December 7, 2013 | by

Need to Save a Life? There’s an App for That.

Three years ago, San Ramon Valley Fire Chief Richard Price was eating dinner when he heard ambulance sirens. Someone next door had suffered a cardiac arrest and was unconscious.

“That whole time, while that crew was making their way to the scene, I had an AED in my car. I could’ve started CPR,” says Price. This event made Price realize that the system in place to help people during a cardiac crisis is not good enough. So, he — like many health care innovators today — turned to technology to enhance our society’s ability to save lives.

Every year, around 383,000 sudden cardiac arrests occur in the U.S. and less than eight percent of people who suffer them outside of a hospital survive. That’s because the first few minutes after cardiac arrest are vital to survival. After a person’s heart stops beating, brain damage can occur in four to six minutes. By 10 minutes, there is almost no chance of survival.

Even in Price’s former fire district, which he said had many advantages, ambulance response times were seven minutes in the city, eight in the suburbs, and fifteen in rural areas. Quality CPR given immediately after cardiac arrest can double, even triple, the chance of survival but this can only happen if CPR-trained people nearby know that someone needs their help.

That is the exact problem that Price is working to remedy.

Rather than merely reflecting on his experience as an unfortunate inevitability, Price was resolved to find out what more he could do to prevent similar situations in the future. That is how he came up with PulsePoint, an app that notifies CPR-trained bystanders of nearby cardiac arrests.

Read the full post by Taylor Kubota at the Xerox Healthbiz Decoded blog.

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December 7, 2012 | by

San Ramon Valley Fire Receives Tri-Valley Heroes Award

Chief Richard Price demonstrating the PulsePoint appIn early 2010, Fire Chief Richard Price was sitting with a couple of his coworkers in a San Ramon restaurant when they heard a fire engine nearby.

That was no big deal. Price hears them all the time, but he idly wondered where the truck was headed. To his surprise, the truck pulled up right next to where he was eating.

Someone had gone into cardiac arrest. While Price gets paged if there’s a fire, he had received no notification of this, even though he had a defibrillator in his truck.

That got him thinking: A brain can survive only about 10 minutes after a heart stops, and the San Ramon Valley Fire Protection District averages about seven minutes to arrive on scene.

It took about a year, but in January 2011 the SRVFPD released an app designed to create “citizen heroes” to offer CPR, and, if possible, to use an Automated Electronic Defibrillator (AED).

Read the full article by Glenn Wohltmann in the San Ramon Valley Express.

The Tri-Valley Heroes award honors individuals or groups for their positive influence on the Valley and the lives of its residents.

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May 30, 2012 | by

Enabling Citizen Heroes

This article is reprinted with permission from EMS Insider

Add a mobile app to your CPR program

EMS InsiderWhen it comes to cardiac arrests, a few well-known facts exist: Time is muscle; the window of opportunity to save a patient whose heart has stopped is excruciatingly small; and getting responders who know CPR to the patient as soon as possible provides the best chance for survival. The third fact was brought home to San Ramon Valley (Calif.) Fire Protection District (SRVFPD) Fire Chief Richard Price during lunch one day. While he was eating at a local deli, he heard sirens in the distance. Then he watched as the engine eventually stopped in front of the restaurant. Because he does not receive pages for medical emergencies, he was unaware that someone had collapsed in cardiac arrest just next door. Had he known, he could have been there in seconds to start CPR and use the AED in his vehicle before the crews arrived. This incident gave Price an idea. With the current cell phone technology and GPS, there must be a way to alert staff who may be in the area of a cardiac arrest, he thought. “It was very conceptual at that time. The idea grew out of that,” Price says. The “idea” evolved into a CPR mobile app for the iPhone and Android, that eventually became known as PulsePoint. Price expanded on his original idea to include citizens trained in CPR, who have indicated they’re willing to assist in case of an emergency. The app uses the GPS feature on the phone to locate citizens who have signed up for the program and are in the vicinity of a cardiac arrest patient. Notifications are sent only if the victim is in a public place and only to potential rescuers within walking distance of the emergency. The application also directs rescuers to the exact location of the closest AED. “We crowd source good Samaritans,” Price says. Price knew he needed help to develop the mobile app, so the district partnered with interns from the College of Informatics at Northern Kentucky University. While they worked out the technical details, Price attended to other issues. Initially, some concern was expressed about sending too many rescuers to what can often be a chaotic scene. However, Price says that this seldom happens. “We can always make the notification circle smaller, if we get to that problem,” he says. Even in the limited cases where extra rescuers respond, it hasn’t been an issue, Price says. On one occasion, a person suffered a cardiac arrest at a coffee shop and a large number of rescuers responded. But instead of causing confusion or getting in the way, they did a good job assigning tasks, and those who weren’t directly involved in the rescue attempt helped by clapping to the beat of the chest compressions.

Privacy issues
Price notes that the chain of survival depends on training people in CPR and sending them out into their communities to respond when needed. “The app doesn’t really change that very much. It just takes some of the fate out of it,” he says. Still, certain privacy precautions had to be considered. To protect the rescuer’s information, the app doesn’t know the identity of the responders—it simply locates a “device” by accessing the unique identification number, which is required for the PulsePoint server to locate and send alert messages to a specific device. Price says the app doesn’t access any other information on the responder’s device. “No personal information is ever collected or retained,” he says. Because the activation occurs within an exceptionally limited radius—within walking distance—the app only alerts people to emergencies in their immediate vicinity. “It makes you more aware of what’s happening nearby you,” he says. He says they were also careful to consider possible Health Insurance Portability and Accountability Act (HIPAA) violations when designing the app. No patient information is ever broadcast or known by PulsePoint. Because PulsePoint doesn’t know who responded, the citizen rescuers are not informed of outcomes. “Occasionally circumstances allow the citizen rescuers to come together with survivors, but it’s a careful, respectful process,” Price says. The issue only becomes problematic if there’s an infectious disease concern.

Where’s the AED?
The biggest hurdle for a seamless citizen CPR response is locating public AEDs. Price says that the district has done a good job of promoting the use of AEDs, but locating them and ensuring they’re properly maintained has been a challenge. “When you’re dispatching people to them, the standard is higher,” he says. “You need to know one is there.” Despite a vigorous awareness program in San Ramon Valley, the use rates of AEDs among citizens are low. Price believes the area for which emergency responders should commit additional resources. “AEDs need to rise to the importance of fire extinguishers,” he says. Some communities are starting to include AED location information in their computer-aided design (CAD) system so dispatchers can provide not only CPR instructions, but also the location of a nearby AED.

PulsePoint foundation
Once the district developed the app, they wanted to share it—and not just with their neighbors. “We want to be around the globe,” Price says. To do so, they created the PulsePoint Foundation, a 501(c)3 nonprofit organization that provides and supports the app free of charge. Supporting services are also provided at no charge to public safety agencies that offer the CPR app in their community. However, charges from the CAD system vendor may occur, which interface with the app. The foundation is working with the CAD vendors to moderate these costs. Currently, the PulsePoint Foundation is working with more than 150 organizations in the deployment of the app.

Community outreach
To launch a successful CPR mobile app program, community outreach is critical. Price recommends a multi-pronged marketing program to encourage citizen awareness and ongoing involvement. The district started with a public service announcement in movie theaters and other venues to raise awareness of both the app and the importance of citizen CPR. SRVFPD used university interns to help develop the PSA. “It was a low-cost way to create tremendous
value,” Price says. The district spent very little public money, and the students received real-world experience. “It gave meaning to their studies,” Price says. “It’s a win-win.” The district continues to promote CPR at all community events, and is working to provide CPR training to all seventh graders in the local school district. It also established a program to manage the maintenance of the approximately 200 public AEDs in the community. “We know where every single one is and have hands on them every six months,” Price says.

Upgrades added
A number of upgrades have been added to the program since the original application launched. A streaming radio function allows citizens to listen to emergency calls anywhere in the world. Most recently, a Twitter feature began broadcasting PulsePoint app CPR activations in real time. The tweet includes the time of activation, the general location and the number of citizen rescuers notified. The goal is to increase awareness of the app and the role it plays in saving lives. The Twitter feed can be found at @1000livesaday, a reference to the number of people who die daily in the U.S. from sudden cardiac arrest. Price says the number of activations is around one per day. On average, 3-4 citizens respond per incident. “I’ve seen as many as 22,” he says. The next release of the app will include a survey tool sent one hour after app users were notified of a need for CPR. The goal is to collect data on the responses to the notifications and create a clearer picture of what happens during the response before the professionals arrive. It will attempt to find out whether a person responded to the notification and if not, why. If they did respond, they’ll be asked whether they performed CPR, if an AED was available, and if so, whether it was used. The optional survey will continue to allow the citizen responder to remain anonymous, if desired. Price says the survey is being developed by Bentley J. Bobrow, MD, medical director of the Bureau of Emergency Services Arizona Department of Health Services; and Steven C. Brooks, MD, MHSc FRCPC, emergency physician and scientist at Sunnybrook Health Sciences Centre and assistant professor at the University of Toronto.

Summary
Because CPR has been around for 50 years, Price says sometimes it can be hard to find something exciting about it. But the process of developing the app and sharing it with others has been just that. “We were right at the time in history when it was all possible. Six months earlier, and it would not have been possible,” he says. Through this process, SRVFPD learned something about human beings that they probably already knew—people really want to help others. “This is a way, at no cost, you can make a significant difference in [out-of-hospital cardiac arrest] survivability,” Price says. “Think about the force multiplier—it’s a huge deal.” However, he warns, the app isn’t a panacea. “It works best in systems that are already good,” he says. That means good citizen CPR programs, an active AED strategy and a strong activation policy for ST-elevation myocardial infarction patients. “It ties a lot of things together and makes good systems pay off bigger,” he says. Although good work can often go unrewarded, this isn’t the case for Price. In February, the Danville Area Chamber of Commerce and the San Ramon Valley Times named Price “Citizen of the Year” for his innovative efforts to protect the lives of the citizens in his jurisdiction and beyond.

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April 21, 2011 | by

San Ramon Valley Fire Protection District Recognized by Computerworld as a 2011 Honors Laureate

SAN RAMON, CA ‐ International Data Group’s (IDG) Computerworld Honors Program today, April 21, 2011, announced San Ramon Valley Fire Protection District as a 2011 Laureate for Innovation. The annual award program honors visionary applications of information technology promoting positive social, economic and educational change. The District was selected for its iPhone application that provides immediate, life‐saving assistance to victims of Sudden Cardiac Arrest by crowd‐sourcing Good Samaritans.

“The number and quality of nominations this year was very inspiring and demonstrated how valuable IT is to community change,” said John Amato, Publisher, Computerworld. “Computerworld is very proud to name the 2011 class of Laureates and showcase their initiatives benefiting society through innovative uses of IT.”

“The application is initially targeting the approximately 300,000 people who suffer out‐of‐hospital cardiac arrest each year in the United States,” said Richard Price, Fire Chief for the San Ramon Valley Fire Protection District. “Numerous investigations have shown that bystander CPR results in a doubling or tripling of patient survival, yet CPR rates across the country have remained unacceptably low at around 26%. The application aims to improve this percentage by immediately alerting everyday citizens to the need for CPR nearby while also directing them to public access defibrillators when available.”

The Computerworld Honors awards will be presented at the Annual Laureates Medal Ceremony & Gala Awards on June 20, 2011 at the Andrew W. Mellon Auditorium in Washington, D.C.

The San Ramon Valley Fire Protection District is an internationally‐accredited special district that provides all‐risk fire, rescue and emergency medical services to the communities of Alamo, Blackhawk, the Town of Danville, Diablo, the City of San Ramon, the southern area of Morgan Territory and the Tassajara Valley, in Northern California (Contra Costa County). The District’s service area encompasses approximately 155 square miles and serves a population of 170,000. The District has established a foundation to assist other public safety agencies to deploy the application in their community.

The application was developed in partnership with the Center for Applied Informatics at Northern Kentucky University (NKU). For additional web and print resources, including sample screen shots, supporting images and video please visit the Fire Department iPhone App landing page at http://www.firedepartment.mobi. A Public Service Announcement (PSA) video to raise local awareness about the application is also available on the site.

About Computerworld Honors Program
Founded by International Data Group (IDG) in 1988, The Computerworld Honors Program is governed by the not‐for‐profit Computerworld Information Technology Awards Foundation. Computerworld Honors is the longest running global program to honor individuals and organizations that use information technology to promote positive social, economic and educational change. Additional information about the program and a Global Archive of past Laureate case studies and oral histories of Leadership Award recipients can be found at the Computerworld Honors website http://events.computerworld.com/Honors2011.

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March 16, 2011 | by

SF Fire to Implement CPR iPhone App

At a press conference, today, March 16, The City of San Francisco became the first major city to publicly announce support for the San Ramon Valley Fire Protect District-pioneered “Fire Department” iPhone application.

In a media release the San Francisco City Attorney Dennis Herrera and San Francisco Fire Chief Joanne Hayes-White announced the SF Fire App Initiative, an extensive citywide effort to reduce heart attack deaths with the implementation of the Fire Department smart phone application which will notify CPR-trained volunteers to assist nearby cardiac arrest victims.

Earlier this year, San Ramon Valley Fire Protection District Chief Richard Price launched the Fire Department iPhone application that links to the SRVFPD computer-aided dispatch (CAD) system to notify CPR-trained volunteers in the vicinity of sudden cardiac arrest events in public spaces and to pinpoint the nearest automatic external defibrillator (AED). Price and his team are forming a foundation to extend the app to other smart phone platforms and provide support to other municipalities seeking to implement the technology.

“When I first learned of the great work by Chief Price and his team, I knew we needed to do everything we could to bring this application and its life-saving benefits to San Francisco,” said Herrera. “The kind of partnership we are building within city departments shows that even in challenging budget times, smart governments and engaged citizens can increase benefits to the community. Just as the state of California has been proactive to ensure that Good Samaritans are protected from civil liability when they assist in times of great need, I’m committed to ensuring that San Francisco is a place where all of us are confident to help each other. I am grateful to have the partnership and support from San Francisco Fire Chief Joanne Hayes-White on this initiative.”

Herrera also announced the launch of a new website, http://www.sffireapp.org, where interested San Franciscans can get information about CPR trainings and volunteer to assist with the initiative. Because the response in the first minutes of a sudden cardiac arrest are critical, the goal for the development launch is to increase the number of local volunteers with CPR training, to increase implementation and awareness of AEDs, and to work with Department of Emergency Management, Fire Department, and the local technology community to deliver the application to San Franciscans as soon as possible.

Bystander CPR and defibrillation combined are the most effective response to a person suffering from sudden cardiac arrest, and can greatly increase the likelihood of the victim’s survival rate. In 2010, the San Francisco Fire Department responded to 356 active cardiac arrest incidents and 39 patients survived to admittance to the hospital. One third of these incidents occurred in a public space, away from home.

“The San Francisco Fire Department is committed to spreading the word that bystander CPR is critical to increasing the odds of survival of a cardiac arrest event,” said Chief Hayes-White.  “In San Francisco, compared to other large cities, bystander CPR is initiated too infrequently. Our hope is that this initiative will provide our residents with the support they need to get trained in CPR and to get involved.”

In San Francisco, civic developers including representatives of Granicus and Firmstep have already volunteered to support development of the application and public access to AED maps.

“This app showcases the real power of mobile, real-time data delivery to connect people and save lives,” said Javier Muniz, CTO and co-founder of Granicus. “We’re excited to support the City & County of San Francisco and the San Ramon Valley Fire Protection District in whatever way we can to scale this app and empower citizens.”

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