How Indianapolis EMS improved communications with reliable network connectivity

By Laura Neitzel for EMS1 BrandFocus

Sponsored by Cradlepoint

Indianapolis Emergency Medical Services (IEMS) is a third-party Advanced Life Support EMS provider serving Indianapolis and Marion County, Indiana, with over 350 personnel providing about 120,000 responses per year in an area of almost 300 square miles.

Like other agencies, IEMS strives to offer high-quality service on a constrained budget, so it has to be proactive in searching for solutions that balance the needs of the community with fiscal responsibility.

technology outpaces infrastructure

IEMS implemented its electronic patient care reporting (ePCR) system almost a decade ago, with the vision of saving lives and improving patient outcomes by giving EMS providers the ability to communicate patient information to and from the receiving hospital in almost real time. That ability relies on stable, reliable and robust connectivity, which was not a guarantee with the cellular hardware and infrastructure IEMS had at the time.

“We knew we could not with certainty assume that there would be 24-hour-a-day connectivity with cellular-based connections. It’s was just not a reasonable expectation,” said Kevin Gona, chief of logistics for IEMS. “There was too much infrastructure that was either being overwhelmed or being replaced and being updated.”

So Chief Gona led the IEMS IT support team’s search for a hardware solution that would provide the improved connectivity needed to make the agency’s ePCR and mobile data terminals (MDTs) function to their potential and reliably communicate with both the public safety answering point (PSAP) and local hospitals.

First, the IEMS logistics team tried using commercial products.

“We would go to the store and buy a consumer-grade router, but they just couldn’t survive,” said Gona. “They were not built for the harsh environment in the ambulance, and consumer-grade electronics just did not hold up.”

Because these consumer-grade products could not withstand the ambulance environment, EMTs and paramedics were constantly reporting lost connectivity or slow connection speeds.

Initially, the only alternative to improve connectivity was to equip the ambulances with multiple computers, each with a built-in cellular modem and separate service plan, to provide connectivity, but that approach was costly and inflexible.

“Paying for multiple single-use cellular transmitters in one ambulance,” said Chief Gona, “was not good from the standpoint of fiscal responsibility, but it was for a time the only option.”

Another challenge for the IEMS IT support team was keeping all the ambulances’ IT systems up to date, or gaining access to an ambulance that was experiencing connectivity issues. It could take a service technician hours to catch up with an ambulance that could be anywhere in a 300 square mile area, then troubleshoot the problem and fix it.

Eventually, the IEMS IT support team found a solution from Cradlepoint, a provider of rugged wireless networking solutions for first responders. Cradlepoint helped IEMS achieve high-speed, reliable, flexible, and redundant connectivity in its entire ambulance fleet.

A RUGGEDIZED ALL-IN-ONE NETWORK

IEMS chose to equip the fleet’s ambulances with Cradlepoint’s COR series routers, essentially replacing multiple devices with a ruggedized all-in-one mobile network device. Adding the Cradlepoint NetCloud Manager platform allows the IEMS IT support team to manage the constantly moving devices from a single location.

“It lets me have a centralized operation that extends the reach of the support staff considerably,” said Chief Gona.

The system provided cost effectiveness as well. By swapping out a cellular modem service plan in the ambulance MDT for the service plan for the Cradlepoint solution, IEMS was able to reallocate the money spent on service for the cellular modem to pay for Cradlepoint’s data service with no net cost increase.

“Cradlepoint presented us with a unique opportunity to both be cost-neutral in terms of ongoing expense and give us the potential to expand capability,” said Chief Gona.

Cradlepoint provides several key benefits for IEMS:

1. Wireless hotspot: Each Cradlepoint COR router projects a wireless hotspot that multiple devices can connect to, both inside and outside of the ambulance.
2. Redundancy: IEMS uses one cellular carrier for service in the Cradlepoint router and another for the cellular modem in the ePCR computer. Doing so gives IEMS two methods of ePCR access, so even if an ePCR computer falls into one carrier’s coverage gap or is out of range of the Cradlepoint Wi-Fi it can access the other cellular carrier for improved connectivity.
3. External antenna: The Cradlepoint router can be connected to an external antenna that includes all antennas needed for GPS, wireless and cellular service. IEMS mounts the external antenna on the exterior roof of the ambulance patient compartment. Externally mounting the antennas prevents the metal chassis of the ambulance from interfering with the Cradlepoint cellular, Wi-Fi and GPS signals. The external mount also offers a substantial ground plane for the antennas – significantly improving connectivity even in areas where cellular coverage is otherwise marginal.
4. Remote management: With NetCloud Manager, the IEMS IT support team can securely connect from any internet-connected computer to the Cradlepoint router in each ambulance to remotely troubleshoot problems or update the system. In the past, the IEMS IT support team would have to physically access the cellular modem to determine if a communication problem with the ePCR was due to the embedded cell card connection or the carrier. Now, if the ePCR is near a Cradlepoint device, a service tech can usually troubleshoot and fix the problem remotely.
5. Improved provider satisfaction: As the Cradlepoint devices were deployed and connected to the MDTs, IEMS saw an abrupt and substantial reduction in the number of complaints about network connectivity, saving man-hours troubleshooting. When it comes to user complaints about network connectivity, Chief Gona considers no news to be good news.

The medics have a thousand things to be concerned about, but connectivity is no longer one of them, says Chief Gona. While occasional issues still pop up, they are usually quickly resolved with minimal disruption or distraction.

REDUCED AMBULANCE DOWNTIME

Although Chief Gona had heard good things about Cradlepoint from other users, there remained one more test before IEMS would commit to buying the Cradlepoint devices. How would the Cradlepoint router really perform in the field?

“We acquired one as a test model and aggressively tested it in a harsh and unforgiving environment.” said Chief Gona. “It held up – and a device that can survive our work environment and testing process without any glitches is a fairly rare bird.”

Chief Gona also especially appreciates that the Cradlepoint team didn’t overstate what the device could do.

“They gave us accurate and realistic information without over-hyping the device,” Chief Gona said.

Since deploying Cradlepoint, the agency’s ambulance downtime due to connectivity issues has been reduced by 90 percent, saving both money and staffing hours while improving connectivity.

The ability of EMS organizations to operate to protect their communities and save lives is ever more dependent on technology. With enhanced and reliable connectivity from Cradlepoint, Indianapolis Emergency Medical Services is better able to communicate critical patient information between their medics and the receiving hospitals to better fulfill the IEMS mission of providing the right care for every patient, every time.