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Background: In rural states there are shortages of medically trained public safety answering point (PSAP) 911 answering stations. Dispatchers in these rural states risk leaving out vital Medical Priority Dispatch System (MPDS) determinants on patient stability and location to emergency medical systems (EMS) paramedics. We developed a smart phone medical education application for PSAP operators in underserved rural areas with a high deficiency of medical training. In Arkansas, as a rural stroke belt state there are 120 PSAP locations and 75 do not require any medical information training from state agencies. Twenty-six of these sites have limited medical training in cardio-pulmonary training. Only five counties have medically trained dispatchers and use MPDS. Following training, certification of dispatchers in any of the remaining underserved 70 counties that provide medical information will be regarded as a success.Hypothesis: The PSAP personnel serving as dispatch operators who utilize a medical dispatch training application will provide training based medical information, and reduce mortality due to stroke, trauma, and ST-elevation myocardial infarction (STEMI).Methods: In our data analysis, we are identifying whether the app intervention training influences telecommunication transition of information such as patient condition and caller location information to emergency medical service (EMS) providers. Other variables include paramedic impression/observation coding and response time to the scene. Baseline data from 2012 to 2014 will be used to compare pre- and post-training and state mortality data for stroke, trauma, and STEMI. Dispatcher to EMS agencies for dispatcher/caller information pre- and post-training will be compared for stroke, trauma, and STEMI mortality data.Results: App downloads have been noted in states across the US and as far as South Africa. At this time, we are still acquiring data for app downloads and user completed course training. Baseline mortality in 2012 to 2014 due to stroke, trauma, and STEMI were 140, 234, and 277 per 100,000, respectively.Conclusion: Currently, non-trained PSAP operators do not provide medical information on 911 calls and risk delayed EMS response time, jeopardizing patient safety.