Linking Pre-Hospital Emergency Care in Baton Rouge
Nov 12, 2014
Linking Pre-Hospital EmergencyCare in Baton Rouge
What is EMS Telemedicine?
TELEMEDICINE is defined as the delivery of health care at a distance.
But isn’t that what EMS has ALWAYS done?
What is EMS Telemedicine?
So why is “EMS” telemedicine something “new”?
What’s “new” is the ability to send large amounts of data at low cost in a
mobile wireless environment.
What is EMS Telemedicine?
So where will this take EMS?Because sending images and data is
becoming as commonplace as the home computer, EMS has already begun to move in this direction.
SO WHAT WE HAVE LEARNED?
The nature of EMS is such that communications and technology
has, and always will play a defining role...
SO WHERE IS ALL THIS TAKING EMS
EMS will improve itself by capitalizing on the capabilities
offered by advanced communications and information
management technologies …You can call it EMS telemedicine
(or whatever you like)!
Cardiac CareTraumaStrokePediatric & Other Specialty Care
MCI & DisasterPatient Refusals
What will EMS telemedicine mean for the Hospital?
Patient Care Applications
Risk ReductionManagement of Patient Data
Alleviate ED OvercrowdingTraining & QAMedical/Legal
DocumentationResource utilization
What will EMS telemedicine mean for the Hospital?
Operational Improvements
Staff TrainingCommunity RelationsEnhance Hospital Stature
Homeland Security & Disaster Response
EMS Included in Pt. Medical Record
Reimbursement???
What will EMS telemedicine mean for the Hospital?
Benefits
Extreme
Example…
Practical Example …Baton Rouge EMS “BR Med-Connect”
Answering the Call
Demo
How Does it Work?
E-Bridge– Ambulance Equipment
CarePoint System– Hospital Equipment
Connectivity – Wi-Fi Mesh Network– Cellular Air Card (Verizon, AT&T)
How Does it Work?
E-Bridge– Ambulance Equipment
How Does it Work?
CarePoint System– Hospital Equipment Controls Data
& Communications
Displays &Controls Video
Contact Any Hospital with 2 button clicks
Once in Session – Doctors Control Cameras from control panel
Can Send 12 Lead Strips to any email or fax machine
How Does it Work?
How Does it Work?
Connectivity – Wi-Fi Mesh Network– Cellular Air Card (Verizon, AT&T)
How Does it Work?
Connectivity – Wi-Fi Mesh Network
How Does it Work?
Connectivity – Wi-Fi Mesh Network– Cellular Air Card (Verizon, AT&T)
Issues with Technology
Is This High-Def TV??
No – We cannot expect mobile video to be crystal clear moving 60 mph down the interstate
– At least not yet!
Issues with Technology
Quality of Transmissions
Over the Wi-Fi Has More bandwidth – very good video, audio,
and data transmissions
Downside – fewer mesh locations available across the city/parish because of the cost of equipment and deployment
Need technical people to maintain the system
Issues with Technology
Quality of Transmissions
Over Air Cards Video quality can be choppy- audio can be
broken up
Sending data is reliable
No maintenance necessary
Upgrading is easy and no additional cost
BR Med-ConnectWIRELESS MESH NETWORK
• 455 Square Mile Area• Currently 9 Square Miles Covered• 95 Total Node and Gateway Radios• 21 Ambulances• 7 Hospital
BR Med-ConnectCONNECTING THE HOSPITALS
Daily telemedicine calls
Ability to share data between hospitals
Video conferencing between hospitals and Office of Homeland Security during disasters
BR Med-ConnectPLAN FOR DEPLOYMENT
• 78 Square Mile – City of Baton Rouge
• Cover Major Streets First
• Expand to Parish Rural Areas
• Work With the 3 Other Cities in the Parish to Include Their Area
EMS Pilot Program
STEMI Patients
“Patients having ST-segment elevation myocardial infarction, or STEMI, heart attacks have the best chance of a good outcome if they get primary percutaneous cardiac intervention (or "angioplasty") within 90 minutes of arrival at a hospital, recent research confirms.”
EMS Pilot Program
Process• Acquire 12-Lead• Establish video call with hospital and connect all diagnostic
equipment - ready to send data • Send 12-Lead to receiving hospital
– PDF version goes to CarePoint system– Raw data from Zoll Monitor goes to pick up point on city server to
be retrieved by Southern Medical – to be included with previous patient record
• ED staff conducts patient evaluation – Voice, Video, EKG, SpO2, BP Monitoring, Breathe Sounds, Pulse
• Session can continue in-route to hospital• All data along with voice recordings are part of patient
record
EMS Pilot Program
Future Planned Studies
• Identifying severe sepsis patients – Provide early antibiotics treatment
• Stroke Patients– Early Thrombolytic Treatment ?
• Trauma– Using portable sonogram technology
Funding
• Multi Agency Project– Police Crime Cameras, Reporting– Fire Reporting, Inspections– DPW Inspections– EMS Telemedicine, Reporting
• Total City Investment to Date– $200,000
• Federal Grants– Health & Hospitals– Homeland Security
• Federal Stimulus Money• Department Budget Dollars