EMS Intelligence Sensors

     Michael Petrie is the administrator of the City and County of San Francisco Emergency Medical Services Agency. He is responsible for EMS systems development, planning, regulation, homeland security and disaster preparedness. Petrie also serves on the faculty at the Center for Homeland Defense and Security at the Naval Postgraduate School, and is an advisor to the East Bay Terrorism Early Warning Group. He has been a licensed paramedic for 25 years and holds master's degrees in Business Administration and Homeland Security and Defense.

     In the September 2007 issue of the journal Homeland Security Affairs (www.hsaj.org), Petrie advanced the controversial hypothesis of utilizing EMS personnel as "intelligence sensors." Petrie feels that EMS providers are in the unique position to observe signs of terrorist activity or affiliations and report them to appropriate authorities. For this reason, Petrie argues, EMS providers could be used as information collectors to support terrorism early warning groups and other intelligence fusion centers. This is currently not being done due to concerns about medical confidentiality, EMS professional issues and societal expectations of medical personnel. Taking these issues into account, Petrie's article presented a model EMS information collection protocol. While the ability to use EMS personnel as intelligence collectors will vary from state to state based on laws protecting patient privacy, Petrie argues that the access these personnel have to information regarding potential terrorists could be invaluable to terrorism prevention efforts.

     For this month's column, I had the opportunity to speak with Michael Petrie about the article he wrote titled The Use of EMS Personnel as Intelligence Sensors: Critical Issues and Recommended Practices.

     Can you explain your hypothesis of utilizing EMS personnel as intelligence sensors?

     EMS providers enter thousands of residences and workplaces daily, across all demographic and geographic areas. Because EMS providers respond rapidly and are not considered law enforcement agents, the reporting party may not consider or may not be able to "clean the scene" of indicators of terrorist ideology, planning or operations.

     EMS personnel, working as part of an EMS provider-approved collection program, could be trained to recognize indicators of terrorism that may be present on emergency scenes. Trained personnel could report incident-based and behavioral-based indicators of terrorism. Incident-based indicators of terrorism are based upon what a person observes, hears or otherwise senses. Examples of incident indicators include pictures of known terrorists or unusual chemicals or explosives in a residence. Behavioral indicators are based upon an individual's activities or conduct, such as friends of the patient acting especially nervous during a low-acuity EMS call. EMS personnel should not report trait-based indicators of terrorism. Trait-based indicators of terrorism are based on an individual's race, religion, ethnicity or national origin. This is commonly called racial profiling. EMS personnel should also not report confidential or protected medical information.

     Information should be reported by EMS field personnel through an EMS provider terrorism liaison officer (TLO) to a designated terrorism early warning group (TEWG) or other intelligence fusion center using an established protocol. The protocols should be developed by the EMS provider and the TEWG following review by legal counsel. Terrorism liaison officers, who serve as the conduit for information flow, should also receive special training.

     EMS personnel should be given the opportunity to opt into an information collection program rather than being compelled. EMS personnel should also not individually report suspicious activities unless it is sanctioned by their employer, because lacking training or a formal reporting structure, the report may violate medical confidentiality laws, exposing the employee, the employer and the fusion center to civil and criminal penalties.