Academic journal article Homeland Security Affairs

The Use of EMS Personnel as Intelligence Sensors: Critical Issues and Recommended Practices

Academic journal article Homeland Security Affairs

The Use of EMS Personnel as Intelligence Sensors: Critical Issues and Recommended Practices

Article excerpt


The use of Emergency Medical Services (EMS) personnel 1 as intelligence sensors or information collectors to provide information to Terrorism Early Warning Groups (TEWGs) and other local and state government intelligence fusion centers is recommended by numerous academic papers, professional articles and presentations, and U.S. Department of Homeland Security best-practice documents. These documents identify EMS personnel as valuable intelligence sensors, in part because they have access to locations not routinely available to law enforcement or intelligence communities that may contain indicators of terrorism. 2

In spite of these recommendations, exceptionally few TEWGs have incorporated EMS personnel into their information collection systems. While many TEWGs are interested in integrating EMS collection assets, they have not developed this capability because they are confounded by the complex legal, operational, professional, cultural, and societal challenges of using EMS personnel in this capacity. Conversely, at least one intelligence fusion center developed an EMS-based information collection system, but overlooked federal and state medical confidentiality laws and other strategic issues. 3

There has been no significant debate among federal, state, and local intelligence, EMS, law enforcement, homeland security, and medical communities regarding the best practices and strategic consequences of using EMS personnel as intelligence sensors. 4 Absent an such an interdisciplinary debate leading to the development of model EMS information collection practice standards and the articulation of clearly defined public benefit, elected officials, the leadership of the EMS and medical communities, and other policymakers will not sanction the use of EMS personnel in this capacity, resulting in the inability to use EMS personnel as information collectors to prevent terrorism.

Best practices for using EMS personnel as intelligence sensors must be developed because: (1) numerous TEWGs want to integrate EMS personnel as information collectors; (2) in the absence of peer-reviewed best practices, some TEWGs are instituting information collection practices that breach federal or state medical confidentiality laws, which may result in the unlawful disclosure, reception, and use of protected health information; (3) there are material civil, administrative, and criminal penalties for the improper disclosure, reception, or use of protected health information; and (4) ad hoc collection practices that breach the public's trust and expectation of medical confidentiality may result in the loss of this valuable collection asset or the creation of inordinately risk-averse TEWG oversight mechanisms.

In addition to discussing the strategic and legal issues and recommending practices for the use of EMS personnel as information collectors to support intelligence fusion centers, this article aims to stimulate debate among the intelligence, EMS, homeland security, law enforcement, and medical communities regarding the role of EMS personnel in supporting intelligence fusions centers.


EMS personnel can function as high quality intelligence sensors. They respond to emergencies in residences and businesses owned, rented, or operated by all demographic groups in all geographic areas on short notice, usually arriving within eight minutes of the request for service. In many instances, the reporting party does not have time to "clean" the scene; thus indicators of terrorist ideology, planning, or operations may be visible when emergency responders arrive. Additionally, most people do not react defensively to EMS personnel and may not perceive a need to clean the scene. Patients seeking medical care may be unable to disguise suspicious injuries associated with the logistics of terrorism, such as burns or other trauma from chemical agents or explosives. …

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