Inter-organizational emergency medical services: Case study of rural wireless deployment and management

Over the last two decades, use of mobile communications for emergency services (e.g. 911) has grown exponentially. This rise of mobile networks has increased reliance on new private and public partnerships to deliver these time critical services. Drawing upon complex systems theory and Inter-organizational Systems (IOS) dynamics, a framework is developed for investigating technology, organizational and policy dimensions of Emergency Medical Services (EMS). The case study for this investigation is rural Minnesota, where a series of semi-structured interviews were conducted and supplemented by analysis of candidate EMS system evaluations. The twofold objectives of the study were to explore the nature of inter-organizational dynamics in this setting and to set forth an architecture for measuring and enhancing performance. Key technology concerns included gaps in wireless coverage, complex system upgrades, and lagging integration of wireless communications into existing infrastructures. These issues were intertwined with organizational aspects, such as the challenges in developing coordinated relationships among agencies and between the public and private sectors. Several policy levers were also influential, such as federal standards that had been set forth for E-911 location information and funding initiatives in the transportation area. The final section draws upon these findings to suggest an EMS architecture that portrays the entire system as well as critical IOS linkages. While IOS has traditionally examined supply chains, these findings are aimed to contribute to understanding more complex, dynamic and heterogeneous socio-technical processes. The paper concludes with a discussion of management and research implications.