Toward a high performance architecture for Time-Critical Information Services: Sequential case studies and action research of regional EMS systems

Prior research conducted at Claremont Graduate University has demonstrated that the application of private sector business principles (such as supply chain management, business process management, and performance measurement) can also be applied to the delivery of time-critical emergency medical services (EMS). This research extends these concepts to explicitly focus on the notion of performance as it is incorporated in day-to-day EMS activities and instantiated in the form of a normative system architecture. According to the Institute of Medicine, performance measures such as timeliness and quality of service have significant impact on patient outcomes. An overarching aspect of this research, then, is to develop innovative information technology systems that greatly serve the needs of citizens and perform in a manner that reduces the workload of those who use them. The Time-Critical Information Services Framework guides the action research performed at sequential regional EMS case study locations. A normative architecture is developed as part of the exploratory action research performed in California in collaboration with the San Mateo County EMS Agency. The findings that were uncovered were used to effectively guide the county's procurement strategy and to formulate public and private sector service contracts that will remain in place for the next ten years. At a subsequent case location in Minnesota, at the Mayo Clinic, this normative architecture was then confirmed and cited as a foundational mechanism upon which to base further qualitative and quantitative studies to advance the provision of emergency care.