Emergency Response Community Effectiveness: A simulation modeler for comparing Emergency Medical Services with smartphone-based Samaritan response

Mobile emergency response applications involving location-based alerts and physical response of networked members increasingly appear on smartphones to address a variety of emergencies. EMS (Emergency Medical Services) administrators, policy makers, and other decision makers need to determine when such systems present an effective addition to traditional Emergency Medical Services. We developed a software tool, the Emergency Response Community Effectiveness Modeler (ERCEM) that accepts parameters and compares the potential smartphone-initiated Samaritan/member response to traditional EMS response for a specific medical condition in a given geographic area. This study uses EMS data from the National EMS Information System (NEMSIS) and analyses geographies based on Rural-Urban Commuting Area (RUCA) and Economic Research Service (ERS) urbanicity codes. To demonstrate ERCEM's capabilities, we input a full year of NEMSIS data documenting EMS response incidents across the USA. We conducted three experiments to explore anaphylaxis, hypoglycemia and opioid overdose events across different population density characteristics, with further permutations to consider a series of potential app adoption levels, Samaritan response behaviors, notification radii, etc. Our model emphasizes how medical condition, prescription adherence levels, community network membership, and population density are key factors in determining the effectiveness of Samaritan-based Emergency Response Communities (ERC). We show how the efficacy of deploying mHealth apps for emergency response by volunteers can be modelled and studied in comparison to EMS. A decision maker can utilize ERCEM to generate a detailed simulation of different emergency response scenarios to assess the efficacy of smartphone-based Samaritan response applications in varying geographic regions for a series of different conditions and treatments. (C) 2017 Elsevier B.V. All rights reserved.