The promise of the PulsePoint App

About 12 years ago, I was having lunch in San Ramon Valley, in the district where I was a fire chief. And I heard a siren in the distance.

As I sat there, that siren grew louder and louder and that unit came closer until it pulled into the parking lot and stopped right in front of the restaurant where I was eating. Only after speaking with the responding crew did I learn that right next door, somebody was unconscious, unresponsive, and in cardiac arrest.

It was a pretty startling incident to think about. I am CPR trained and had an AED in my car and probably could have made a difference in the outcome of that event. I was so close, but totally unaware.

And that's where the idea for the PulsePoint App started.

The birth of an idea

I didn't have a radio with me. But I had my phone and I wondered if we could use a person’s cell phone like firefighters use a radio to notify people near a cardiac arrest or near someone in need directly from the dispatch center.

The dispatch center would know where the cardiac arrest was – and the phone would know the responders’ location. And I wondered, “Could we marry those two together?” I thought about how we dispatch firefighters and paramedics to incidents. They don't have to see the incident. We know where the incidents are and we send them to those events.

So it was a fairly simple idea: Notify people who were near events based on their cellphone location. This was 11-12 years ago and push notifications and GPS on devices were still fairly new. But that was the genesis of the idea – at lunch that day on the back of a napkin.
 

Brainstorming

So we started brainstorming right then. San Ramon Valley Fire Protection District was doing a good job with cardiac arrest survival. We were teaching CPR in our community, placing AEDs, and dispatchers were giving CPR instructions over the phone.

We trained our crews in high performance CPR. We were doing everything we were supposed to, everything we knew to do.

But this exposed a gap. While we train a lot of people, they might not witness that event. So the question was, “How do we get them there – if they’re close enough to get there before the fire department – so they can provide aid?”

It was an exciting idea to pursue, to see if we could bring these pieces together.

We spent a year trying to make that idea work. Fire departments don't have developers on staff, but we had a very good understanding of the problem. When you have a cardiac arrest, your heart stops, you stop breathing and you have maybe 10 minutes to survive.

To get a paramedic, firefighter, EMS to that scene – and not just parked in front, but at the patient's side doing CPR, applying an AED – inside that 10 minutes is critical. It's 10 minutes before you have no chance of survival, but less than that – 4-6 minutes – before you start having damage from not having circulation in your body to your organs and your brain.

Because of this excruciatingly short window of opportunity, most people don't survive cardiac arrest. We understood the problem. We just didn't have mobile app developers on our staff.
 

Partnering with a university

So we partnered with Northern Kentucky University. They had a mobile app development program with a graduation requirement to create a real world app.

With their expertise of mobile app development, our expertise in cardiac arrest response and emergency dispatch, we brought this idea together and proved that it would work. Plus, we had variety of members of the fire department who were specialists in IT and dispatch.

Once we completed that proof of concept, we deployed in the community to about 170,000 people and we had great early success. That led to creation of the PulsePoint Foundation because there was interest in it from other fire departments and EMS agencies. It was not something our fire department could sustain, but they saw the potential and they wanted to see it move into other agencies, across the country.

The San Ramon Valley Fire Protection District actually formed the 501(c)(3) PulsePoint Foundation to help other agencies deploy the app. I left the fire department at that time to run the foundation. One of the initial board members of the foundation was an elected board member of the fire department. They worked to set up the board. I worked to set up the staff and the volunteers that would help the other agencies.

Today, PulsePoint is in more than 4,000 communities.
 

What success looks like

One of the first times it activated was at a coffee shop in a downtown area on a weekend morning. When the crews arrived, they had two people doing CPR and about eight people clapping to 100 beats a minute, encouraging those rescuers.

A lot of times when crews arrive, nobody is doing CPR, no AED is in use, and you know your chances of success are low. You're starting in a hole.

But when you arrive on scene and CPR is in progress, or you see AED pads on somebody's chest with someone delivering shocks, you're motivated. You know, you have a chance for this person to survive. And to see people respond to the scene from the app – and not just one person, but two people – that’s exciting. CPR can be hard work. So having multiple people on scene is ideal.

There were other early successes like that. Initially, we weren't sure if people would download the app or if they would be willing to respond. Today, we have more than 3 million people who have downloaded the app. So we’ve learned that people will participate and they will respond. They want to be part of the solution.

And we need them because there's no way professional responders can always get there in time. That's why we train people in CPR. It’s why we place AEDs in the community because you just can't build enough fire stations. You can't have enough ambulances to arrive in those short timeframes. You’re already relying on the community. So all we were doing is increasing the efficiency around those existing resources.
 

Getting FirstNet Certified™

One of the early design considerations of PulsePoint was that we would not introduce any new dispatcher workflow. We wanted the activation of the app to be transparent to the dispatch operation. We didn't want to bring up another screen or do something that would make call processing take longer or require new training. So that meant we had to build a very sophisticated interface that we could integrate tightly with the computer aided dispatch (CAD) system.

In doing that, we needed a way to instill confidence in those public safety agencies and in our CAD partners that we were doing things correctly, storing data properly and taking privacy into consideration.

To do that, we turned to FirstNet because FirstNet would do those types of reviews. They would make sure that the application was secure. They would make sure that it was reliable. They would make sure that it used the network efficiently.

Before FirstNet, there was nobody looking at those kinds of things. And now PulsePoint Respond and PulsePoint AED are both FirstNet Certified™ apps.

Getting FirstNet Certified was a milestone to achieve. Receiving certification is a lot of work, and it was an accomplishment for sure. Today, we:

• Have about 3 million users who carry the app.
  
  
• Are in more than 4,000 communities.
  
  
• Have notified more than 500,000 people of a nearby need for CPR on more than 150,000 cardiac arrest events.
  
  
• Process more than 800 reports of cardiac arrest each day from PulsePoint-connected agencies.

We don't activate on all of those reports because we don't always have somebody nearby. We notify people who are nearby – and, on average, more than five minutes ahead of first responders arriving. We call that the early arrival opportunity – like when I was in that restaurant. We typically notify two to three people per event.
 

The responders

The response time for our PulsePoint-activated users is slightly over two minutes, which is a fantastic response time. If you can arrive in that first two minutes, you're going to make a significant difference.

To think about what happened with Al Hart – the difference it made in his life and everything he's been able to do since – there is nothing more satisfying to our team. Much of our team is volunteer. Our development staff work for other companies and volunteer their time with the foundation. To them, those outcomes are what makes their effort worthwhile. It’s why we're all here doing what we're doing.

But I don't want to underestimate the impact that it has on the people who respond.

They are the ones telling their story. It'll be a doctor who responded to a neighbor's house or a nurse who was on duty and crosses the street to a bus stop or a teacher who leaves their classroom to respond to another classroom.

The majority are firefighters, paramedics, nurses, doctors, lifeguards. They’re carrying the app off-duty and have the confidence to respond.

It takes a lot of courage to respond. Probably half the people who take a CPR class won't be able to respond. But if multiple people go, it makes a difference. Where I might not have the courage by myself, if a couple other people show up with me, together we could do it. Bringing two or three people to the scene helps.

So it’s pretty special to have the Al and Trishes of the world out telling your story and talking about what's possible and realizing the promise of PulsePoint. Because in the beginning it was just a story, it was just an idea.

I have been following FirstNet since its inception, especially on the app development side. Obviously, it’s a highly redundant, reliable network that works across disciplines, which creates the opportunity for a common operating picture.

We're very, very fortunate as a country to have FirstNet.

Richard Price was in the fire service for 33 years. He began his career as a firefighter at 18 years old and worked his way through the ranks, holding most positions in the fire service, including line battalion chief for 18 years. His duties included IT and dispatch responsibilities, which would later come to serve him well. He retired as fire chief from the San Ramon Valley Fire Protection District and transitioned directly from the fire service into the PulsePoint Foundation.