IN THE BOX THINKING: The GEMS team, after their CAMTech hackathon win, from left: COO/ Chief Medical Officer Ted Liao, CEO Andrew Schwartz, CFO Annie Feldman and CTO Jeffrey Lipton. Courtesy Photo
By ALLISON HUBER
BOSTON—In the United States, the average emergency medical response takes up to 12 minutes—crucial, life-saving time that GEMS CEO Andrew Schwartz and his team plan to make even shorter.
In Boston, according to EMS, Priority 1 response averages about half this time, at 6.3 minutes as of 2016. But even that brief time delay has caused permanent brain damage for victims of overdose in particular.
With the deadly opioid crisis spreading threefold in just a decade and 15 million Americans now diagnosed with food allergies, Schwartz says empowering bystanders to respond to emergencies can make all the difference.
Their solution: GEMS boxes, full of medical supplies and located around the city like U.S. mail boxes, can be remotely unlocked so bystanders can be guided by 911 to save a life.
“Our boxes aren’t just for opioid users, these are public preparedness boxes,” Schwartz says. “So just as someone who overdoses on oxycontin or heroin would use (the naloxone in) this box, a child stung by a bee could use an Epipen.”
In 2015, 33,091 Americans died from opioid overdose, according to the Centers for Disease Control—nearly triple the number claimed in 2002. Now, the North American opioid market, which accounts for 70 percent of global consumption and valued at $12.4 billion in 2015, is expected to hit $18.5 billion by 2024, according to pharmaceutical research firm PharmExec.
GEMS boxes contain naloxone (more commonly known by its brand name, Narcan), epinephrine and hemorrhage-control products. Emergency response dispatchers can unlock these boxes and guide callers through their uses, turning bystanders into first responders, saving valuable time and hopefully, lives, says Schwartz. GEMS, winner of the $10k Opioid Epidemic Post-Hack-a-thon Award from CAMTech, in conjunction with Massachusetts General Hospital, is a current finalist in MassChallenge. Schwartz and his team of doctors and technologists hope to make the next cohort of PULSE, the healthcare-oriented division of the incubator, in December.
Schwartz, Jeffrey Lipton and Annie Feldman have now been friends for nearly a decade, Schwartz tells FoundersWire. With a diverse set of backgrounds—Lipton, a postdoctoral research associate at MIT, Schwartz with a master’s in government and Feldman, an MBA from Babson—the team complements each other’s strengths. The team collaborated with Dr. Ted Liao, a resident at Brigham and Women’s Hospital, and now COO/chief medical officer, who earned his medical degree from Boston University School of Medicine, and his master’s and bachelor’s degrees in electrical engineering from Stanford. They group began collaborating over what kinds of supplies to store in the boxes.
“There’s a whole list of things you can put in there, but they have to meet some requirements. One, easy to apply without any medical training, and two, items that would not kill someone if administered incorrectly,” Schwartz says.
Once an individual sees an emergency and dials 911, the operator would receive his or her GPS coordinates and direct them to a box. Because the boxes will have different compartments containing Narcan, tourniquets and Epipens, the caller will be given a pin code to unlock the necessary medical device.
“I’ve been thinking about the idea of assistance in emergency situations for a while,” Schwartz says. “Once I found out about Narcan and how easy it is to implement it and how there are no side effects—you can have no medical training—I thought it would be the perfect application, along with Epipens or tourniquets for hemorrhage control,” he says.
Dr. Gabriel Wishik-Miller, an internist and primary care provider at Boston Health Care for the Homeless Program, has seen the devastating effects of addiction pass through his clinic for the past seven years. Wishik-Miller works as a backup physician for The Supportive Place for Observation and Treatment (SPOT), a program that engages people in the midst of overdose, provides medical treatment for over-sedation and connects patients to treatment programs. The program is part of the Boston Care for the Homeless Program, one of the 19 original pilot Health Care for the Homeless programs founded in 1985. In 2016, SPOT faced 3,852 overdose encounters.
“What we’ve been seeing since I got here seven years ago is the overdoses happening on the street and in our building. The substance use, the activity—everything has been going up every year,” Wishik-Miller says. “People are injecting and overdosing, sometimes not very far from us, and it’s tragic. These are people we know and who we take care of, and if they’re dying on our watch, it seems wrong.”
Wishik-Miller says he attributes the rise in overdose to the appearance of synthetic drugs on the market, which are faster-acting and higher risk. In order to combat overdose, he insists that Narcan, a nasal spray, is safe and easy to use for the average bystander in cases of emergency. “Narcan is a very safe medicine, it can be used by anybody if it is in the proper formulation. It can start the reversal process immediately. You don’t have to wait for 911 to get there for EMS to arrive. So to have a bystander with Narcan available when someone is dying can be life-saving.
“In our public spaces, that’s where most overdoses happen. Anybody who is on the street in the public space should have Narcan available to use if they have seen somebody that has gone out, and so I think having them in boxes on the street is a fantastic idea. It would be very, very useful,” Wishik-Miller says.
In addition to cutting down EMS response time and saving lives, Schwartz says GEMS may eventually educate the public about health through videos and advertising campaigns. “One of the real beauties of our system is that you don’t even need to know what it is to use it.”
Currently, GEMS is seeking communities to pilot the boxes. Schwartz says he aims to complete this initial study this year, moving one step closer to implementing the boxes in municipalities across the country at an affordable price.
“We hope to get to the point where we can shorten response even five to seven minutes, and it would be a dramatic life saver. Save lives. That’s our No. 1, 2 and 3 goals.”
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