cards and flyers are available in the Emergency Department, the Heart and Vascular Center, and on some units.
But the efforts to publicize Smart911 first took root with the hospital's ongoing push to offer Hands-Only CPR classes, Pizzi says. Bystanders are often hesitant to perform CPR when someone collapses, just as many people hesitate to call 9-1-1. But any delay in getting the right care started can be dangerous or even fatal. She and the other members of the hospital's cardiovascular outreach team promote that message however they can. The American Heart Association recommends calling 9-1-1 and then performing Hands-Only CPR - with no mouth breathing - as a two-step process that most people can learn to help someone in cardiac arrest.
"We call it 'treating from the street,'" says Pizzi, "and we try to get the community involved." When the team learned that Smart911 was available in Chester County, she adds, it seemed to supplement our efforts beautifully."
Ralph Smith, BSN, RN, CCCC, coordinator of the Chest Pain Center and a member of the outreach team with Pizzi, recalls hearing about Smart911 at a community health fair and immediately seeing its potential. The team toured the 9-1-1 Communication Center in West Chester and then invited Chester County Department of Emergency Services Acting Director John Haynes and Community Outreach Coordinator Amy Amer to present Smart911 at a Chest Pain Center meeting and to the hospital's clinical managers.
"The Chest Pain Center is focused on building a system of care - and when I say "system of care" I mean that to include the public," Smith says. "The sooner someone realizes they are having a cardiovascular event and the sooner they get help, the better outcome they have."
He adds that the 9-1-1 Center is a critical part of that system. "The training of the call takers is truly amazing,"he says. "We can help them provide an even better system of care by urging people not just to call 9-1-1 but to sign up for Smart911. You can give better care to patients when you know their history."
Smart911 users can provide as much or as little information as they wish and update it over time. The profile is available only to the 9-1-1 agent who takes the call, and he or she then passes the information along to the emergency medical services (EMS) team. If someone travels outside of Chester County, the profile will show up if the local emergency response center uses Smart911. John Haynes of Chester County Emergency Services notes that it is part of a national initiative called Next Generation 911, which aims to better harness the power of information technology.
"9-1-1 services have traditionally been behind the technology curve,"Haynes says. "Now we are a mobile society and how much time do you really spend in your home?" As people phase out landline phones, attaching information to cellphone numbers makes sense, he says. At the same time, the population is aging and many people live alone or with a similarly-aged partner. "The ability to have someone's medical history and medication information contacts for family members - that is just amazing."
Smart911 is a powerful tool - but only if residents sign up for it. Haynes notes that about 30 residents per month were signing up in early 2018, but that number spiked to 77 in August. He and his team are now working on technology that would allow 9-1-1 call takers to create a secure link to a person's Smart911 profile that could be sent directly to EMS and the Emergency Department at Chester County Hospital.