Putting Emergency Logistics Into Play
Spurred by the sad saga of 1,900 Gulf Coast children separated from their parents in the chaotic aftermath of Hurricane Katrina in 2005, the Department of Health and Human Services attached a mandate to implement a patient tracking system with federal grants that are annually funneled through the Michigan Department of Community Health’s Office of Public Health Preparedness.
Connie Maxim, education coordinator for the Region 6 Biodefense Network, has been coordinating the local implementation of patient tracking. Maxim said $230,000 has been spent to equip 110 ambulances in 17 emergency services with heavy-duty, waterproof laptop computers, wireless, mobile Internet connections and UPS bar-code-based software. The system, expected to be fully implemented by Oct. 31, will be used to track patients from the field to the hospital on a routine basis so that it will require no special implementation in cases of multiple-casualty disasters, Maxim said.
The system also involves 27 hospitals and 12 county emergency medical authorities, she said. Counties involved include Clare, Ionia, Isabella, Kent, Lake, Mason, Mecosta, Montcalm, Muskegon, Newaygo, Oceana, Osceola and Ottawa. A pilot program is under way in Muskegon, Newaygo and Oceana counties, she said.
Maxim said the grant purchased the laptops as well as on-board boxes that provide a mobile wireless connection: the onBoard Mobile Gateway system from In Motion Technology of Vancouver, B.C. The system provides a wireless “cloud” of 200 to 300 feet around the ambulance, allowing paramedics to venture outside without losing connectivity. The system relies on cellular providers to provide the wireless connection, Maxim said.
Each laptop runs UPS Trackpad, a database application based on the delivery service’s package tracking system, she said. Instead of tracking packages, she said, the customizable database will track patients.
“Who better to help you design tracking software but the best tracking company in the world?” added Brent Walker, a paramedic for Life EMS in Grand Rapids, who demonstrated the new system.
The program assigns bar codes to follow each patient from the field, en route, and then at the hospital, he said. The emergency responders at the scene add identifying information to the database, such as age and gender.
Maxim said the data is uploaded to a regional database, and hospitals then can pull information about each patient from there.
However, hospitals have had to upgrade their own software to implement the system in their emergency rooms, and that has been a sticking point as each one is at a different place in the process.
A simulated disaster — a break in the Croton-Hardy Dam area — in June revealed that parts of the system worked well and others proved a challenge. Walker said he was able to use the system to communicate with Gerber Memorial Hospital, but Maxim said cell signals were inconsistent near the dams.
Life EMS Ambulance, which is putting laptops in 50 of its rigs, showed off the new system.
Mark D. Meijer, Life EMS president, said his company will take advantage of having laptops on board by adding applications such as a custom global positioning mapping system.
“We would have never dreamed back in the mid-’70s we’d be looking at this kind of technology, but this is probably one of the most integrated technology platforms in any emergency unit anywhere in the country,” Meijer said. “We’ve been using some of this stuff individually but now to have it connected in a better fashion is pretty exciting.”
Among the tools available to ambulance crews is a mapping system that can overlay the location of Life EMS vehicles in real-time. The emergency medical technicians and paramedics also can get crucial information such as traffic and weather alerts.
Life EMS, which includes 25 wheelchair transportation vehicles in addition to the ambulances, relies more on online mapping with the demise of companies that produce local annual paper maps, Meijer added.
Meijer said he expects the technology will help to deploy ambulances more efficiently and perhaps even reduce fuel usage, as fuel costs are up $200,000 so far this year.
Walker said the mapping system is very helpful in determining entry and departure routes at an incident scene, particularly in major incidents such as fires that demand multiple ambulances.
Walker, who oversees safety issues for Life EMS, said information from each ambulance’s “black box,” which tracks items such as use of emergency lights and safety belts, now can be uploaded in real-time to the home office. Emergency responders also can access Web sites that provide information such as how to deal with different chemicals that may be present at a tanker accident, for example.
Previous mass disasters have shown that patient-tracking systems were lacking, Walker added.
Patient tracking systems have been implemented in a few other states, Maxim said. She said the biggest advantage to using Trackpad is the one-time licensing fee and the versatility of platform versions that can run it. HQ