Internet of Things (IoT) and Prehospital Care
Wearable technologies and the internet of things (IoT) are poised to transform prehospital care.
A spectrum of vital human functions can be monitored while a patient is at home and remotely monitored by their medical providers using modified off the shelf devices or via specialty hardware that integrates with wifi or wireless communication services.
Basic knowledge of the tech and its shortfalls will be important for emergency medical professionals to understand, so they may approach utilizing these technologies safely.
Smartphones are nearly everywhere and the barriers to creating smart homes are rapidly falling. Therefore, we must consider and design with empathy and intention smart devices for the healthcare industry lest we repeat recent history.
How is IoT Changing Emergency Services
IoT has the potential to improve emergency services for both first responders and patients. Improving driving conditions for paramedics and providing information on a structure’s integrity are just a few ways IoT is impacting prehospital care.
FirstNet is the first nationwide network engineered specifically for first responders. Paramedics, EMTs, police officers, firefighters, and any EM professionals can access the broadband network to communicate with other first responders. The First Responder Network Authority predicts that FirstNet will serve the public in ten critical ways:
Communication across jurisdictions: emergencies such as fires and floods often spread to more than one jurisdiction. FirstNet allows first responders to communicate and collaborate quickly and efficiently on one network.
Connecting responders in rural areas: FirstNet connects first responders in remote areas where traditional communication is impossible or difficult, allowing them to serve the people in these areas quickly.
Improving awareness during emergencies: enables quick communication among first responders by delivering high-speed data, location information, images, and videos.
Establishing public safety as a priority: FirstNet’s wireless broadband network is dedicated to public safety, so first responders can communicate about everything from daily occurrences to emergencies.
Capacity is key for large events: concerts, festivals, sporting venues and other large events draw hundreds of people to one location. These large crowds may cause signal interruptions, but FirstNet allows first responders to communicate during these events without service interruption.
Data via apps and devices: FirstNet delivers actionable data through several apps and devices, allowing communities to take advantage of economies of scale to maximize the value of every public safety dollar.
Reliability and security during the worst disasters: FirstNet provides a reliable network that gives first responders the capability to prepare and plan for and respond to a disaster.
Coordinating responses to man-made and natural disasters: quick communication and collaboration are crucial to responding to attacks and natural disasters. That’s why FirstNet is designing a broadband network with interoperability built-in, so first responders have access to critical data and can communicate with the public.
Innovation and value for public safety: law enforcement, firefighters, paramedics and other emergency responders will have access to new technologies that revolutionize the way they communicate and access data. Ultimately giving them the technology they need to serve the public more efficiently.
A broadband network for public safety by public safety: FirstNet is establishing a public-private partnership to deploy the first nationwide, high-speed, wireless network for public safety that is inspired by the challenges first responders have faced terrorist attacks like 9/11 and natural disasters like Katrina.
Smart Traffic Lights
Fast transportation to a hospital can mean the difference between a patient’s life or death, but navigating traffic often impedes EMS’s response time. Smart traffic lights according to Government Technology’s 2019 article, “operate in conjunction with GPS technology in response vehicles, smart traffic lights can help first responders avoid traffic congestion and safely reduce response times.” In addition, it may help them navigate roads faster and safer by pausing traffic at lights where paramedics need to pass.
Wearable medical devices, such as blood pressure and glucose monitoring systems are becoming very popular among individuals. Wearable medical devices provide data in real-time and are often more convenient. For example, wearable devices that monitor your sugar allow you to use your phone or the manufacturer's sensor to measure your glucose without constantly sticking yourself.
These medical devices have the added benefit of being able to give first responders immediate information and even send data instantly to your doctor or a healthcare facility.
First responders can also look forward to smart devices that give them feedback on structures. Imagine if paramedics and firefighters could view a 3D image of a bridge, building, sidewalk, or road before entering the area. The technology could help them identify areas where the structure’s integrity is weak, allowing them to enter through the safest locations. Not only would this make response time more efficient, but safer for first responders.
For example, Qwake Tech’s C-Thru Technology combines neuroscience, computer vision, and augmented reality to overcome the drawbacks first responders experience with current imaging solutions. With C-Thru Technology, first responders “apply neuroscience principals to computer vision and augmented reality, enhancing their cognitive abilities which allow them to focus on mission-critical tasks.”
Electronic medical records have been used for years to improve accuracy and efficacy. Add Cloud-based software to the healthcare sector, and you have an up-to-date medical record that can be accessed from anywhere by those with proper authorization. Cloud-based medical records have the potential to aid paramedics and EMTs immensely by giving them vital information about their patient which is particularly important if the patient is unresponsive.
Smartphones and watches are nothing new to this era and smart homes which were once a science fiction fantasy are now becoming a reality. So, it’s no surprise that smart ambulances might be in our future too.
Smart ambulances could change prehospital care in many ways, most notably is by reducing the number of people transported to the hospital or by improving the patient’s health condition before hospital care.
As with any technology, smart devices, hospitals, and ambulances pose threats, risks, and drawbacks. Below, we discuss the risks associated with integrating IoT and smart devices into the healthcare space.
What are the Challenges of IoT in Prehospital Care?
Lessons can be learned from the rollout of electronic health records (EHR). A failure to consider the integration across local, regional and national geography and its undue cost burdens can be seen in the tsunami-like adoption of EHR over the past decade. More clinical information has become digital, but the lack of cross-talk between EHR systems has effectively created digital fiefdoms.
EHR adoption 1.0 has had some unintended consequences mainly because EHRs were not designed looking out from the bedside perspective. Information contained in the EHR is still tied to institutions rather than the patient, which can create undue obstacles to efficient care when a patient finds themselves outside the confines of a particular digital fiefdom.
Certainly, unintended consequences are likely to be repeated by a groundswell of wearables from smartwatches to internet-connected pacemakers. Take for example a half-million devices recalled by the FDA over concerns about the hacking vulnerabilities of internet-connected pacemakers.
The present conditions point toward the need for widely adopted standards in order to achieve the creation of a smart-ready ambulance and EMS system.
The Individual Patient
How do we put this all together to connect a seamless chain of life for one patient? For example, a 65-year-old woman who collapses in the street?
Designing and implementing an answer to that single case feels frankly like a bit of a moonshot, but possible with proper allocation of resources and incorporating sound principles of design.
Now imagine creating a system that is designed well enough to accommodate a near-endless permutation of clinical scenarios when factoring in a population of over 300 million people, six thousand medications and four thousand medical conditions/procedures.
All this to emphasize that technology is useful, but there is no tech as of yet that can do it all and certainly, there is no tech that can save us from severe vulnerabilities in our healthcare infrastructure.
The Big Picture
There is an opportunity for amazing implementation in the space where public safety and public health intersect, which is the sweet spot for EMS.
Such potentials include:
Integrated disease surveillance [Influenza-like illness (ILI) data or ESSENCE by the DoD]
Integrated bioterrorism surveillance (Bio-Sense, EARS]
IoT has the potential to reduce medical errors, improve patient experience, and make prehospital care safe and more efficient for both medical professionals and patients. As with any new technology, medical facilities must reevaluate their areas of weakness and allow time for implementation. However, once these challenges are addressed, IoT can reshape the healthcare industry in positive ways.
Government Technology: Integrating IoT Devices to Help First Responders Save Lives
Qwake Tech: C-Thru
WRITTEN BY HECTOR CARABALLO AND BRANDY VICKERY
Hector Caraballo, MD is a practicing Board Certified Emergency Physician and Chief Medical Officer at MedCognition.
Brandy Vickery is a professional medical writer with a degree in Health Administration and is currently earning a degree in English Creative Writing. She enjoys writing about medical technology, processes, and concepts that improve the healthcare industry for everyone.