Controversy has arisen after it was revealed that the Seattle Fire Department (SFD) has been using artificial intelligence (AI) to analyze 911 medical calls for the past two years without the public’s knowledge, connecting some callers to nurse support centers instead of ambulances. According to the Seattle Times, the Seattle Fire Department is using technology from Corti, a Denmark-based medical AI company, to analyze 911 medical calls in real time.
The AI listens to the caller’s symptoms and conversation, and if it determines that a particular patient has a low level of urgency, it sends a pop-up notification to the dispatcher (911 dispatch center staff) recommending that they be connected to Nurse Line, a nurse support center located in Texas. The fire department has been applying this system to real-time medical calls since December 2023 but did not notify citizens separately or undergo a public review process. It was only two months after the Seattle Times began investigating the matter that the fire department officially confirmed the use of AI.
The biggest controversy surrounding the introduction of AI is the “lack of transparency.” Citizens were completely unaware that their 911 calls were being analyzed by AI. There is no relevant notice on the fire department’s website, nor have evaluation metrics been disclosed regarding how effective the AI has actually been in improving patient classification and emergency response.
Ryan Carlo, a professor at the University of Washington (UW) School of Law, pointed out, “The fact that private companies’ AI intervened in the 911 reporting process without citizens’ knowledge raises serious concerns,” adding, “If someone was misclassified and pushed out of the emergency system, they have the right to know how that process was carried out.” In fact, Seattle’s nurse counseling centers have already been embroiled in controversy on several occasions.
Earlier this year, the Seattle Times reported instances where some patients waited anywhere from a few hours to over ten hours to receive an ambulance. Notably, in 2022, retiree Pamela Hogan was connected to a nurse counseling center after calling 911 and waited for an ambulance for over ten hours before eventually dying at her home without receiving proper treatment; her family is currently pursuing legal action.
The Fire Department emphasizes that AI does not make final decisions. Chris Lombard, Deputy Director of Resource Management, explained, “The dispatcher holds all decision-making authority, and the AI merely provides reference information.” Corti also stated, “AI is a tool intended to support, not replace, the judgment of medical professionals.” Nevertheless, experts are raising concerns regarding the risk of AI making biased judgments based on race, gender, and socioeconomic background, as well as privacy issues. In particular, the fact that the process by which AI analyzes 911 calls was not sufficiently evaluated under the City of Seattle’s Surveillance Ordinance is also a subject of controversy.
The fire department is currently paying Corti approximately $260,000 annually, and it is reported that last year, they even provided AI system demonstrations and tour programs to officials from the U.S. Coast Guard, Alaska, Taiwan, and Dallas, Texas. In the wake of this controversy, the City of Seattle has set out to establish an AI governance framework. Mayor Katie Wilson’s office stated, “We are establishing an open management system to evaluate the impact of AI use on privacy, bias, and the public interest.”
Experts unanimously agree that while the expansion of AI utilization in the medical field is an inevitable trend, transparency, accountability, and sufficient oversight mechanisms must be in place, especially in areas directly linked to citizens’ lives, such as emergency medical care. In particular, with the possibility raised that an era may come where AI voice operators, rather than humans, directly answer 911 calls, interest and concern are growing simultaneously regarding what changes artificial intelligence will bring to the emergency medical system.