It is surprising to me that airports do not use an interlock system for deconflicting the various paths segments that may be occupied by a vehicle. Trains have used mechanical ones since the 1800s [0]. The story and comments seem to indicate the only thing preventing collisions is the mind of one person--that sounds insane.
If school busses can look both ways before crossing train tracks you'd think a firetruck would look both ways for airplanes coming down a runway. Don't want to blame the firemen though - this was a series of extrmeemly unfortuante scenarios and people trying to keep the airport running safely. For years people have been on soap boxes saying the FAA/NTSB needs to do better, and yet year after year they are poorly run and poorly funded.
While it's not as sophisticated, there is a technology called Runway Entrance Lights [0] that does somewhat the same thing in the specific context of this incident. LGA is one of 20 airports around the country where this system is installed, and you can clearly see that the system was functioning if you know where to look in the surveillance video that is circulating online. For whatever reason, the truck did not respect the indicator that they should not enter the runway. So in this specific incident, short of rail-like physical limitations on movement, I think it's unlikely that any amount of additional technology would have helped.
0: https://www.faa.gov/air_traffic/technology/rwsl