By MES Dispatch Staff
The Briefing
- Seattle City Councilmember Bob Kettle questioned Seattle Fire Department officials Tuesday about a Texas-based nurse line and an AI program used to help triage 911 medical calls.
- Since 2022, some 911 callers with less-urgent issues have been transferred to a nurse line run by ambulance contractor American Medical Response; those nurse-ordered ambulances are exempt from city response-time standards and are not tracked by the city.
- A 71-year-old woman, Pamela Hogan, died in 2022 after waiting more than 10 hours for an ambulance ordered through the nurse line; her estate’s lawsuit against the city and AMR was settled this summer by AMR.
- Since 2023, an AI program from Danish company Corti has been listening to all Seattle Fire Department 911 medical calls and prompting dispatchers to consider transferring certain callers to the nurse line; the program was introduced without public disclosure.
- Fire Chief Harold Scoggins said dispatchers retain full control over transfer decisions, and the University of Washington is evaluating the AI program’s effectiveness, though no metrics have yet been shared publicly.
SEATTLE — The Seattle Fire Department may pursue greater accountability from its ambulance contractor after City Council members raised concerns Tuesday about a nurse line used to triage some 911 medical calls and an artificial intelligence program that flags calls for potential transfer.
Councilmember Bob Kettle called Fire Department officials before his public safety committee following Seattle Times reporting this year that raised questions about both systems. “That’s the main to-do item,” Kettle said after the meeting, referring to his desire for enhanced oversight of ambulance responses ordered through the nurse line.
Most basic life support 911 hospital transports in Seattle are handled by the city’s ambulance contractor, American Medical Response. Since 2022, the Fire Department has transferred some 911 patients with less-urgent issues to AMR’s nurse line, based in Texas, where nurses can offer advice, connect callers to virtual care, arrange rideshare transport to clinics, or order an ambulance. “We only have so many units to go out the door,” Fire Chief Harold Scoggins told the committee. “This was the tool that was implemented to help with that.”
At the same time the nurse line was introduced, the department changed AMR’s contract to exempt nurse-ordered ambulances from city response-time standards and stopped tracking their wait times. In 2022, 71-year-old Pamela Hogan waited more than 10 hours for an ambulance after being transferred to the nurse line, despite calling 911 back multiple times, and died without receiving care. Her estate sued the city and AMR; AMR settled the case this summer. Kettle noted the city cannot determine whether Hogan’s experience was unusual, since it no longer tracks such waits. “That (type of) call is up to AMR to track,” Scoggins said, adding that once calls are identified as lower-level medical emergencies, they fall outside the city’s tracking system.
Since 2023, an AI program developed by Danish company Corti has monitored all of the department’s 911 medical calls and sent live prompts suggesting dispatchers transfer certain callers to the nurse line. The department introduced the program without disclosing it to 911 callers and operated it for more than two years without public review, raising concerns among some experts about transparency and accountability. Scoggins said dispatchers, not the AI, retain decision-making authority. “It can pop a message up on the screen based on the words that the caller is using, the pace, the tone, the tenor,” Scoggins said. “The dispatcher can send that call to the nurse line or not. That still rests with the dispatcher.” Councilmember Rob Saka said he appreciated that dispatchers remain in control of the process.
As of May, the department had no public metrics on the AI program’s effect on patient outcomes. Officials said Tuesday that the University of Washington is evaluating the program’s effectiveness but did not share further details.
Scoggins said the department holds quarterly meetings with AMR regarding the nurse line and could raise the possibility of tracking and time standards in future contract negotiations, though AMR signed a new five-year agreement last year and would need to agree to any changes. “We haven’t asked that question. We can ask that question,” Scoggins said. Kettle said he plans to follow up with Mayor Katie Wilson’s office on the issue.