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GCN : February 2014
GCN FEBRUARY 2014 • GCN.COM 19 agencies, it will be cheaper to go to the cloud," McCarthy said. "Most of these or- ganizations are running extra lean. They will put most of their IT solutions in the cloud, including business analytics, host- ed databases and storage.'' Two agencies that are reporting sig- nificant returns on their investment in cloud-based data analytics are Wake County Emergency Medical Services in Raleigh, N.C., and Montreal's transpor- tation agency, The Société de transport de Montréal. HEART ATTACK DATA REVELATIONS Wake County EMS has changed its rec- ommendations for how long to continue CPR on cardiac arrest patients based on a data analysis project that it outsourced to SAS Advanced Analytics Lab for State and Local Government. Beginning in 2005, when hypothermia treatment became commonplace for car- diac arrest patients, Wake County emer- gency response crews found they needed to administer CPR to patients for much longer time periods --- up to an hour, in- stead of 25 minutes that was the indus- try best practice. In order to come up with new CPR guidelines for its crews, Wake County EMS hired SAS to analyze a database of all of its responses to cardiac arrest pa- tients from 2005 through 2012, includ- ing the amount of time spent on CPR and the patients' outcomes. "SAS was able to do all the regressions, the statistical analysis and to control for all the variables, and they gave us a plot of our data that basically showed we have a logical survival rate to continue CPR for an hour," said Dr. Brent Myers, Medical Director of Wake County EMS. "We were able to use the data to change our approach to cardiac arrest patients. We are presenting our findings to the national association for EMS phy- sicians in January in Tucson. We think our data will also influence EMS care elsewhere once people see our results." Wake County, which includes North Carolina's capitol Raleigh, has a popu- lation of 950,000. Wake County EMS responds to approximately 88,000 calls per year, including 500 cardiac arrests that require CPR. The agency operates 40-plus ambulances manned by para- medics. For 20 years, Wake County EMS has maintained a database of its cardiac ar- rest patients and whether EMS crews re- stored a pulse doing CPR. But in 2005, it signed cooperative agreements with area hospitals to receive data on how these patients ultimately fared from their medical treatment. This is the data- base that Wake County EMS hired SAS to analyze. SCRUBBING BIG DATA "We thought our data was clean and ready to go until SAS looked at it," Myers said. "It took about six months for them to clean it up and analyze it." Myers said the initial project with SAS cost around $100,000. Now, Wake County EMS is in discussions with SAS to host all of the agency's emergency call- related data on a permanent basis. As a result of the initial project, Wake County EMS has changed its recommen- dations for cardiac patients. If a patient has a flatline on a heart monitor, emer- gency crews will stop CPR after 25 min- utes. However, if they are able to get the heart re-started through CPR, they will continue CPR for as long as an hour without worrying that the patient will end up in a vegetative state. "When we looked back at our data from 2005 to 2012, it showed that if we had stopped administering CPR at 25 minutes, which was the old guideline, we would have terminated 100 people that ultimately left the hospital," Myers said. "Now we have the data to make the Wake County emergency response crews found they needed to administer CPR to patients for much longer time periods --- up to an hour, instead of 25 minutes that was the industry best practice.