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Digital EMS Program Overview

Digital EMS Program Overview. Larry Flournoy Interim CIO Texas A&M University System Health Science Center Associate Director - Academy for Advanced Telecommunications and Distance Learning 6 May 2002. DREAMS TM Research Areas. Focused on improving the recovery of civilian and military

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Digital EMS Program Overview

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  1. Digital EMS Program Overview Larry Flournoy Interim CIO Texas A&M University System Health Science Center Associate Director - Academy for Advanced Telecommunications and Distance Learning 6 May 2002

  2. DREAMSTMResearch Areas Focused on improving the recovery of civilian and military personnel subjected to trauma B Basic and Clinical Sciences Focused on detection, identification, and remediation of biological & chemical agents B Biological and Chemical Warfare Create virtual presence by the physician to enable earlier intervention into the medical emergency D Digital EMS

  3. Digital EMS The Problem How to overcome the negative impacts of increased time and space during a medical emergency. The Approach Use high quality video and physiological telemetry to create an adequate level of situational awareness for physicians to telementor emergency medical personnel onboard the ambulance. Challenges • Managing high bandwidth applications in a wireless environment. • Providing a common user interface while integrating many systems related to medical monitoring and diagnostics.

  4. Design Philosophy • The well-being of the patient is and will always remain our top priority. “Saving lives is the only motivation for this project.” • System design will emphasize “graceful degradation” of onboard systems. “The total failure of all Digital EMS systems leaves EMS personnel with the same capability that they have currently.” • Digital EMS systems will be designed to aid EMS personnel and make them more effective without introducing a large training requirement. “A large part of this project involves the development of user interfaces that are as simple as possible and can easily be integrated into current EMS personnel’s procedures.” • Frequent interaction with the user is essential to the overall success of the program.

  5. “Scoop and Run” • Augmentation for traditional ambulance missions (esp. rural areas) • Physician intervention sooner Transport • Monitor patients while transporting from one treatment facility to another • Army field ambulance mission Defining the Mission Space Telemedicine • Lowest common denominator • Especially useful in medically underserved areas Disaster Relief • Command center during mass casualty situations • Facilitate triage

  6. Ground Ambulance Primary Hospital Man Portable Systems Air Ambulance Secondary Hospital People Existing Infrastructure • Includes both civilian and military prototypes • Full implementation of Physician’s Workstation • Includes Medicam, Xybernaut, and WARP • Hermann Life Flight • Less than full implementation of Physician’s Workstation • Physicians, EMS personnel, and system maintainers • Integration into current practices and procedures System Components

  7. The Systems Integration Challenge

  8. Internet Current System • Vital Signs • Monitor MEDICAL BreezeCom • Driver’s License • Scanner Campus Fiber • Physician • Workstation • Portable Ultrasound HARDWARE • Digital • Physiological • Data Richardson Building • Paramedic • Workstation • MedicCam • Wireless HMD • Run Record • Database • Xybernaut • Wearable • Computer • Electronic • Patient • Record • Database HARDWARE • PTZ Cameras • GPS Receiver Wisenbaker Engineering Research Center • Video Capture Xybernaut • BreezeCom • Base Station • Microphones • & Speakers • CDPD via the • Internet MedicCam • BreezeCom • Wireless Network • Ambulance • Communications • Bridge CDPD COMMUNICATIONS • CDPD Modem COMMUNICATIONS • MedicCam • Receiver

  9. Parallel Activity Satellite Antenna Development Decision Support Systems Standards and Policies Digital EMS Systems Integration Security (HIPAA)

  10. Digital EMS Breakthrough Technology Areas • System Level Impact of Digital EMS • A unique collection of digital technologies will create a virtual presence by the physician and permit a remote mentoring environment. • This virtual presence will enhance current life-saving protocols by involving the physician sooner. • Intelligent Communications Processing and Management • A “smart” communications manager using software agent technology that can balance bandwidth requirements versus bandwidth availability will be developed. • Multi-modal communications will be treated as a single channel with dynamically varying capacity. • Multi-Channel Real-Time Video/Audio Processing • Dynamic management of multiple video/audio streams will permit a high level of on-board situational awareness by physicians at remote locations.

  11. Intelligent Communications Manager • Linux-based middleware that “multiplexes” both heterogeneous and homogeneous communications paths to facilitate management as a single pipeline. • Phase 1 - Complete data stream sent over selected path • Phase 2 - Packet level management for selected path • Rule-based approach where n is the number of communications paths available

  12. Intelligent Communications Manager Satellite Bandwidth Pool Data Radios Cellular Modems CDPDs Virtual Pipeline (all communications systems operational) CDPDs Cellular Modems Bandwidth Pool Data Radio Virtual Pipeline (after loss of satellite and one data radio)

  13. NBC News Coverage

  14. Technology Transfer • Where possible, existing or newly developed technology should be shared between the Army and the Digital EMS project (bi-directional). • Two candidate Army programs for integration into Digital EMS: • Medicam • Life Support for Trauma and Transport (LSTAT)

  15. U.S. Army Field Ambulance • Feasibility studies have begun to look at requirements for transferring Digital EMS technology to a U.S. Army field ambulance. • Digital EMS team willing to outfit and field prototype anywhere in the world based upon desires of U.S. Army.

  16. Standards

  17. Standards in DEMS • Open standards • De facto standards • Internal standards • Hardware • Software • Development

  18. Standards in DEMS • Adopt • Existing standards where they exist and the standards meet our needs • Adapt • Existing standards where feasible • Develop • Internal standards as needed • Drive • Development of new standards with SDOs

  19. Standards in DEMS • Tracking an erratically moving target • Using IEEE, ASTM, HL7 approved or draft standards • Working within several SDOs to influence the development or revision of standards

  20. Interact Photographs

  21. The Box

  22. The Action Wall

  23. Tracking Ku Band Prototype

  24. Antenna Details

  25. Training Simulator

  26. HMMWV Photographs

  27. These are Good Conditions

  28. A New Patient Compartment

  29. A Real Patient Compartment

  30. Environment

  31. The Houston Flood

  32. Problems • Lack of Medical Equipment Standards • Electrical and Power • Network Protocol Support • Web and Programming APIs • RF Noise Suppression • Acoustic Noise Suppression • Shock and Vibration Isolation

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