Transform911 Unveils Recommendations to Improve Nation’s Emergency Response Network

By Eric Wicklund

A collection of healthcare stakeholders has released a policy blueprint aimed at updating and improving the nation’s 911 Emergency Response System, with recommendations that range from establishing a Cabinet-level position to setting standards for new and innovative technology.

Transform911, an initiative launched in 2021 with more than $1 million in funding, led by the University of Chicago Health Lab and comprised of more than 100 stakeholders, has unveiled six key recommendations, the result of 18 months of meetings and research into the 54-year-old emergency response network.

“It’s clear that the times call for the most comprehensive overhaul of the nation’s 911 system ever, to ensure that the right professional responds to an emergency call at the right time,” S. Rebecca Neusteter, PhD, executive director of the University of Chicago Health Lab and principal investigator of Transform911, said in a press release. “Recent events highlight that policymakers at all levels of government must identify, debate, and implement changes to the emergency response system. It’s a matter of life or death.”

The group has issued the following recommendations:

  • Create a Cabinet-level position within the US government to report to the President on urgent 911 improvements;
  • Create a federal task force to set standards for new technology, including digital health and telemedicine platforms and tools, and addressing such concerns as security and privacy of 911 calls and data;
  • Create protocols for training and access to technology to ensure that the nation’s 911 workforce is well-resourced and trained;
  • Create a separate governance structure for 911 centers so that they’re independent and equal to police, fire, EMS and other public safety entities, giving them the autonomy to address and report on public safety issues as they see fit;
  • Integrate community perspectives into 911 policies so that 911 centers can better understand and build relationships with different members of the community – especially minorities, who may not trust the system or believe it’s equitable; and
  • Re-introduce the 911 network to the American public, with an awareness campaign that highlights the training and capabilities on 911 centers and tackles the misconception that “911 is a switchboard service staffed by operators.”

According to the group, the nation’s more than 6,000 911 centers function through a patchwork of governance structures over seen by local, state, and federal agencies. There are no common standards at present for how these centers select and train their staff, use technology, collect and report on data, or ensure quality and security. This also means there isn’t that much federal support or funding to make improvements.

Much has changed in the half-century that 911 centers have operated, including recent efforts to better determine who should be dispatched to 911 calls (for example, replacing police as first responders with trained mental health crisis professionals or – in mobile integrated health programs – specially trained paramedics).

New technology is also improving the 911 process, through telemedicine platforms and digital health tools that enable 911 centers to coordinate emergency care through virtual channels, bypassing a trip to the ER when that’s not the best option, or enable first responders to access resources and connect with healthcare specialists.

“The time to update and transform the emergency response model in the United States is now,” Walter Katz, vice president of criminal justice at Arnold Ventures, a philanthropy that is helping to finance Transform911, said in the press release. “Local communities and the country need a comprehensive, transparent, and innovative approach to strengthen the 911 system. These recommendations help establish a more effective, equitable, uniform emergency response that protects public health and safety.”

Along with Arnold Ventures, the group is supported by the Microsoft Justice Reform Initiative, the Sozosei Foundation, and the Wagner Foundation. Other partners in the project include Code For America, the Full Frame Initiative, the New York University School of Law’s Policing Project, and the Research Triangle Institute (RTI) Center for Policing Research and Investigative Science.

Eric Wicklund is the Innovation and Technology Editor for HealthLeaders.