gms | German Medical Science

49. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds)
19. Jahrestagung der Schweizerischen Gesellschaft für Medizinische Informatik (SGMI)
Jahrestagung 2004 des Arbeitskreises Medizinische Informatik (ÖAKMI)

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie
Schweizerische Gesellschaft für Medizinische Informatik (SGMI)

26. bis 30.09.2004, Innsbruck/Tirol

Teleambulance: An UMTS Trial for Emergency Medical Services

Meeting Abstract (gmds2004)

Suche in Medline nach

  • corresponding author presenting/speaker Mehmet Kus - Centre for Information and Communication Technology (ikom), Bremen, Deutschland
  • Lars Ehrichs - Centre for Information and Communication Technology (ikom), Bremen, Deutschland
  • Amadou Amadou - Centre for Information and Communication Technology (ikom), Bremen, Deutschland
  • Manfred B. Wischnewsky - Centre for Information and Communication Technology (ikom), Bremen, Deutschland

Kooperative Versorgung - Vernetzte Forschung - Ubiquitäre Information. 49. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds), 19. Jahrestagung der Schweizerischen Gesellschaft für Medizinische Informatik (SGMI) und Jahrestagung 2004 des Arbeitskreises Medizinische Informatik (ÖAKMI) der Österreichischen Computer Gesellschaft (OCG) und der Österreichischen Gesellschaft für Biomedizinische Technik (ÖGBMT). Innsbruck, 26.-30.09.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04gmds019

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/gmds2004/04gmds019.shtml

Veröffentlicht: 14. September 2004

© 2004 Kus et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Introduction

The xMotion project (eMobile test-bed for interoperability of networks in eLogistics), was supported by the information society technologies program of the European Union, and includes three trials, which all employ the UMTS technology in new application areas [2]. One of these trials is Teleambulance, which is using the UMTS technology for emergency medical services. Analysis of the current services shows deficits in the area of communication and documentation. This paper describes the results of the Teleambulance trial.

Methods

One important goal in emergency medical services is to provide the most experienced knowledge and expertise available as soon as possible and in the most cost-effective manner. This is assisting the earliest possible treatment for patients. Teleambulance builds a bridge betweeen the intensive care unit at the hospitals and the ambulance cars, starting on arrival at the scene of emergency. There are many factors that influence the time to arrival at the hospital emergency ward. The project implements the UMTS technology in telemedicine to provide a monitoring link between patient and the medical care teams and medical specialists.

The Teleambulance trial considers two application scenarios, the emergency case and the transport of patients. In the first scenario, after giving the patient first aid on the emergency location, the patients' fast transportation to the hospital and the instantaneous further treatment in the hospital are decisive. This procedure can be greatly improved by the use of advanced communication systems as applied in the xMotion project. Remote expert support can be given to the paramedics on spot and in the ambulance. Live Medical data, audio/video data and the emergency report are transmitted in advance to the hospital, allowing to prepare the treatment immediately after arrival. The second scenario performed in the Teleambulance trial of the xMotion project is the transport of patients. The patient is monitored while being transported from one hospital to another, because there is better or sooner treatment available. Remote expert support can be given to paramedics or doctors accompanying the patient.

Ambulance services use many different communication systems and therefore are a prime candidate for interoperability tests. The communication needs of paramedics vary greatly depending on the situation they are in. For routine calls it is helpful to access a patient's medical record to make a full assessment of their condition. In emergency situations it may be necessary to transmit the patient's vital signs and 12 lead electrocardiograms to the hospital or to receive consulting advice from specialist doctors not available at the patient's location. Teleambulance is enabling these technologies over 2.5 and 3G networks. The demonstration system comprises different technologies together with user-friendly interfaces for paramedics and doctors, and wearable monitors with digital transmitters. The communication networks used in the project are GPRS, WLAN and UMTS. Public communication networks considered for the Teleambulance trial are the T-Mobile UMTS test bed in Bremen as well as the commercial T-Mobile GPRS service. Teleambulance considers standards on a number of levels, namely: data exchange and security level; syntactic level (e.g. XML); semantic level (e.g. clinical coding standards such as International Codes for Diagnosis - ICD10, SCP-ECG, LOINC); and user level. It is essential for this kind of project that security standards are considered at every development stage.

Results

Teleambulance realizes a common workbench which combines different medical devices in one universal user interface. In the workbench the output of all devices can be shown. It is also possible to select manually which data is sent to the hospital. The emergency doctor report [1] contains administrative data (name, address, assurance information and technical data), patients' emergency records (findings, first diagnosis and measured values like ECG) and results of the emergency treatment. The gathering of electronic data for the emergency doctor report is realized by using an electronic pen (based on AnotoTM technology), which scans the data while the doctor is filling the report on a digital paper. Teleambulance successfully implements the transmission of 12 lead live ECG based on Corpuls soft- and hardware. A communication gateway realizes a transparent use of applications regarding the available channels GPRS, UMTS and WLAN [3]. The best available services on given smart profiles are automatically selected, depending on the bandwidth required by the respective application and the urgency or nature of the data to be transmitted.

The Teleambulance trial is based on the integration of information and mobile communication technologies. The development and introduction of new technologies progress more adequately if they are evaluated systematically from a user point of view. In evaluating user aspects of the Teleambulance trial, a set of related interacting factors was considered: i.e. the interaction of users, tasks and the technical system in a 'context-of-use'. Essential for the development of Teleambulance application was the attention to the needs and problems of the different stakeholders. The system was tested under two conditions: (1) lab testing, in which the Teleambulance unit was in a laboratory, and (2) on-site-testing, in which the Teleambulance unit was placed on a moving ambulance with simulated patients. For each test, user groups evaluated the trial.

There are particular savings and benefits from doctors' use of Teleambulance. Doctors can intervene earlier when a patient's condition is deteriorating or medics can involve other specialists to examine patients. The system can also save time in the documentation process. Savings and benefits for patients are that patient emergencies can be managed immediately and treatment can begin earlier. Patients in rural countries can have consultation treatment via Teleambulance, saving the cost and time involved, more experts or external knowledge sources are available. Doctors have more time for patients resulting by the faster and easier documentation process. The project demonstrated successfully the use of UMTS/GPRS technologies for ambulance services. The extensions of the xMotion visions to the homecare sector and for other mobile health solution are future opportunities.

Discussion

For many people working at emergency services, mobility is an ever-present aspect of their work. Medics in the emergency area for example are used to work on a team basis and need cross-references with others. The basic knowledge has to handle specific emergencies on various specialities e.g. cardiologic, gynaecology and surgery. Mobile audio and video communication can substantially improve safety, efficiency and service quality for mobile workers. Introducing changes in the field of emergency work requires an understanding of the existing structures including work processes and business models. The collaborative scenarios of new emergency applications and services achieve a seamless integration of gathered data by ambulance doctors, fire fighters and policemen. Mobile communication technology can be used to support both the central as well as the distributed disposition of available forces. Emergency features of the cellular and mobile networks (2.5/3/4G) and the integration with ad-hoc networks are exploited to set-up special on-demand communication networks and distribute context sensitive data, supporting the emergency units. The decentralized nature of Europe's Emergency Management can lead to difficulties with the co-ordination and communication of the involved forces. With new emergency services and applications this complexity of coordinated operations can be reduced.


References

1.
DIVI. Harmonised German Emergency Doctor Report. German Interdisciplinary Association of Critical Care Medicine. http://www.divi-org.de/
2.
Official Web-Side of the project xMotion (eMobile Testbed for Interoperability of Networks in e-Logistics), IST Programme, Contract No IST-2001-36059, http://www.ist-xmotion.org
3.
Timm-Giel A, Amadou, Aust St, Ehrichs L, Görg C, Kus M, Wischnewksy MB. UMTS Applications Trials: Teleambulance IST project xMOTION. IST Mobile & Wireless Communication Summit 2003. Aveiro, Portugal 2003; 727-731