technologies including virtual reality and augmented reality promise remarkable training and support for EMS in the near future. 142
and worth the effort. To achieve these ends, the following recommendations have been developed for consideration by local, state, and federal EMS partners and stakeholders.
In summary, the barriers to harnessing EMS data and HIT are real but eminently solvable
FIRSTNET: A PLATFORM FOR INNOVATIVE INFORMATION SHARING WILL CHANGE HOW EMS IS PRACTICED
KEVIN MCGINNIS, MPS, PARAMEDIC, FIRSTNET EMS BOARD MEMBER
As spectacularly as EMS has blossomed as a medical and operational public service in the past 50 years, we have not substantially progressed in the way that we share information. The VHF/UHF/ 800 trunked and other radios we used, and still use, to get dispatch information while speeding to a call, are narrow-band communications. These land mobile radio (LMR) systems are great for voice communications, but send data as slowly as dial- up internet access 20 years ago! That is insufficient to support text, picture, video, imaging and most other data communications. With the right equipment, connections and broadband communications, EMS capabilities and practice itself would change. We could, for example: • Be notified of a vehicle crash, exact location, and likelihood of severe injuries seconds after it occurs in a rural location; • Use video transmission, voice to text transmission, biotelemetry transmission, and access to/transmission of emergency health data from HIEs, to populate a patient-incident data base for access by all involved responders and hospital team members sixty seconds after arrival on scene; and • Train basic personnel in rural areas to use a portable ultrasound probe with trauma patients and transmit those images for remote interpretation. Prehospital professionals today are using commercial wireless broadband access (e.g. Verizon, AT&T) to send various types of data, mostly for administrative purposes.
Some are piloting telemedicine and other patient support uses in real time on calls. This exhibits positive attitude toward adoption of innovative technology, but a significant problem remains: • Commercial wireless broadband is not an adequate platform for mission-critical/patient-critical purposes. It lacks the reliability and resilience of public safety grade LMR systems, is not adequately cyber-secure, and has no ability to offer EMS or other public safety providers priority or preemptive use. In short, it is susceptible to the same dropped calls, diminished data rates, and network failures as are regularly experienced by public customers. During local emergencies, when the public is communicating the most (e.g., talking, texting, streaming video), responders have their worst access. The First Responder Network Authority (“FirstNet”) was signed into law in 2012 as the nationwide wireless broadband network dedicated to public safety (http:// www.firstnet.gov). It will provide virtually limitless broadband “pipe” for EMS and other responders, as well as for hospital EMS support services. Some early-builder sites already exist in New Jersey, New Mexico, Colorado, California, and Texas, and the nationwide network link is expected to be established in the next five years. It will serve as a platform for application innovation and is already seeing an explosion of EMS, police and firefighting applications being developed (e.g., http:// appcomm.org/ ).
142 Duncan McConnell, The Paramedic Foundation. IRCP 2016 January. Youtube, 1:16:22. Published January 18, 2016. https://www.youtube.com/watch?v=Ufo68NxLvq4&feature=youtu.be
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MOUNT SINAI HEALTH SYSTEM | UNIVERSITY OF CALIFORNIA, SAN DIEGO
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