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Ambulance-based Telemedicine Saving Lives in Real-Time

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For disaster relief operations or emergency medical services (EMS), time is much more than a matter of money—it's a matter of life and death. An ambulance-to-hospital based telemedicine system is the best example of how mobile technology can help save lives, by providing real time patient information to the hospital via wireless communications, enabling remote diagnoses and primary care, and reducing rescue response time.

Ambulance-based Telemedicine Saving Lives in Real-Time

Telemedicine, as defined by the American Telemedicine Association (ATA), is the use of medical information exchanged from one site to another via electronic communications, to improve a patient's clinical health status.

Telemedicine includes a growing variety of applications and services—from remote health monitoring to medical education. Among these applications, ambulance-based telemedicine uses the most up-to-date vehicle electronics and mobile communications technology, aimed at providing a significant time advantage, expediting critical treatment and improving patient outcomes.

For example, when rescuing car crash victims, with a telemedicine system onboard an ambulance, the vital signs of the wounded (e.g. ECG, blood pressure, respiratory rate) can be measured and transmitted to the hospital instantly via a wireless (3G/Wi-Fi) communication network. Additionally, videos taken by digital cameras installed in the ambulance can be sent to the hospital in real-time.

On the hospital side, emergency room physicians and nurses can receive and review the incoming data at a desktop PC or on a mobile device such as a tablet or smartphone, and make preliminary assessments before the arrival of the patient. The ER docs can also zoom-in to see the wounds, discuss the situation with the emergency medical technicians (EMTs), and instruct the EMTs to administer primary care or emergency medical services, such as giving injections or fracture treatment.

The emergency and trauma physicians can also triage cases remotely, and start to prepare a surgery team if needed, prior to the patient's arrival. If they decide the available medical resources of the hospital are insufficient for the situation, they can refer the case to an alternative medical care center, to save time.

Ambulance telemedicine is aimed at sparing every minute that can possibly be used to save lives. Such pre-hospital systems are also vital for patients suffering from a stroke or cardiac diseases. Earlier assessment and treatment of strokes during critical moments can save lives and minimize aftereffects.

Ambulance-based telemedicine is particularly valuable for residents living in remote areas, a long distance from hospitals and clinics, as well as for casualties in remote locations.

Application Architecture

An ambulance-to-hospital based telemedicine system requires a ruggedized IPC platform to enable multiple onboard wired and wireless devices (including medical apparatus), and to provide wireless connection with the hospital.

Digital cameras must also be installed in the vehicles, to record how emergency medical services are administered, and to send the hospital real-time images of the patients. A microphone is also necessary, for communication between onboard ambulance technicians and doctors in the hospital.

GPS deployment is also desirable, in order to allow the hospital to locate the vehicles and provide the shortest routing, so patients are sent to the hospital as quickly as possible.

In addition to the hardware platform, well-developed software is necessary to carry out these applications using a seamless and reliable connection.

The telemedicine system must be integrated with the hospital's patient information system, so ambulance technicians and hospital physicians and nurses can retrieve patients' medical history as required, to expedite medical decisions.

Additionally, the patient's most updated physiological data and test results can be sent immediately to the hospital information system, avoiding duplication of tests or treatments, and expediting medical treatment.

Functions

  • Remote patient monitoring:

    The patient's vital signs are measured onboard and sent to the hospital physicians for real-time monitoring and later review; such data may include blood pressure, blood glucose, blood gases, ECG, etc.

  • Real-time physician "telepresence":

    With direct live transmission of voice and video, physicians at the hospital can watch over the patient en route to the hospital, make remote preliminary diagnoses and triage decisions, and prepare for surgery if needed.

  • Mobile EMS services and teletrauma care:

    With directions from ER docs, EMTs can provide primary care and emergency medical services to patients onboard, such as giving injections or fracture treatments. Stroke assessment and intensive care services can also be made earlier, in critical life-saving moments.

  • GPS tracking:

    The vehicle GPS system ensures unmatched precision in dispatching and routing, allowing hospitals to reroute vehicles and reduce response time.

  • Electronic patient care reporting (e-PCR):

    The ambulance telemedicine system enables real-time transmission of vital ECG and other patient information to the hospital information system to establish or update the patient's electronic health report. This can avoid duplicate tests or care procedures, and saves lives by reducing time to treatment.

  • Specialist referral services:

    With patient information available prior to the patient's arrival, hospitals can make triage decisions earlier, and notify specialty physicians. If the patient's situation is beyond the hospital's resources or ability to care, the patient can be referred earlier to other hospitals or medical care centers to save time.

ADLINK Solution

The ADLINK MIX-110 is a small form factor (234.4mm x 191.2mm x 56.6mm), low-power, and mechanically ruggedized system providing rich I/O that can be used to connect on-board devices, enabling wired and wireless connections, and suitable for the deployment in an ambulance-based telemedicine system.

Its rich I/O features include a GPS module for providing real-time vehicle location, 3G and Wi-Fi modules to allow for wireless communications, and a mini-PCIe expansion slot that can be used to enable video applications.

Ambulances typically move at high speed in life-saving situations, so the greatest challenge for a vehicle-based telemedicine system is maintenance of reliable wireless data connectivity. The ADLINK MIX-110 provides both Wi-Fi network and high bandwidth mobile cellular network connections to ensure more reliable connectivity.

System integrators can develop application software independently, purchase applications from a third party, or use application-ready solutions provided by ADLINK.


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