Conference
The EMS Data Equity Conference was held on January 19, 2024 at San José State University. The conference was funded by a grant from the CARESTAR Foundation and by the National Science Foundation Civic Innovation Challenge. Nearly 100 participants from 43 agencies and organizations across 22 counties in California gathered together to improve equitable delivery of EMS and pre-hospital care.
EMS Data Equity Conference
Emergency medical services (EMS) are a critical component of the healthcare and public safety landscape, yet longstanding inequities across the United States persist. Racial, ethnic, and socioeconomic disparities have been documented across many areas of healthcare, including in pre-hospital care (see, for example, Racial, Ethnic, and Socioeconomic Disparities in Out-of-Hospital Pain Management for Patients With Long Bone Fractures). These inequities are compounded by gaps in availability, accuracy, and utilization of EMS data; particularly data that captures information about a patient’s race, ethnicity, language, disability status, and housing status.
In response, the EMS Data Equity Conference 2024 brought together practitioners, health agencies, researchers, administrators, and advocates from across California to explore how equitable data collection and use can improve the quality of care, reduce harm, and improve health outcomes in patients. ​​
The EMS Data Equity Conference convened nearly 100 participants from 43 agencies and organizations across 22 counties in California to collectively examine the role of data in advancing equity in emergency medical systems. This diverse gathering aimed to foster collaborative learning and action towards leveraging data to see, understand, and address disparities and to improve equity in EMS services.
Key Objectives
1
Gain an increased understanding of equitable delivery of EMS and
pre-hospital care.
2
Learn from other EMS providers on approaches to equitable service delivery.
3
Identify shared data opportunities to support equitable and sustainable EMS programming.
4
Foster collaboration among California EMS agencies and providers to improve equitable delivery of EMS services through a year-long Community of Practice.
Presentation Highlights
Public Health Advocates: First Response Transformation Campaign
​Public Health Advocates presented the FRTC – a statewide initiative that seeks to reposition community-based responders as a formal fourth arm of emergency response by 2030. The campaign supports local advocates to design and implement community-centered emergency response programs that operate in partnership with, but independently from, traditional response entities. ​
FRTC is structured around three pillars:
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Build It: Develop locally informed pilot programs through deep engagement with community members and stakeholders
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Advocate for It: Advance policy and narrative shifts that center community ownership over first response infrastructure
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​Sustain It: Secure long-term funding mechanisms and policy structures to embed community-based response into broader public safety systems
FRTC responds to the growing recognition that conventional response systems often miss the mark in meeting the nuanced needs of communities, particularly those with legacies of systemic neglect, disinvestment, and healthcare exclusion. Public Health Advocates emphasized that meaningful transformation requires not only technical integration. It also requires cultural and political shifts in how safety, care, and accountability are defined and delivered in our communities.
Healthforce Center at UCSF: Community Paramedicine Evaluation
Janet Coffman and Lisel Blash from the Healthforce Center at UCSF, shared insights on the role of community paramedicine (CP) and Triage to Alternate Destination (TAD) in expanding how EMS systems support patients with complex, non-emergent needs. Their presentation emphasized how these models can shift the landscape of emergency response by enabling more flexible and patient-centered pathways to care.
​One of the substantial barriers to understanding and addressing inequities in CP and TAD is the absence of disaggregated, community-representative data. Limited language coverage, minimal stakeholder engagement, and structural mistrust among community members reduced utilization of these services and affected how they were experienced, undermining their potential to improve the lives of Californians. The discussion raised critical questions about equity, representation, and access in CP and TAD initiatives, pointing to the need for more inclusive data and stronger community partnerships to inform future implementation efforts.
Jen Correa: EMS Data: Impacting Equity in Care
The National EMS Information System (NEMSIS) is the national standard for EMS data collection, designed to ensure accuracy and precision. EMS data moves quickly – from the ambulance to state and national databases – in as little as seven minutes, and can be shared broadly across the nation to support timely decision-making.
Data linkage efforts, such as the Multi-State EMS and Medicaid Datasets (MEMD), demonstrate how integrated data can advance equity in care. By connecting EMS and Medicaid data across states, MEMD enables a deeper understanding of patient-centered outcomes. It helps to identify and reduce barriers to care for Medicaid beneficiaries, improves EMS coverage and quality of interactions, and encourages more robust data integration across historically disaggregated systems.
This approach also supports a more accurate understanding of community health needs – recognizing that knowing what a community needs is the first step to better serving it. In doing so, it promotes a more resilient healthcare system equipped to respond to public health emergencies, that in turn, ultimately leads to stronger EMS services, enhanced patient experiences, and improved health outcomes.
Tania Jogesh:
Case study: Analyzing Equity Among SF EMS High Utilizers
San Francisco Fire Department Community Paramedicine Division and DataSF presented a case study on how to conduct an equity analysis. They used data from EMS-6, a SFFD Community Paramedicine program serving high-utilizers of 911 services, as the example dataset. Clients of EMS-6 have complex healthcare and social needs, and the program collaborates with other services providers throughout the city to try to stabilize these clients, address underlying needs, and reduce their reliance on emergency services.
The presenters described how SFFD shared EMS-6 data with data scientists working with DataSF, who disaggregated the dataset by race, ethnicity, age, housing status, and other factors. The analysis results provided critical insights for SFFD about the program’s reach and where changes might need to be made to enhance outreach to specific populations. With this analysis, SFFD was able to take the next step to address disparities and improve outcomes.
Thank You
We extend our gratitude to NSF and CARESTAR for their support, enabling us not only to advance our work in San Francisco but also to share valuable strategies and insights with EMS agencies nationwide.
