EMS SURVEILLANCE PROGRAM ASSISTS WITH ‘FREQUENT FLYERS’
>> BY ANNE-MARIE JENSEN, EMT-P, & JAMES DUNFORD, MD
PHOTO LIZETH ROMO
The eRAP technology identifies &
ranks calls from high-need patients,
helping EMS work with community
partners by redirecting patients to
the appropriate agency.
The San Diego Resource Access Program (RAP) is an EMS- based surveillance and case management system. Conceived in 2008 by the San Diego Fire-Rescue Department (SDFD)
and Rural/Metro Ambulance, this paramedic-coordinated project
was designed to help individuals who repeatedly accessed 9-1-1.
Since its inception, RAP has evolved from a gumshoe case management approach into a health information technology (HIT)-enabled
program supported by real-time EMS and computer-aided device
surveillance. The features of the electronic component of RAP (eRAP)
illustrate an EMS application capable of assisting communities to
achieve better care and improved health at lower cost.
Chronic 9-1-1 use is often an indication of a health or social vulner-
ability. Frequent users typically suffer from combinations of chronic
medical diseases, psychiatric disorders, drug and alcohol dependence,
in-home difficulties and homelessness. For this population, repetitive
transport to emergency departments (EDs) is a particularly ineffec-
tive and wasteful use of 9-1-1 resources. The underlying need often
remains unaddressed and EMS dependence persists. RAP identifies
such patients, investigates the underlying circumstances and seeks to
reduce dependence on acute care services by linking these individuals
with resources more appropriate to their situations.