Ohio’s 988 modernization is built around a difficult design principle: create one connected operating environment while preserving the relationships and judgment that make local crisis response work.
Building one statewide crisis system across nineteen local centers is a major coordination challenge—and an opportunity to make the entire network stronger.
Nineteen systems become one. Separate reports become a dashboard. Different communications channels enter a common environment. The state gains a clearer view and the network becomes easier to manage.
Our job is to connect those centers while carrying their local knowledge into every statewide workflow.
A local 988 contact center knows more than a caller’s area code. It knows which Public Safety Answering Point serves a community, which mobile team is available, how regional providers operate, where capacity changes after hours and which handoff practices have earned trust over time. Those details are not exceptions to a statewide system. They are part of its intelligence.
That is the central tension in Ohio’s 988 State Centralized Platform, which we are developing with the Ohio Department of Behavioral Health and the state’s 19 local 988 contact centers.
Our objective is to make local knowledge usable across a connected statewide system.
A statewide number does not create a statewide system
The 988 Suicide & Crisis Lifeline gives people a simple way to call, text or chat for support during a suicidal, mental-health or substance-use crisis. Ohio’s program provides free and confidential support around the clock, and the state’s local centers collectively respond to a large and varied volume of contacts.
The public experience is deliberately simple: remember three digits.
The operating environment behind those digits is not.
A contact may arrive by voice, text or chat. The person may need emotional support, a safety plan, a connection to a community provider, mobile crisis response, coordination with 911 or a transfer to another center. The appropriate action can depend on geography, immediate risk, local resources, center capacity and information gathered during the interaction.
If telephony, documentation, referrals and reporting live in separate environments, the specialist becomes the integration layer. Information is re-entered. Context can be lost during a transfer. Supervisors see only part of the operation. State leaders receive delayed or inconsistent pictures of demand.
A three-digit number can open the door. It takes infrastructure to preserve the pathway after someone enters.
Local knowledge is operational data
In Ohio, local experience is not separate from the data model; it informs the data, rules and workflows the platform must carry.
The statewide platform has to make that local intelligence usable.
The knowledge that one contact center has developed about a local PSAP relationship, a regional mobile team or a community referral pathway directly affects what the system should do. If that knowledge is not reflected in routing and workflow logic, a technically correct transfer can still be operationally wrong.
Ohio’s modernization starts from a practical premise: local practice is valuable operational intelligence.
We have used structured discovery sessions, workshops and continued engagement with contact centers, local behavioral-health authorities and mobile crisis partners to understand how work actually moves. The questions are concrete. What does the specialist know at each stage? Which information has already been collected? What triggers escalation? Which relationship determines the appropriate destination? What must accompany a warm transfer? Where does duplicate entry occur?
RingMD COO Varun Arora leads that translation from frontline experience to delivery. He brings the State’s mission, stakeholder priorities and our product and implementation teams into one operating conversation so the expertise of crisis specialists reaches the platform, integrations and implementation work.
This shared operating picture gives our teams a practical basis for testing whether each workflow reflects what specialists actually do.
Discovery is part of engineering
For RingMD, discovery is hands-on engineering. The work we do with crisis specialists, local centers and partners determines how useful the platform will be in day-to-day operations.
A diagram can show that 988 connects with NG911, Mobile Response and Stabilization Services, mobile crisis teams and community providers. It cannot, by itself, explain how a specialist decides which connection to make, which information may be shared, what happens when a destination is unavailable or who remains responsible during the handoff.
We learn those conditions directly from the people performing the work and build them into the platform.
The process also exposes differences that should not be erased. One center’s workflow may reflect its staffing model. Another may reflect rural geography. A third may have a long-established relationship with a particular PSAP. The design task is to distinguish beneficial local variation from fragmentation that creates unnecessary burden or risk.
That is why we treat stakeholder engagement as part of the engineering itself.
One environment, three ways to ask for help
Voice, text and chat are often managed as separate channels because they arrive through different technical paths. The person seeking help does not experience their need as three different services.
In the Ohio platform now under development, we are bringing those modalities into a common statewide environment. A text exchange has a different pace and information pattern than a phone conversation, and specialists and supervisors need coherent tools across all three channels.
That coherence can reduce avoidable switching and re-entry. It can support more consistent documentation and make it easier to understand system demand across modalities. It can also help the state see whether staffing and resources match when and how people are reaching out.
For specialists, fewer transitions between tools mean more attention can remain with the person asking for help.
Our job is to make the technology recede so the specialist can keep listening.
Smart routing begins with geography, but cannot end there
We do not treat routing as a simple queue that sends the next contact to the next available person.
For crisis systems, availability is only one variable.
The most appropriate center may be determined by the caller’s location, local response resources, an existing PSAP relationship or a community pathway that can continue care after the conversation ends. Capacity still matters, especially when demand rises, but expanding capacity should not casually sever the local context that gives a response meaning.
We are designing Smart Routing for Ohio to balance those factors. It prioritizes geography and established PSAP relationships while allowing the network to expand response capacity when circumstances require it.
Our routing design has two jobs: get people to the right help quickly and give the statewide workforce the flexibility to absorb demand without isolating local centers.
For Ohio, good routing preserves local continuity even as the statewide network shares capacity.
A warm transfer must carry more than a call
A warm transfer is more than keeping one party on the line while another joins.
It works only when context and responsibility move with the call.
The receiving party should understand why the contact is being transferred, what has already been learned, what level of concern has been identified and what the person expects to happen next. The original specialist should know when responsibility has actually changed. The caller should not have to reconstruct the entire crisis for every new participant.
We are designing Ohio’s platform to connect 988 interactions with NG911, MRSS, mobile crisis and community resources in ways that support coordinated dispatch and follow-through. That requires communications, documentation, roles and workflow to align.
Continuity depends on technology, policy, training and human judgment working together.
The button initiates the handoff; the surrounding workflow makes it warm.
Documentation should follow the conversation
Crisis specialists must be present with the person while also creating an accurate record. When forms are repetitive or disconnected from the interaction, attention is divided and the same information may be entered several times.
We are building adaptive documentation capabilities that respond to the course of the interaction instead of forcing every contact through an identical sequence. We are also implementing consent-based smart-documentation functions that can help create structured drafts for specialist review.
Our approach keeps the specialist in control: the platform assists with drafting, and the specialist reviews, corrects and approves the record.
The specialist can review and edit the draft before approving it as part of the record, protecting both usefulness and accountability.
Our goal is documentation that protects the specialist’s attention and preserves the conversation accurately.
Statewide visibility should serve local action
A centralized platform can give state leaders a more timely view of contact volume, modality, staffing demand, transfer patterns and regional service use. That visibility can improve planning and resource alignment.
We are designing statewide visibility around action, not reporting alone.
The value of statewide information is what it allows people to do: anticipate a surge, identify a capacity gap, adjust staffing, strengthen a referral pathway or understand where callers are having difficulty reaching the next level of care. Local centers should gain useful operational clarity as they contribute to the statewide picture.
That exchange keeps the platform useful at both levels: consistent information for state planning and timely operational clarity for local centers.
That is the statewide feedback loop we are building with Ohio.
Modernization advances through disciplined delivery
Work on Ohio’s State Centralized Platform is actively advancing.
Together with the State and local centers, we are translating frontline realities into configuration, integrations, testing, training and implementation decisions. We measure progress by whether the platform being designed is moving closer to the system people actually need.
Ohio’s 988 Administrator has recognized RingMD’s approach as collaborative, transparent and stakeholder-driven, with attention to both center-level operations and state-level oversight. That is the standard we bring to the work every day.
RingMD builds confidence through visible delivery: we listen before configuring, test with the people who will use the platform, preserve accountable human decisions and keep local partners inside the feedback loop.
Our architecture is built to strengthen statewide coordination and local intelligence at the same time.
A centralized crisis platform succeeds when one connected system makes the knowledge of nineteen centers available at the moment one person needs the right local response.