USA119: Why an Emergency Medical System Mistook Incident Reporting for Enterprise Architecture
- Sunil Dutt Jha
- Jul 10
- 2 min read
Overview:
This case is part of a 120-diagnostic series revealing how emergency medical service (EMS) agencies have mislabeled reporting automation as “Enterprise Architecture progress.”
In regional EMS systems, a recurring pattern is treating the digitization of incident reports as proof of architectural maturity.
Paramedics could log patient details in the field, dispatch centers could receive reports instantly, and compliance forms were auto-generated — yet the enterprise structure linking triage protocols, hospital coordination, resource readiness, training, and quality improvement was never modeled.
P1–P6 Insight Preview:
These six perspectives define how an enterprise connects intent to execution
— P1: Strategy, P2: Business Processes, P3: System Behaviors, P4: Component Governance, P5: Implementation, P6: Business & Technology Operations.
P1 (Strategy): Reporting automation was marketed as a life-saving upgrade, but no architecture-led roadmap tied it to improved survival rates, readiness metrics, or cost efficiency.
P2 (Process): Incident logging was streamlined, but patient handoff, feedback loops, and continuous improvement workflows remained inconsistent.
P3 (System): Reporting platforms weren’t behaviorally integrated with hospital EHRs, training systems, or equipment maintenance platforms.
P4 (Component): Mobile devices, report templates, and dispatch modules were governed separately, leading to inconsistent data formats.
P5 (Implementation): Deployment prioritized compliance readiness, while process reengineering and cross-agency integration were deferred.
P6 (Operations): Business ops captured reports faster, but tech ops still relied on manual follow-ups to close the loop on patient care and resource tracking.
Stakeholder Impact Summary:
CEO/EMS Director – accountable for public safety and service quality: Limited by weak P1 Strategy — digitization improves speed but not systemic readiness or patient outcomes.
CIO – responsible for EMS technology and interoperability: Impacted by P3 System Behaviors and P4 Component Governance — fragmented systems reduce operational agility.
Sales Head (Municipal & Hospital Liaison) – manages stakeholder and partner relationships: Affected by P2 Processes and P5 Implementation — can showcase reporting speed but not end-to-end patient care improvements.
Chief Enterprise Architect – ensures EMS operations align with strategy and cross-agency workflows: Confronts P1–P6 issues — reporting exists in isolation from the full emergency response architecture.
Head of Field Operations – oversees paramedics and resource allocation: Feels P2, P3, & P6 — still manually coordinates hospital notifications, equipment readiness, and patient transitions.
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