Editors’ note: This is part one of a two-part series. Read part two here.
There is a saying in economics and finance: “Don’t fight the Fed.” Usually, this refers to the Federal Reserve, whose chairman has been called the actual most powerful person in the world (surpassing even the president and the chief justice of the U.S. Supreme Court).
Here, we aren’t referring to our central bank, rather, to the power of the U.S. federal offices that oversee Fire and Mobile Medicine—like FEMA’s U.S. Fire Administration (USFA), which recently declared that it is broadening its purview and name to include Emergency Medical Services (an appropriate call, given that some 75% of Fire Service activations are medical in nature).
USFA’s expanded orientation means that Mobile Medicine now has two federal agencies focused on it (of course, the other is NHTSA’s Office of EMS). For all who adamantly press for a “dedicated federal agency” and are keeping score, consider that physicians have zero federal agencies. Nurses have zero federal agencies. The Fire Service has one. One can only imagine how much magic would result if the effort used to advocate for a cabinet-level post were instead invested in forging bonds with those who are already trying so hard…?
This author has harped for years on the risk of over-consolidating fire record management systems (RMSs) into the hands of a few companies. I have noted that a profession whose very premise is based on maintaining the ability to respond has tumbled, head-over-feet, seemingly unaware, and definitely anti-resilience, toward “too big to fail.” The business pitch has been a simple one: blend mandatory documentation with back-office solutions, promising that only one contract will cover both Fire and EMS data. Voila! Convenience, quality, and the possible ease of a sole-source RFP. What could go wrong?
A Black Swan Event, or “BSE,” derives from a book of the same name by essayist, economist, philosopher and NYU professor Nassim Nicholas Taleb. A BSE is an event so unexpected and ultimately seismic to common understanding that it alters the very definition of what is expected. It’s based on the so-simple analogy of defining a swan as a white bird. If, after that point, a black swan is identified, even once…the definition must change. The thing is, who would have expected that a fundamentally white bird could be black? Exactly—essentially no one sees a BSE coming.
Except that some people do. Equally prevalent throughout the Mobile Medical profession is the Cassandra Complex, named for a Greek myth about a priestess whose curse was to correctly tell the future…only no one would believe her. Mobile Medicine has spent years predicting its own demise—who has heeded the warnings? Now, popular media are running hair-on-fire about calls to 911 that elicit no response.
During the COVID-19 pandemic, the Congress of Mobile Medicine Professionals correctly predicted certain logistical-operational challenges. So many people postulated that ET3, as originally conceived, would fail. So they declined to participate. Now ET3 is ending—because too few people participated—why is anyone surprised? Why aren’t they saying: “Cool! That’s past us now. Let’s build back better!” Because the Cassandra Complex that innervates the Mobile Medical ecosystem makes us hesitate to try again. But we will, because we have to.
Here’s why.
BSEs are difficult to see coming because (a) their non-obviousness is what makes them unexpected; and (b) no one wants to see a crisis coming. We want to feel comfortable in our faith and our decisions, to focus on our daily work—especially if it’s already complicated—and to clothe ourselves in the illusion of control (another noteworthy irony in a profession that is built on the notion that sometimes things go sideways).
But has the demise of the Fire RMS system really been unexpected? I would argue: No. Aside from worthy questions about monopoly as anathema to innovation, there are really just two main risks associated with hanging the fire data ecosystem over to fewer than a half-dozen companies:
- A company’s scale grows so big that unless it is flush with profitability—and few fast-growing, private equity- or VC- funded software companies enjoy such a position—a bankruptcy (the risk of which rises in lockstep with interest rates) and render years’ worth of data unreachable; or
- The federal government could kibosh said growth, spiking the risk of #1.
These risks are no longer theoretical, but not nearly enough attention is being paid to them by an industry that wants contingency plans for everything, and most loves those that it never has to use.
During the first half of 2023, USFA quietly disseminated details about a new data standard to take the place of the National Fire Incident Reporting System (NFIRS), which underpins every Fire RMS system. On July 13, a Black Swan flew in the door. From a technology implementation USFA Administrator Lori Moore-Merrell said exactly the right things.
During a webinar called Modernizing the U.S. Fire Data System: Introduction to the National Emergency Response Information System (NERIS)—co-hosted by the U.S. Department of Homeland Security (DHS) Science and technology Directorate, UL’s Fire Safety Research Institute (FSRI), and the U.S. Fire Administration (USFA), Administrator Moore-Merrell’s plan to “decommission” NFIRS and actualize NERIS came across as articulate, ambitious, cogent, and—as a modern data system should be—intensely focused on interoperability that respects existing public investments and leverages APIs (even though they have not yet been defined).
She even nodded to those who aspire to build to the new technology: “I love the ‘we’re not going to slow down part, because that’s imperative. We just saw the timeline; we know that we put you all under a lot of pressure, and held accountable, and so (Underwriter’s Laboratory, the USFA vendor) has taken that on very soberly, I must say.”
In other words, the Feds blew a hole in the fire RMS ecosystem, which will ultimately be a very good thing. Moore-Merrell noted that it will force the modernization of a dataset that is some forty years old, while eliminating the option not to reach out and touch other parts of the mobile medical ecosystem.
In bold letters on its NERIS website, USFA says: “It is important to note that the new NERIS platform will not integrate with or co-mingle data from the legacy NFIRS.” In short, Fire RMS systems will have to be totally rebuilt because the old ones won’t work anymore.
But the projected start of the NERIS rollout is projected to be in “early 2025”…or just 1.5 fiscal cycles for agencies who start their accounting in July. What happens to the old stuff when the new system comes online? What will happen to the systems that agencies currently rely on—but which they probably shouldn’t have been relying upon because they should have upgraded years ago?
Will the companies that build Fire RMS systems now be invited to do so for the new platform, or will USFA take an approach more aligned with USAJOBS.gov, and forge a single source of truth? In other words, will agencies be required to just submit data through the one-and-done federal site? If so, what happens to new and existing Fire RMS investments when their data become obsolete?
All these questions are to be determined, but the government’s most brilliant decision so far was fundamental: it stayed quiet until the ball was already rolling. It isn’t talking about what might happen; it’s talking about what is happening. A train is rolling, not being contemplated. That essential pills are sometimes jagged doesn’t make them less essential. Mobile Medicine—including the Fire Service—needs to advance.
That means learning from its history, not just preserving it. Let us not ignore the lift needed to accommodate a new nationwide data standard that builds on NEMSIS, incorporates Social Determinants of Health, and pays heed to responder wellness. But if we only do what we’ve always done, we cannot hope to be more.
USFA just ripped off the bandage, and beautiful new interoperable skin is already showing underneath.
More from the Author
The Economics of Co-Response: Designing a Sustainable Approach
The Powerful Potential for Artificial Intelligence in Mobile Medicine & Fire
