In the late 1960s Gene Roddenberry, creator of Star Trek, envisioned a future society in which people could communicate from the ground to an orbiting starship, utilize a moderately-sized electronic device to take environmental readings and use an even smaller device that could be passed over the human body to diagnose injuries and illnesses.
We’ve seen some of these items come to fruition in modern times—Roddenberry’s communicators, CGIs and tricorders are our direct-connect phones, combustible gas indicators and thermal imagers—but we have yet to see the medical scanning device. We are close, however, and those of us who have been in EMS for a significant length of time have witnessed the changes that technology has brought to EMS, many of which have only just occurred within the last 10 years or so.
We are now on the precipice of taking the next big leap with the coming of the nationwide public safety broadband network (NPSBN). The First Responder Network Authority (FirstNet) has been tasked with developing and managing this network, and its Public Safety Advisory Committee has requested that organizations submit potential current and future applications that could operate on this network. The National Public Safety Telecommunications Council’s (NPSTC) EMS working group within the interoperability committee developed and submitted a list of broadband applications for consideration.
The first item on the list is a standard application programming interface (API) between EMS patient care equipment and the network. The intent is that the “interface will allow existing EMS equipment to communicate across the FirstNet network to dispatch centers and receiving hospitals.” Patient care, through the use of audio, video and data transmissions between the field provider and base hospital, could be greatly enhanced with the ability to discuss and treat a patient’s condition in real time with specialists who may be hundreds or even thousands of miles away. Rural EMS stands to benefit greatly from this technology alone.
Once the ability to communicate is established, there are a number of applications that can then be employed to include speech-to-text integrated patient care records, video-assisted patient care and vehicle design and extrication guides. Imagine having the ability to record real-time patient care information, contact the hospital and transmit data hands-free, all while remaining securely seated in the patient care compartment. Couple that with helmet cameras, point-of-care testing, portable ultrasounds and even portable brain scanners (look up the Medlogic Infrascanner 2000), and we have literally delivered the ED to the field.
Other potential applications on the list include patient tracking systems, monitors for patients with mild cognitive impairment (MCI), interactive EMS databases, resource management of personnel, EMS vehicles, helicopters, EDs, geographic information system (GIS) data and incident command systems (ICS). I could go on and on, and the list actually has 37 specific items with varying degrees of priority, but you get the gist of where this is going.
So far we have been fortunate enough to realize the benefits of dramatically improved technology and, to some degree, it has been Star Trek-like. We have improved patient care through the use of 12-lead electrocardiograms (ECGs), continuous positive airway pressure (CPAP), pulse oximetry, capnography, and blood glucose level (BGL) testing in the field, just to mention a few. We can wirelessly transmit this data from the device to a laptop computer and then on to the receiving facility where the staff can be prepared for our arrival. Ten years ago, many of us would have laughed if we had been told we would be doing these things today. Yet, here we are: We can see the future, and we are thirsting for more. While we may be part of the original series, we are rapidly advancing to The Next Generation. Our only limitation is our imagination.
For a complete list of the EMS broadband applications, go to www.npstc.org.