Jeff Clawson, M.D.

Jeff Clawson, M.D.

Ask Doc

By Jeff Clawson, M.D.


I recently came across an article that has raised some concern regarding horizontal versus vertical dispatching. I was hoping you could clarify some questions. In the article it states the following: Team approach is referred to as “horizontal” dispatching. The interrogator (calltaker) follows the entry and key question protocols while the radio dispatcher listens and, at predetermined points during the questioning, dispatches the appropriate response as indicated by the information.


This was an early chapter I wrote in 1994 about Emergency Medical Dispatching within the American College of Emergency Physicians (ACEP) EMS Textbook.

Below I have attempted to address each of your questions with answers shown in a blue font.

Does the dispatcher listen in on conversation over another phone?

Basically, the listening part is simply not done anymore – this particular method is very outdated, and essentially pre-dated computerized dispatch protocol systems. Twenty years later, the various points at which a dispatch code-based “send” occurs are now well defined in the protocol and automatically done in the ProQA software where the call is pended to the radio dispatch position. ProQA dispatches (sends code to CAD) at different points depending on the level of acuity and urgency determined.

Does the dispatcher stand over the shoulder of the calltaker and listen?

No, never.

If the calltaker is on one side of the room and the dispatcher is on the other side where they cannot hear the calltaker and, information is sent through a CAD system, is this still referred to as horizontal dispatching?

Yes, what you have just described above is the correct definition of a “horizontal” set-up. Horizontal simply means that the “interrogator/coder/instruction-giver” is a different person than the “radio dispatcher/unit allocator/queue handler.”

How would this be considered faster and better than vertical dispatching?

It is only faster, or more efficient, in that two people are performing some different functions in parallel. In this regard, it is obvious that some time can be saved and the caller is not left with any pregnant gaps while the vertical (single) calltaker/dispatcher sends the call and interacts with responders. For example, while the radio dispatcher is sending the response and interacting with them as they come on radio, the interrogator is giving Post-Dispatch Instructions or Pre-Arrival Instructions and Case Exit instructions. Of course, if calls remain in the queue for any length of time, part of this time saving is lost.

The article goes on to say:

“Vertical” dispatching makes each dispatcher responsible for a geographical area and requires that individual to handle all calls from start to finish. This dispatch configuration is less effective for EMDs using priority dispatch protocols.

Today this would be worded differently, as most centers with more than one person on the floor, don’t just do different “areas”.

Does this mean that your protocols are not as efficient for a single dispatcher center to use? Or does this mean that doing EMD as a single dispatcher regardless of what protocols are used is less effective?

The latter is correct. The type or brand of protocols is irrelevant to this issue. I was referring to any dispatch protocols generically in this regard.

This horizontal versus vertical dispatch configurations aspect has raised issues regarding whose software to purchase being a single dispatcher center.

Dispatch center configuration isn’t an issue in selecting software per se. The Academy protocols are used in many single dispatcher centers around the world. The issue of protocol/software brand should be based on the completeness and robustness of the content, sophistication of the protocol software navigation, and its CAD interface preciseness to name a few. A greater issue is that with the MPDS/FPDS/PPDS, you are not just buying products; you are really obtaining the IAED system that created them, maintains them, and perpetually evolves them to be on the cutting edge of the standard of care, practice, and public service. With now just over 3,600 center users of these, the feedback alone, provides the Academy with an endless supply of cases, experience, and input unlike any other.