Broadband for EMS

     There is a certain irony to the fact that your personal cell phone may have superior communication capabilities (e-mail and instant messaging, capturing and sending images and video clips, accessing the Internet and locating information, etc.) to the communications systems many EMS agencies use. If we want EMS providers to be at least as capable as their average adolescent offspring, it's going to take broadband. Getting that, and using it to help patients, is the vision of a February report to Congress that examined the current state and potential future of emergency-care communications.

     It was the work of the Joint Advisory Committee on Communications Capabilities of Emergency Medical and Public Health Care Facilities—the Joint Advisory Committee, or JAC, for short. Created last year per a directive from the 9/11 Commission, the JAC included representatives of EMS and related healthcare and emergency-response fields, as well as communications experts and representatives of major associations and vendors. It issued four key findings and five broad recommendations to serve as a road map for realizing the potential advanced communications technologies hold.

     "The state of communications in EMS and through hospitals is behind the times, both in technologies in use and in leveraging new things coming out," says committee member Curt Bashford, vice president of New Jersey-based EMS communications provider General Devices. "The things we can be doing now require new technologies and, basically, more bandwidth. We need these larger pipes, if you will, from the ambulance back to the hospital."

     The benefits of those larger pipes could be substantial. Imagine funneling rich streams of data, including video, from incidents scenes or the backs of ambulances; high-speed access to pictures, maps, graphics and databases; rapid dissemination of information among incident players and supporting resources; redundancy and surge capacity for times of trouble.

     Bits and pieces of that are happening now, here and there, but it's piecemeal, and current infrastructure isn't sufficient to do it on any sort of broad, systematic scale. JAC recommendation No. 1, then, is to encourage the deployment of interoperable broadband networks, built on standard Internet Protocols, to serve as a nationwide backbone.

     That's the biggest obstacle to progress at present, given the failure of attempts so far to create a single national public safety broadband network and the largely unrealized potential of encompassing municipal systems. In the interim, services can consider an option that is increasingly available, if not exactly "public safety" grade.

     "We may be forced to rely on cellular broadband," says Bashford. "EMS and public safety tend to not look toward those types of networks, but they're something we can increasingly put our hands on today. There's probably never going to be a perfect network out there, so the best bet is to leverage what you have, and just build it as open as you can and let it grow."

     However you construct them, communications networks are only as good as the people and devices using them, so the JAC's second recommendation is to improve interoperability through better interagency coordination. To this end, it proposes the creation of a Federal Interagency Committee on Emergency Communications Systems (FICECS) to provide standards and guidance. FICECS would coordinate at the federal level, establish benchmarks and generally oversee the migration of EMS, public safety and public health communications to interoperable IP-based networks.

     Standards are essential for allowing disparate systems to link, and recommendation No. 3 is to foster consistency through use of common standards and protocols. Doing this would resolve a significant barrier to the adoption of technologies such as electronic health records. The same section promotes common criteria for communications contracts and grants.

     With such a foundation in place, new capabilities could then be added and advanced through improved integration (recommendation No. 4). Telemedicine networks, for example, could be linked into emergency-response systems, potentially allowing remote care and better access to specialists. Geospatial command/coordination and vehicle tracking capabilities could improve situational awareness. Cross-system data analysis could give everyone more accurate big-picture views.

     The final step, then, is to ensure access. The committee goes so far as to argue that even beyond first responders and the healthcare community, broadband services should be available to the general public as an "essential healthcare communications imperative." Broadband at home, they argue, could enable advances like remote consultation and monitoring, giving providers critical information faster.

     It is undeniably an ambitious agenda, and it can't come without significant investment. But the payoff, committee members feel, could be enormous.

     "Some of these technologies are going to be what allows EMS to go to the next level," says Bashford. "Certainly it's going to take money, which we didn't get into. What we've provided is a blueprint: Here's what we're missing, so let's get on the stick, and here are the plans to get to the next step tomorrow."

     Find the report at www.fcc.gov/pshs/advisory/jac/index.html.