Exchanging Information in the Multimedia Age

EMS’ struggle to get on the same wavelength

 

 
 
 

Gregg Lord, MS, NREMT-P | From the October 2010 Issue | Friday, October 1, 2010


In 1990, the Institute of Electrical and Electronics Engineers defined interoperability as, “The ability of two or more systems or components to exchange information and to use the information that has been exchanged.” 1

This definition, although not entirely applicable in today’s emergency environment, points to the foundations of interoperability.

The term “interoperability” has been broadened to go beyond systems and information and include the ability to freely communicate across any medium. Despite a significant effort in the past 10 years, the after-action reports from virtually every disaster in recent history have identified “communications” as a major issue during the response. It almost seems that interoperable communications is the “holy grail” of disaster operations.

After billions of dollars, we still don’t have a magic button that will enable us to talk to all other responding agencies and disciplines. So why is it that we can see uploaded videos from virtually anywhere in the world within minutes of an incident, yet we still struggle to be interoperable in the multimedia world? The issue is only partly technological. But in order to truly create interoperability, we must also address the human element.

Interpersonal Engagement
On a local level, interoperability is usually less about technology and more about interpersonal engagement. Federal Emergency Management Agency (FEMA) Deputy Administrator Richard Serino puts it succinctly with his statement, “Being at the table is a big issue for EMS systems. If you, as an EMS system, aren’t participating [at the table], you won’t be interoperable when the need arises.”

Interoperability is fundamentally a process whereby emergency response systems continually interact and evolve with each other, both technically and human-to-human, to ensure communications capability every day. Interoperability during times of disaster should not only involve public safety agencies, but also incorporate the non-governmental organizations (NGOs) that will be active participants in a large-scale incident.

All of us have firsthand experience with the difficulties encountered due to the lack of interoperable communications between first responders and related agencies and entities. Why do we continue to tolerate significant gaps in this area? The answer is simple but not easy. We need systems, procedures and agreements (human relationships) that allow all first responders to effectively communicate and share information in real time to meet operational needs.

To implement this “simple” answer, three areas must be addressed and resolved:
Human Elements: jurisdictional and procedural alignment and agreements;
Technical Elements: physical commu-nications media;
Time Elements: ease of adoption and use of technology.

Until these areas are addressed, interoperability will be an issue. Addressing them involves several different disciplines within several organizations across varying geography and demographics, each with different views of the problem and the “right” solution.

A frequently proposed solution involves massive investments in new communications technologies; however, in other instances it involves the implementation of standard operating procedures that can be at odds with commonly practiced procedures.

Unfortunately, both “solutions” ignore some critical realities, such as the inherent lack of fiscal resources for massive equipment purchases and the equally important area of human factors that will affect resolving interoperability.

Human Operability
Lack of Proper Communication: First, we often describe the problem by saying, “people can’t talk to one another,” which creates an operational environment at an incident where information isn’t reaching those who need it most. An equally serious problem can occur when too many people are talking, which can lead to a far more serious problem—misinformation.

Lack of Familiarity: The second human factor involves the use of special operating procedures that come out only during a “unique” incident requiring an interoperability solution. From an emergency operations perspective, exchanging business cards on game day is the wrong time to get to know your colleagues. This concept applies to people as well as special equipment or systems that are literally hauled out during an incident for use by people who have not seen or used them in some time or have never met each other.

Lack of EMS Engagement: Showing up matters. The EMS system’s leadership must act as a gateway to the hospital systems that serve our communities and also ensure a presence at every meeting involving preparedness, response and recovery issues within their community. EMS must be the face of the health and medical response. This requires effort and consistency to ensure collaboration and cooperation with other public safety agencies. Enabling and engaging the health-care community in the development of interoperable solutions will allow the incident command system to make good decisions regarding the management of the sick or injured during an event.

The flow of data, voice and video can provide significant operational awareness to the responders and to the first receivers and other NGOs who will be participating in the incident. EMS should actively advocate for this inclusive process.

Technical Interoperability
Historically, we think of interoperability as the linking of land mobile-radio systems used for communications between dispatch and field personnel and for field-to-field communications.

Different frequency bands, channel allocations, modes of operation, protocols and coverage areas can inherently lead to the inability to communicate. Our communications systems in public safety, like our EMS systems, are all unique.

Therefore, it’s not practical to assume all this equipment can be replaced and standardized in today’s economic climate. User needs vary, and the “one size fits all” approach isn’t practical or politically viable. In the absence of standardized equipment, radio transmissions standards continue to evolve, albeit slowly.

A good example is the current state of the APCO-sponsored Project 25 (P25). The P25 is the standard for the design and manufacture of interoperable digital two-way wireless communications products. Developed in North America with state, local and federal representatives and

Telecommunications Industry Association (TIA) governance, P25 has gained worldwide acceptance for public safety, security, public service and commercial applications. Such companies as Motorola Inc., Harris Corp., EF Johnson Technologies, European Aeronautic Defense and Space Company (EADS) have developed systems that comply with the P25 standards. This valuable work needs to be continued, but it merely addresses the transmission of radio waves. It’s not “the” answer.

Unfortunately, neither is the proposed 700MHz broadband initiative, which uses the 3GPP Long Term Evolution Standard because this system builds on existing infrastructure that has yet to be updated to 4G systems. This initiative aims to use previous television spectrums to overlay broadband for the development of extensive voice and date capability. Broadband wireless data network systems via Internet protocol (IP), which send data from one computer to another via the Internet, may be the best answer for many locations. However, its ability to accommodate voice and be used extensively across the country may be questionable due to capacity and infrastructure issues.

Another concept in development is the notion of public/private integrated networks in which broadband and frequency-based systems are being synchronized, but the technical and economic details are a long way from being resolved. Eventually, all the technical hurdles will be overcome by both P25 and broadband 700MHz, yet the high costs and lengthy implementation cycles will prevent these systems from resolving the current interoperability issues.

Time Elements: The ease of adoption and the availability for everyday use dictates the time capability of any system put into use. Whether it’s a “radio patching” system or a 700MHz broadband system, the ease with which a first response system adopts the technology must be brief and above all, require limited training. This will ensure that regardless of who’s using the technology, they can learn on the fly and enable the interoperable communications when needed. If the time to learn a new system is extensive, then it will limit its use when the incident requires everyone to use it.

Common Solutions
The most common current solution to the interoperability problem involves either radio swapping for fiscally challenged systems or, for fiscally robust systems, cross-patching communications channels while on scene. There are, of course, many variations of these two basic concepts. The radio swapping technique relies on individuals with one of each radio involved to provide “human cross-patching.” This technique is error prone at worst and confusing at best.

Providing common radios to all users on site or asking all users to use a common mutual-aid channel improves this situation if enough equipment is available and each user understands how to use the equipment. However, the increased potential for “too many people talking too much” could lead to extensive command and control issues.

Channel cross-patching is a technique that can occur at either a centralized location (e.g., a dispatch center) or on scene. This technique assumes that this central point person should take control of the resources and decide “who will talk to whom, when and for how long.”

In typical on-site systems, a communications vehicle equipped with radios from each potential organization may become involved in an incident. A communications officer then patches the various radios together to form one or more common links among those present at the scene. Another option for creating radio inter-connectivity is the use of IP as the preferred common denominator to patch these systems together.

This approach focuses on interoperable voice communications between public safety agencies. This leaves out the largest-growing area of interoperability—data transmission. During incident operations of the future, the solution should include real-time data on assets deployed, and, in reserve, patients triaged, treated and transported and video feeds of the event. However, due to Federal Communications Commission restrictions, our current, common solutions also prevent the integration of NGOs; the P25 and proposed public safety wideband initiative are limited to public safety agencies only.

Response to a large-scale incident, the most frequent reason for “interoperability,” can no longer be viewed strictly as a public safety operation. Communitywide interoperability plans must account for and develop capacity for the integration of the NGO community (e.g., The American Red Cross, hospitals and shelters), which will participate in the incident response.

We can no longer restrict our perception of the interoperability problem as strictly involving voice communications.

We must also think of multimedia communications, involving multiple public agencies and private entities within the community. Private EMS services, mass transit operations, hospitals, public venues, utilities, schools, shopping malls and private company facilities should be involved in natural and man-made event response.

With such wide audiences and disparate multimedia devices, EMS leaders must find unique approaches to addressing all three interoperability issues. Imagine a paramedic team en route to a mass casualty incident being able to communicate directly with providers already on site and with their base hospital.

Imagine them seeing live video of some of the patients. Furthermore, visualize a senior official, watching live video of the scene and also communicating via the interoperable network. This should ideally be accomplished with a few mouse clicks. This sort of inclusive, interactive and connective technology can improve the human element of the interoperable problem.

Leading the Pack
One system leading the pack in interoperability is New Jersey’s Preparedness Network. This system, produced by Mutualink, uses a robust, redundant and secure data backbone Internet protocol network that links all entities together and supports real-time voice, video and data transmissions. The network consists of law enforcement agencies responsible for dozens of communities in eight counties representing a population of 5 million people, as well as the statewide transit agency, various agencies’ command vehicles, a rescue boat, 25 hospitals, shopping malls, corporate office facilities, a sports arena and schools.

Another application currently using IP for the communications backbone is the Cisco Systems, Inc. IP Interoperability and Collaboration System (IPICS). This system, in use in the city and county of Honolulu, creates an environment where system administrators can connect various public safety communications users.

The use of IP to develop connectivity and interoperability appears to be a cost-effective solution in the short term and the long term, as the capability of broadband wireless technology continues to evolve. The real issue presented by technological solutions is whether they promote the human element.

Conclusion
Your agency should be asking, ‘Do the systems in place promote ongoing and consistent engagement with ease of use and the opportunity for daily use as part of the interoperability process?’

Communitywide interoperability systems are available today and can and should be implemented by agencies and entities of virtually any size. Combining that type of technology with human participation and inclusion at all preparedness and planning meetings will serve everyone in your system well when the “big one” happens in your community.

Interoperability is a perpetual journey, not a destination. It must be developed, nurtured and consistently practiced if we are to achieve a state of community interoperability. The technical systems are only part of the solution, but as with all technology, it is the human utilization and expertise that will lead to a successful operation.

The process of collaboration will alleviate turf battles, enabling all response organizations to seamlessly communicate in real-time. Someday, we may even have an after-action review that doesn’t start off by saying “communication was a major issue.” JEMS

References
Institute of Electrical and Electronics Engineers. IEEE Standard Computer Dictionary: A Compilation of IEEE Standard Computer Glossaries. New York: 1990. http://ieeexplore.ieee.org/servlet/opac?punumber=2238

This article originally appeared in September 2010 JEMS as “Communication Breakdown: EMS’ struggle to get on the same wavelength.”
 
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Gregg Lord, MS, NREMT-P Graydon "Gregg" Lord, MS, NREMT-P, is associate director for the National EMS Preparedness Initiative and senior policy analyst at the Homeland Security Policy Institute of The George Washington University. He retired from Worcester EMS in Worcester, Mass., in 2001.

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