Analyzing EMS Data in Virginia for Better Health Interventions
Analyzing EMS Data in Virginia for Better Health Interventions
In the wake of the pandemic, the number of drug overdoses in the U.S. reached an all-time high—a trend driven largely by the abuse of synthetic opioids. Preventing and responding to drug overdoses is an urgent matter—one that usually falls on police, emergency medical technicians, community health centers, and others on the front lines.
While the opioid crisis is undoubtedly complex, harm reduction doesn’t have to be. By arming first responders with the right data, they can identify vulnerable populations and potential interventions. That’s precisely what’s been happening in the Commonwealth of Virginia.
A few years ago, Voyatek worked with Virginia to develop a powerful cross-agency data sharing platform called the Framework for Addiction Analytics and Community Transformation, or FAACT. By bringing together disparate data sets from state police, the medical examiner’s office, emergency medical services, and more, the team created easy-to-use visualization and analysis tools that quickly bring health indicators and disparities to the surface.
Recently, we analyzed all EMS incidents in Virginia for the years 2019 and 2020 to better understand the opioid crisis. Overall, from 2019 to 2020, opioid-related emergencies increased by 37%, with the greatest increase taking place in the state’s central region (a 50% year-over-year increase). By digging into the 28,079 reports, we were able to identify trends and outliers that could be useful to policymakers and first responders alike.
Demographic Trends
Not all opioid-related emergencies are fatal, but the number that were increased 42% from 2019 to 2020. The percentage of incidents that were fatal was consistent across all age groups. When zooming out to all opioid-related EMS incidents, though, younger adults were the most impacted. Some key data points include:
- Those aged 30 to 39 accounted for more than a quarter of emergencies in both years, while those aged 20 to 29 were close behind.
- The only group that showed a decrease in opioid-related EMS incidents was those aged 70 and up.
- Finally, 63% of EMS incidents were among males, while 62% were among white people.
Having such granular insights can help health departments know which age groups to focus on. Ideally, they will conduct tailored assessments to understand why certain demographic groups abuse opioids more. Is it because they are unmarried and don’t have kids—two things that often act as behavioral controls? Do they have greater access to drugs, perhaps because they have greater disposable income? By understanding who needs health interventions, public officials can better tailor their response.
Naloxone Administration
Every time a doctor prescribes an opioid, they are also supposed to prescribe naloxone. The EMS data we had available suggests this does not always happen. A few key data points include:
- Naloxone was only administered in a 28% of all emergencies in 2019 and 2020.
- First responders also classify incidents as opioid-related based on their primary and secondary impressions. In 2020, 51% of incidents were primarily reported as opioid-related, up from 44% the year before.
Our analysis suggests the increase in primary impressions could be a result of updated guidelines. Still, it begs the question as to why naloxone wasn’t administered in more of these incidents, if it was known that they were opioid-related. Of course, this is only EMS data. Naloxone was perhaps administered at a higher rate in harm reduction centers or other settings.
The Bottom Line
Having data on the opioid crisis can help first responders and public health officials spot trends that may be contributing to a rise in overdoses. Additionally, they can assess and identify the most vulnerable members of a region’s population, while also identifying effective approaches for early intervention. Certain regions may demand higher hospital and police staffing, for instance.
As we analyzed EMS data from the Commonwealth of Virginia, we also made control charts, where you find the average incidence number, then map the upper and lower control limits. By looking at any outliers—data points that exist outside these control limits—health departments can better understand what drives dates with a high number of emergencies and overdoses.
The unfortunate reality is that the opioid crisis does not seem to be abating. So far, FAACT has been implemented across the Commonwealth of Virginia and is being used to equip Virginians with the data they need to support people with serious mental illness. Digging into any and all data we have available is a key part of combatting this crisis, in the Commonwealth and beyond.
-Mehret Girmay, Senior Consultant, Epidemiologist, MPH