Grafton EMT goes to Memphis
GRAFTON >> Grafton Rescue Head of Service Keith Hermiz recently returned from Memphis, Tenn., where he looked at how the demand for ambulance services is exceeding the supply at certain peak times.
"Like most cities and communities, the answer wasn't, 'Well, we'll just buy a new ambulance and put it on the road for the $1 million,' or whatever it would cost a large city," said Hermiz. "They were looking at ways to address the problem."
Hermiz, also a senior data scientist for IBM and captain of the Grafton Fire Department, was asked to participate along with four other IBM experts in the Smarter Cities Challenge scheduled for three weeks in February and March. The team was asked to bring recommendations to Mayor Jim Strickland.
The idea of the program is that cities will be home to more than two-thirds of the population by 2050. Cities already have more economic power and have access to more advanced technological capabilities than ever before, according to a press release. But at the same time, cities are struggling with a bunch of challenges and threats to sustainability in their core-support and governance systems. Issues involve transportation, water, energy, communications, health care and social services.
Memphis was chosen as one of 16 cities to receive a grant through the program for 2015 and 2016.
"Over the past five years, 132 cities have been selected to receive grants," the press release said. "The Smarter Cities Challenge is the largest philanthropic initiative IBM has launched, with contributions valued at over $66 million to date."
Hermiz said somebody sought him out after an IBM grant administrator had mentioned, "Keith (Hermiz) up in Vermont keeps asking for money for the fire department and rescue. I wonder if he's a fireman?"
"They found me," Hermiz said. "I was happy to do it."
Only top employees are chosen for the program, according to IBM Public Affairs Specialist Ari Fishkind. Other team members came to Memphis from places such as Brazil and Boston, Mass.
"We have teams spend time on the ground, interviewing 60 to 80 stakeholders. They visit city agencies, get their feedback, input and think about what they said and come out with these recommendations," said Fishkind. "A lot of times, cities are doing the right thing on paper. They just need an extra boost on coordinating better."
Municipalities are asked to submit applications for a grant process that opens every year or so. Fishkind said he was not sure when the next round will begin as the company was still completing projects from the last cycle. About 700 employees have participated in this program to date and there is another program where employees are sent to developing countries.
Hermiz helps IBM's clients by performing analyses then coming up with recommendations. In Memphis, he was expected to apply his skills as a data scientist and look at theories for why things were happening they were there. But he was also the team's resident expert on fire and emergency medical services.
"There's a lot of lingo," he said, adding that the software system used in Memphis for EMS data is the "exact same" used in Vermont. "All over the county, people are facing similar problems and trying different ways to address them. It's an issue of people using the EMS system as primary care."
A change in the way 911 calls are handled could help. Having paramedics check in on or assist residents who regularly call 911 was one idea put forward by the team. Or a nurse could be put in the dispatch center. Then an ambulance would not need to go if the situation, like a toothache, seems manageable.
"Part of it is this nurse being there as a way to get appropriate resources," Hermiz said. "Another recommendation is just getting better medical care into the community so people don't see 911 as their primary source of health care."
Putting medical centers closer to areas in demand and launching an educational campaign also were recommended.
A report is expected shortly, outlining costs, funding sources and planning around implementation. Altogether, Hermiz expects about a dozen recommendations.
Integrating health care information was looked at by Hermiz's team. He acknowledges there being a generalized fear about one source having all health records as the system could get hacked or compromised.
"But when you think from the perspective of an EMS provider, especially in a city where you're trying to provide proactive services through the paramedicine program, you don't have access the same way a physician at Brattleboro Memorial Hospital might," he said. "Memphis has several hospital networks that are in the area. This need to integrate information across the healthcare system is another important aspect. There's at least a seed of that in the Memphis area."
By policy or "folk law," Hermiz said people dialing 911 ultimately make the decision on whether they are transported to the hospital. Volunteering at the Brattleboro-based Rescue Inc., he saw how some people would abuse the system. They were not complying with instructions on medicine from their doctors or had substance abuse issues or just wanted someone to talk to.
In Memphis, Hermiz said there were anywhere from 1,500 to 2,000 people calling 911 more than five times per year.
"I think this is a big societal question," he said of allowing rescue personnel to assess whether to transport. "You can train paramedics and educate them."
Similar calls come in at Grafton on occasion, Hermiz said, referring to the non-profit, first-response organization that does not transport patients. But the larger issue there has to do with provider fatigue.
"For pay providers, they can just grouse about it, which happens in cities like Memphis. It's not good for retention or morale," said Hermiz, calling to mind Vermont's new FallScape program which is described on healthvermont.gov as a free, in-home program offered to older residents in communities to help reduce the risk of falls by providing evaluations and information.
Grafton has a few subscribers to the program and in return gets a grant.
Hermiz has been on Grafton Rescue for about 10 years and the Grafton Fire Department a couple years longer. He did not think he wanted to get involved with the medical side of things but both groups were on the same radio frequency, causing him to wake up for both medical and fire calls. Like Hermiz, his wife Rachel Laliberte is an advanced emergency medical technician or EMT.
"She and I have been in this together from the start," Hermiz said.
Grafton Fire Chief Rich "R.J." Thompson said Hermiz previously served as assistant chief on the fire department but "dropped down" to captain a couple years ago so one of the younger guys could step up. Hermiz also performs the duty of treasurer for the fire department and is a training officer on the rescue squad.
"He takes care of all the paperwork for the fire department. He goes out on calls with us. He was our training officer for the year," said Thompson, who's also vice president of Grafton Rescue. "Whatever's asked of him, he just gladly does it. There's no qualms about it. He's getting a little older now so he did take a few steps back with the physical stuff. But still, whatever is needed of him he's all over it."
Describing Hermiz as a "computer geek," Thompson said Hermiz has connected the town's computer system. He served on the town's capital budget committee and has been "instrumental" in providing CPR classes in Grafton and Athens. He has done outreach on CPR and stroke awareness in the community.
Thompson said Hermiz "silently but effectively touches people in Grafton in many ways that most folks that live here don't even realize and they assume that it all happened by accident."
"But the reality is someone behind the scenes is spending their own free time and doing the work to make it all happen," Thomson said. "And I've witnessed Keith (Hermitz) be that person for years now."
Contact Chris Mays at firstname.lastname@example.org or 802-254-2311, ext. 273.
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