Joe Graw, Chief Growth Officer at ImageTrend – Interview Series

Joe Graw, Chief Growth Officer at ImageTrend, brings over 22 years of leadership experience to the company. Since becoming Chief Growth Officer in 2023, he has advanced strategic initiatives and innovation. Previously, he served as President and CEO from 2020 to 2023, guiding the company through significant growth, and as Chief Operating Officer from 2017 to 2022, driving operational excellence. His passion for learning and forward-thinking approach extends beyond managing growth, focusing on shaping the future of ImageTrend and helping clients use data to achieve meaningful results.

ImageTrend is a leader in emergency response and healthcare software, turning incident and operational data into actionable insights. Its unified platform supports fire departments, EMS agencies, hospitals, and researchers with tools for documentation, data exchange, analytics, and compliance—empowering organizations to improve outcomes and deliver more effective community care.

You’ve spent over two decades helping shape emergency medical services and fire operations technology. What originally drew you to this field, and what keeps you motivated today?

I’ve always been passionate about technology’s potential to solve real-world problems, especially in critical sectors like EMS and fire services, where the stakes are highest. What motivates me today is the ability to create tools that directly enhance public safety and improve lives. Every innovation feels like a small victory for first responders and the communities they serve.

AI is often associated with hospitals or predictive analytics. But ImageTrend is bringing AI directly to the front lines—how are EMS and fire agencies using AI in real-time, and what kind of impact is it having on the ground?

AI is transforming EMS and fire operations because it enables real-time decision-making and automates critical tasks in the field. One of ImageTrend’s customers, Los Angeles County Fire, is currently field-testing voice-to-text technology to document patient information hands-free, allowing responders to save time and focus more on patient care. They’re also using intelligent image recognition to extract and apply key information from virtually any document with the snap of a photo, which speeds up documentation on scene. These innovations are improving situational awareness, accelerating processes, and enhancing the quality of care—all while reducing administrative burdens.

Voice-to-field documentation is one of the standout features you’ve implemented. How does this change the day-to-day experience of first responders, and what are the challenges in making it reliable in high-stress environments?

At ImageTrend, our voice-to-text solution is tailored for the field. It accurately captures medical shorthand like “A&O x4,” “18 gauge in the left AC,” or “SPO2 99% on room air,” and smartly applies those values across relevant fields. Providers can dictate narratives, assessments, vitals, and procedures in plain language as structured data populates automatically, eliminating countless clicks.

However, the challenge remains to ensure the system remains accurate and reliable in high-stress environments. That’s why our AI-assist solution has been tested in noisy environments like coffee shops, used mid-transport with gloved hands, and even deployed by flight medics during trauma calls to make sure it performs consistently despite the unpredictable and demanding nature of field operations.

Many platforms talk about “AI integration,” but often it’s a bolt-on. What does full integration look like at ImageTrend, and why is that distinction important for emergency services?

Full AI integration at ImageTrend means more than just adding AI to existing systems or workflows. It’s about creating a unified ecosystem that proactively optimizes the way responders work. Fully integrated AI anticipates the needs of EMS teams, offers real-time suggestions, and streamlines field operations. Rather than juggling multiple disconnected tools, responders have everything they need in one place, seamlessly integrated into their daily operations. This eliminates friction, speeds up decision-making, and ensures that responders can focus on delivering care, which is what matters most.

Image recognition and real-time decision support are now being deployed in high-pressure, low-margin-of-error settings. How do you ensure these systems are not just fast but also trusted by responders?

Trust comes from consistent, proven performance in real-world situations. By working closely with first responders, refining our systems through feedback, and ensuring rigorous validation, we maximize accuracy and reliability when it matters most. Additionally, every AI-suggested value can be reviewed and either applied or dismissed when it comes to our AI-assist solution. Nothing enters the report without the provider’s approval. The provider always stays in charge.

Interoperability is critical in emergencies, where time and data save lives. Can you walk us through how ImageTrend enables smoother communication and data sharing across hospitals, EMS, and fire agencies?

ImageTrend’s Health Information Network solution bridges the critical data gap between EMS and hospital systems by allowing real-time, bidirectional data exchange. When paramedics send ePCRs directly to hospitals, clinicians can immediately return patient outcomes, dispositions, and diagnoses back to EMS, providing everyone with the full picture—no delays, no gaps. This seamless integration breaks down silos and unifies EMS and hospital systems into a single, intelligent network. With our platform, there’s no need for disconnected tools or half-integrations. Whether it’s unlocking actionable data insights, streamlining reporting workflows, or ensuring hospital-EMS coordination, ImageTrend ensures that no data is left behind.

What trends are you seeing in AI-powered alerting and intelligent workflows—especially in prehospital environments—and how do you see them evolving in the next 3 to 5 years?

We’re seeing a shift toward predictive, AI-powered workflows that anticipate needs before they arise. In the next few years, expect to see more proactive alerting, where AI can flag potential issues like staffing shortages, high-risk patients, or transport delays. This will help agencies be more prepared and efficient before problems arise or challenging situations escalate.

Many agencies are facing burnout and staffing shortages. How can AI meaningfully reduce that burden without adding to the cognitive load of responders?

AI is automating routine tasks, streamlining documentation, and providing decision support, so responders can focus on critical thinking and patient care. By offloading these administrative and mental burdens, AI is minimizing the risk of burnout because it’s allowing responders to work more effectively without overwhelming them.

In your view, what does the future of AI in emergency response look like—do you envision fully automated triage systems, or will the human always be at the center of the decision-making loop?

While AI will continue to evolve, I believe humans will always play a central role in emergency response. AI will be an essential tool for decision support, but the empathy, judgment, and adaptability of human responders can never be fully replaced. I’m confident the future is one of collaboration between AI and human expertise.

Looking back at how far AI has come in this space, what’s one advancement you would have thought was still years away—but is already making a difference today?

When we first started exploring AI in EMS, the idea of real-time, AI-powered decision support in the field seemed like something we’d see far down the road. Yet, here we are—AI is already helping first responders make faster, more accurate decisions, even during high-stress moments. From real-time image recognition to predictive analytics guiding patient care, these technologies are working seamlessly on the ground today. It’s exciting to see how quickly the field is evolving, and even more thrilling to witness how these innovations are already saving lives and improving outcomes.

Thank you for the great interview, readers who wish to learn more should visit ImageTrend.