Rapid advances in wireless communications and networking technologies, linked with advances in computing and medical technologies, facilitate the development and offering of emerging mobile systems and services in the healthcare sector. The objective of this paper is to provide an overview of the current status and challenges of mobile health systems (m-health) in emergency healthcare systems and services (e-emergency). The paper covers a review of recent e-emergency systems, including the wireless technologies used, as well as the data transmitted (electronic patient record, bio-signals, medical images and video, subject video, and other). Furthermore, emerging wireless video systems for reliable communications in these applications are presented. We anticipate that m-health e-emergency systems will significantly affect the delivery of healthcare; however, their exploitation in daily practice still remains to be achieved

m-Health e-Emergency Systems: Current Status and Future Directions [Wireless corner]

Background Emergency medical services (EMS) agencies transport a significant majority of patients with low acuity and non-emergent conditions to local emergency departments (ED), affecting the entire emergency care system’s capacity and performance Opportunities exist for alternative models that integrate technology, telehealth, and more appropriately aligned patient navigation While a limited number of programs have evolved recently, no empirical evidence exists for their efficacy This research describes the development and comparative effectiveness of one large urban program Methods “Blinded for Peer Review” EMS initiated the Emergency Telehealth and Navigation (ETHAN) program in 2014 ETHAN combines telehealth, social services, and alternative transportation to navigate primary care related patients away from the ED where possible Using a case-control study design with multiple outcome variables, we describe the program and compare differences in effectiveness measures relative to the control group Results During the first 12 months, 5,570 patients received the intervention We found a 76% decrease in ambulance transports to the ED with the intervention (18% vs 74%, P<001) EMS productivity (median time from EMS notification to unit back in service) was 44 minutes faster for the ETHAN group (39 vs 83 minutes, median) There were no statistically significant differences in mortality or patient satisfaction Conclusions We found that mobile technology-driven delivery models are effective at reducing unnecessary ED ambulance transports and increasing EMS unit productivity This provides support for broader EMS mobile integrated health programs in other regions

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Telehealth-Enabled Emergency Medical Services Program Reduces Ambulance Transport to Urban Emergency Departments.

Paramedic Determinations of Medical Necessity: A Meta-Analysis

Background: Air transport of burn patients is plagued by frequent overtriage. We examined the use of air transport and the feasibility of using alternative methods such as telemedicine to assist in evaluation and treatment of burn patients within our region. Methods: We reviewed all burn patients transported by air during 2000 to 2001. Each patient was classified as being most appropriate for air, ground, or family transport. In addition, a decision was made regarding whether telemedicine evaluation of the patient before transport could have significantly altered initial treatment decisions. Results: Two hundred twenty-five acutely burned patients were transferred from referring hospitals in nine states, at a mean distance of 246 air miles. Mean burn size calculated by burn center physicians was 19.7% total body surface area, whereas referring physicians' mean estimate was 29% total body surface area. In 92 cases, over- or underestimation of burn size by referring physicians of as much as 560% or decisions regarding performance of endotracheal intubation suggested that telemedicine evaluation before transport might have significantly altered transport decisions or care. Air transport charges exceeded hospital charges in 21 cases. Conclusion: Frequent discrepancies in burn assessment contribute to overuse of air transport. The ability to evaluate burn patients by telemedicine may have the potential to assist decisions regarding transfer, avoid errors in initial care, and reduce costs. We are currently attempting to develop and test such a system.

Regional air transport of burn patients: a case for telemedicine?

Rapid advances in wireless communications and networking technologies, linked with advances in computing and medical technologies, facilitate the development and offering of emerging mobile systems and services in the healthcare sector. The objective of this paper is to provide an overview of the current status and challenges of mobile health systems (in-health) in emergency healthcare systems and services (e-emergency). The paper covers a review of recent e-emergency systems, including the wireless technologies used, as well as the data transmitted (electronic patient record, bio-signals, medical images and video, subject video, and other). Furthermore, emerging wireless video systems for reliable communications in these applications are presented. We anticipate that in-health e-emergency systems will significantly affect the delivery of healthcare; however, their exploitation in daily practice still remains to be achieved.

Paul A. Haskins

Papers

Predicted utilization of emergency medical services telemedicine in decreasing ambulance transports.