By Nick Morgan
The Daily News
LONGVIEW, Wash. — Among the first uses for the city’s seven-figures in opioid settlements will be a six-figure software system to help Longview firefighter-paramedics make informed decisions about a new way to respond to overdose calls.
Longview’s police and fire departments outlined at the last City Council meeting multiple spending priorities — as well as some direct requests — for using the more than $1 million in opioid settlements the city has already collected, plus another $1.7 million and counting that’s in the pipeline over the next decade.
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The most comprehensive of the proposals presented to the council on Jan. 22 was a $100,000 request from the fire department to boost its long-term EMS outcomes for overdose calls and beyond.
LFD: Analyzing data has saved lives before
Longview fire’s Battalion Chief Eric Koreis outlined a request totaling $100,000 to migrate its data to the firm Darkhorse Analytics and use a suite of new data analysis tools.
According to a synopsis of the funding request in the City Council agenda packet, the system is designed to “strengthen our data capabilities related to overdose response, naloxone program tracking and public education.”
Darkhorse’s website shows a suite of tools that, among other things, can visually represent emergency incidents and outcomes on color-coded maps to outline risk areas. The company’s programs tailored for fire departments can help them make “a comprehensive data-first approach to their operations,” according to the firm’s website.
In introducing the proposal, Koreis highlighted an earlier example of how research and data helped the department improve its responses to cardiac arrest calls.
“When you responded to a cardiac arrest (call) in 1990, almost everybody died,” Koreis said. “You just felt very hopeless.”
Over the years, reports and research surfaced around what was known at the time as “high-performance” or “pit-crew style” CPR. Koreis said the procedural changes were slight compared to what was standard practice at the time, but tracking their results helped Longview get significantly better outcomes.
“It was a little bit mystical about why that would have such an impact on survival rates, but hey, that’s what the pros are doing we’re going to try that,” Koreis said. “Almost immediately we saw an improvement in survival rates.”
Koreis said the department has made it a priority to find other breakthroughs based on that success.
The fire department already uses portable EKG monitors and software equipment to “analyze every cardiac arrest that we respond to — down to the second,” Koreis said.
Yet some of that information needs refinement tools they don’t yet have.
“It’s like drinking from a firehose,” Koreis said. “It’s way too much data to consume and operationalize.”
Sending overdose patients directly to treatment
Koreis said the data analytics tool can help the fire department explore a new approach to overdose responses.
“One of the areas of prevention that we’re looking at right now that we plan to implement rather soon is alternate destination transport,” Koreis said.
Instead of rushing an overdose patient directly to a hospital — where the patient gets medically stabilized, but is then released back to their environment. Alternate destination transport would have first-responders resuscitate the patient and then transport them directly to a local treatment facility.
2025 Cowlitz County opioid data
Quarter 1
42: Suspected opioid overdose emergency department visits
60: Suspected opioid overdose Emergency Medical Services responses
Quarter 2
48: Suspected opioid overdose emergency department visits
53: Suspected opioid overdose Emergency Medical Services responses
Quarter 3
32: Suspected opioid overdose emergency department visits
57: Suspected opioid overdose Emergency Medical Services responses
Quarter 4
32: Suspected opioid overdose emergency department visits
34: Suspected opioid overdose Emergency Medical Services responses
Source: Washington State Department of Health
Koreis said in a phone interview Monday that the fire department has an agreement in place with Columbia Wellness, but Koreis said his agency is still in the process of refining procedures before bringing the new protocols online.
It could be implemented by March, but Koreis said the protocol won’t go into effect until everything is dialed in. Because local EMS has historically only had one destination (the hospital), new protocols for taking patients to treatment include procedures for those with standing orders and ensuring the treatment center has room.
Koreis told the council the goal is to “interrupt their cycle” and put the patient in a place where they would be surrounded with more resources and support.
“In order for our cycle to work, we have to — in real time — be able to observe what the outcomes are,” Koreis said.
The need for analytics only grows as first-responders “add more ingredients to the soup, so to speak,” Koreis said.
He described possibly having paramedics administer the drug buprenorphine, which Koreis said is “a powerful medicine that helps fight withdrawals,” specifically for opioids.
He said he’s seen studies showing buprenorphine improving patients’ treatment acceptance rates and treatment attendance in the 30 and 60 days after an overdose. The Darkhorse modules tracking overdose responses, naloxone program tracking and other efforts will help the department see how that approach is working locally in real time.
“But again, we want to do it right,” Koreis said. “We’re reflecting back on what we did with cardiac arrest, and how first we looked at industry trends, we started to implement those but then we fine-tuned it to the city of Longview.”
Councilmember Mike Claxton, a retired lawyer, asked during the presentation how they can track outcomes without violating patient privacy laws. Koreis explained that there are carveouts in HIPAA that allow EMS to access health records for healthcare decisions and for quality assurance.
Koreis also said the data analytics tools will also serve as a “force multiplier” for other areas of its operations.
As an example, Koreis touched on the EMS levy lid lift being proposed for the November ballot. There will be questions about how the tax measure will make an impact, and they’ll be able to answer with concrete data presented visually about which communities will be served better.
“Darkhorse give us the ability to actually show the public based on real operational data over several years,” Koreis said. “So it’s objective — if we get money to do these things, this is what you can expect.”
The costs
The fire department’s $100,000 request includes a one-time $50,000 onboarding fee for the technical integrations required to bring Darkhorse’s enhanced “risk visualization” module online, plus five years of its subscription cost of $10,000 per year.
“We already have access to the data, but that helps pay the company to make those technical connections so now the data is all flowing into their product,” Koreis said.
The fire department is separately going to pay Darkhorse $20,000 per year for an emergency response data module. Previously the fire department paid another provider $13,000 per year for an analytics program.
Darkhorse’s Emergency module carried multiple endorsements from fire officials across the West Coast including from retired Spokane Fire Chief Brian Schaffer, retired Western Fire Chiefs Association Executive Director Jeff Johnson and current Vancouver, British Columbia Fire & Rescue Services Chief Karen Fry.
Other organizations that use Darkhorse visualizations include Harvard University, the Economic Policy Institute and Environmental Defense Fund, according to its website.
Mayor Pro-tem Keith Young asked if it would be possible to “tack on” something similar for the police department at minimal cost.
Koreis said the risk module can work with a wide assortment of data streams, and “the opportunity is limitless for what they could do with it.” He cited as an example that the city of Portland uses Darkhorse modules for crime analysis.
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