Alberta Health Services to be 'held to account' by City

Airdrie's city council will be more determined in holding Alberta Health Services to account when it comes to the data that is presented to city officials on ambulance response times.

During a city council meeting on Monday evening, the administration was directed to work more closely with a local paramedic, Ryan Middleton, in developing strategies to expedite information requests, specifically Freedom of Information and Protection of Privacy Act (FOIP) requests to Alberta Health Services. 

The motion came after council received a letter from Ryan Middleton, a local primary care paramedic. The letter was sent to council a week after Middleton presented various statistics at a town hall addressing EMS issues last month.

The statistics that he provided the public at the town hall were made through numerous FOIP requests he initiated in his role as a patient advocate and as a resident of Airdrie and not as an employee of Alberta Health Services (AHS). 

In his letter, Middleton stated that public emotional investment in the issue remains significant, underlining that in his view, the average citizen feels 'beguiled, and disenfranchised that they lack agency in advocating for their own public safety.'

Middleton added in his letter that if there was a way to establish a more efficient pipeline of information from AHS EMS to the public and a more established procedure for 'validating and discussing concerns', he would be more than willing to participate in the process. 

"While much of the movement and collaboration regarding municipal-provincial affairs is tectonic and not visible to the public, it is a challenge for the average citizen to visualize or conceptualize progress if they are not apprised of developments or consulted. This sentiment grows as metrics like response time and resource shutdowns continue to trend upward in the community while narratives provided by [Randy] Bryksa & [Robert] Swanson et al run contrary to data obtained through FOIP."

Councillors reflected that one of the contentious points that surfaced during the town hall in late April was the observation that statistics are provided by both AHS Emergency Medical Services (AHS EMS) officials and other provincial officials, when compared to statistics that are provided by FOIP requests tend to show vastly different numbers. This has led many to believe that statistics being offered by AHS and the province are sometimes omitting critical metrics. For example, currently, AHS EMS only accounts for the highest priority calls when calculating response times (Delta and Echo) and the response times do not factor in Charlie, Bravo, or Alpha calls. 

Councillor Chapman pointed to what Middleton had echoed during the town hall; other provinces' health bodies have data readily available online which allows the public to have a much clearer and more objective understanding of ambulance response times. 

"I think we should request an update from EMS at least quarterly until this gets looked after. I think it's something that we need to hear from them. I think in the past, they've been blowing smoke," Chapman said.

Councillor Al Jones noted that one of the more difficult things to do is to refute statistics provided to council during presentations by AHS EMS as a presentation is occurring. 

"We can't refute those stats, because we're not in the industry - till afterwards, when we're educated by someone such as Mr. Middleton. I think there would be value... I don't know if this is possible - [to FOIP] data ahead of time, before they actually appear before us; so that we know the appropriate touch points to challenge them on."

However, the city's Fire Chief, Mike Pirie who was also present at the meeting before council on Monday, noted that requesting FOIP documents and data is much more complex and that larger data sets that are requested can take anywhere from 30 to 60 days to be fulfilled.

"What you've been provided in previous years is not terribly helpful when you're gauging the effectiveness of an EMS system, or quite frankly, an emergency system. A simple metric is not a simple metric. There are multiple layers of data and understanding behind them," he said. "I think the first question you should ask is, 'What do you really need to know?' I would make the request directly, yourself."

Chief Pirie also noted that the motion council presented would eliminate duplications of data requests between himself and Middleton.

"I do think there are efficiencies to be gained. I don't think the public should have to FOIP - essentially - their own organizations to find out metrics. I do think though, it's important to work with Mr. Middleton. I think we both have a very similar view on the value of data because data does drive."

Hence, council is hoping that the motion they passed will not only allow for a more streamlined request for data but also signal to AHS EMS officials that they will be questioned on data much more thoroughly. 

Council also cited that they will be looking to meet with AHS EMS officials on a more regular basis, citing quarterly updates would be preferred. Airdrie’s Director of Community Growth and Protective Services, Kevin Weinberger, noted that while a request can be made, it will ultimately depend on the AHS EMS officials.

"We can request all we want, [but] that doesn't mean everyone's going to come. We can ask all the time, but unless there's new information... It took a long time even to find out who our interim contacts are," he said. "We now have and so we'll start that relationship and hopefully get them here."

The last time city council was provided a presentation by AHS EMS officials was in November 2022. However, in late April, Member of the Legislative Assembly (MLA) RJ Sigurdson, the Parliamentary Secretary for Emergency Medical Services (EMS) Reform presented statistics during an informational session on EMS in the city. 

It should be noted FOIP requests are available to all residents. The fee for submitting a FOIP request is $25, however, the fees can increase depending on the amount of type of data requested. 

Middleton concluded his letter by stating that while he could not realistically represent or speak on behalf of the citizens of Airdrie or its paramedics, he did state because he is both a resident and a paramedic, his perspective is unique.

"I have the unique privilege of having a foot in both worlds. To me, an accountability framework includes regular KPI [Key Performance Indicators] reporting, and I cannot see an advisory body disagreeing that meaningful change begins by defining success. I would define success as the achievement of response time goals within a calendar year (eight-minute 50th percentile, 12-minute 90th percentile), 50 per cent reduction in resource shutdowns, and implementation of new local service standards for minimum ambulance coverage within the city."

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