WASHINGTON — The Middle Class Tax Relief and Job Creation Act of 2012 created FirstNet and made the concept of a Nationwide Public Safety Broadband Network (NPSBN) a reality. FirstNet, the governing authority created to oversee the planning and build-out of the network, encourages EMS and state representatives to participate in the process.
Much conversation has focused on how the network will help first responders and its potential role in major events, such as the Boston Marathon bombing and the recent Navy Yard shooting. But it is expected that EMS will see benefits from the implementation of this network day-to-day, with better information on scene and the ability to provide electronic patient records to hospitals while in transit. Here’s how it could work.
The Scenario
Two cars are involved in a head-on collision at moderate speed in a remote part of an EMS response area. The crash is not witnessed, and the vehicles’ occupants are unable to call for help. However, both cars were equipped with and subscribed to an automatic crash notification (ACN) system. The 911 public safety answering point (PSAP) is alerted that a crash has occurred, notified how many occupants were in the vehicles and provided with GPS coordinates that are mapped to a location in the Master Street Address Guide in the computer-aided dispatch system. The PSAP is also told that additional information regarding vehicle speed, angle of impact, rollover and potential for serious injury is available.
Based on the analysis of data, the PSAP activates the emergency response, dispatching fire rescue, two ambulances and a helicopter. The area trauma center is notified to expect casualties. Analysis of the ACN data is simultaneously sent to the responding ambulance and the trauma center. The patients’ medical records are immediately made available to the first responders and the trauma center, giving the medical team valuable information on the patients’ “normal” vitals and potential complicating conditions.
The crash victims are located, extricated, treated, triaged and transported. As the paramedics check the patients’ blood pressure, apply the 12-lead ECG, use the portable CT to check for internal injuries and monitor other vitals, the data are seen in real time at the trauma center. The paramedics enter their findings into their electronic patient care reports, and the data are shared in an automatic burst to the trauma center. With two-way video in the back of the ambulance, the trauma physician can provide direction for patient care that’s beyond the paramedics’ basic trauma protocol.
The emergency department trauma team is well prepared to take over patient care with no lag as soon as the helicopter and ambulances arrive.
Does this scenario seem far-fetched? It shouldn’t. The technology already exists, and a National Public Safety Broadband Network is in the planning stages to make data sharing (and eventually mission-critical voice communications) a seamless process.
FirstNet Benefits for EMS
“I want to emphasize how fundamentally important this network is to EMS,” says FirstNet Board member Kevin McGinnis, chief/CEO for North East Mobile Health Services, the largest paramedic service in Maine.
He outlines several benefits, saying, “A lot more information will be available to help EMS providers make better treatment, operational and transport decisions.”
The result: EMS providers will have the ability to make more effective decisions in the field, and patients will receive definitive care more rapidly.
The ability to almost instantaneously share patient information and real-time monitoring of vitals while the EMS provider is talking with the trauma team will provide a common operating picture from which clinical and transport decisions can be made.
The network will allow for:
- Audio/video/data interfaces with home monitoring, or “I’ve fallen” systems
- Automated dispatching based on monitored patients and vehicles
- Access to searchable patient records/images/data
- Real-time vehicle extrication hazards alerting, including video/images as necessary
- Syndromic surveillance and quick alerts to specific, at-risk populations
- Physician-mediated interface among EMS dispatch, EMS crews and nurse call centers to optimize patient disposition
Getting EMS Involved
FirstNet has held six regional meetings so far to solicit input from stakeholders, and it has received requirements documents from several groups, including the National Public Safety Telecommunications Council (NPSTC) and SAFECOM. Individual state meetings are also being planned.
“EMS needs to be at the table when the network is being planned and grants are discussed,” says McGinnis. “They need to know who the single point of contact for grants is.”
State and Local Implementation Grant Program (SLIGP) funds will enable states to perform research and data collection to provide FirstNet with information about available infrastructure and resources needed for the network build-out. Although the contact list has not yet been released, EMS leaders can call the governor’s office to find out who their single point of contact for grants is. The FirstNet staff can also be contacted to identify the point of contact in each state. A list of awarded SLIGP grants can be found here.
Many states have already been awarded grants to support state planning, consultation and outreach activities as these states prepare for the launch of the first nationwide public safety broadband network. Colorado, Connecticut, Delaware, New York and Ohio will receive a total of $13.1 million. All U.S. states and territories are eligible to apply for the grants, and a partial match is required. Future grants to the remaining states and territories will be awarded on a rolling basis. For more information about the grants, visit here.
Reaching Out to Other Stakeholders
“I highly recommend that state EMS councils and associations start discussions with hospitals and other stakeholders about how data will be used and shared in that state,” says McGinnis. “Talk about the types of data and the ways the data can be shared to cut the time it takes to get definitive care to the patient. How can we use data to make clinical decision-making better and more effective for the patient’s benefit?”
The input of states, tribes, and local governments will be critical as FirstNet develops its plans for this historic network as recently noted by Lawrence E. Strickling, Assistant Secretary of Commerce for Information and Communications at NTIA.
“NTIA’s State and Local Implementation Grant Program will give states the resources they need to consult with FirstNet on deployment of a nationwide public safety broadband network,” Strickling said.
McGinnis says there are many ways to ensure EMS benefits from the network.
One opportunity: NPSTC has established an EMS Working Group to develop potential applications for EMS and funnel that information to FirstNet. McGinnis suggests EMS leaders contact NPSTC to see how they can get involved. More information can be found here.
The network is still in the planning stages, and now is the time for EMS to act. The opportunity is here to improve patient care and save lives, and EMS leaders should make sure they speak up to make sure the nationwide broadband network meets the needs of EMS providers and their patients.