Summary
Objectives: Demographic change, rising comorbidity and an increasing number of emer -gencies
are the main challenges that emer -gency medical services (EMS) in several countries
worldwide are facing. In order to improve quality in EMS, highly trained personnel
and well-equipped ambulances are essential. However several studies have shown a deficiency
in qualified EMS physicians. Telemedicine emerges as a complementary system in EMS
that may provide expertise and improve quality of medical treatment on the scene.
Hence our aim is to develop and test a specific teleconsultation system.
Methods: During the development process several use cases were defined and technically specified
by medical experts and en -gineers in the areas of: system administration, start-up
of EMS assistance systems, audio communication, data transfer, routine tele-EMS physician
activities and research capabilities. Upon completion, technical field tests were
performed under realistic conditions to test system properties such as robustness,
feasibility and usability, providing end-to-end measurements.
Results: Six ambulances were equipped with telemedical facilities based on the results of
the requirement analysis and 55 scenarios were tested under realistic conditions in
one month. The results indicate that the developed system performed well in terms
of usability and robustness. The major challenges were, as expected, mobile communication
and data network availability. Third generation networks were only available in 76.4%
of the cases. Although 3G (third generation), such as Universal Mobile Telecommunications
System (UMTS), provides beneficial conditions for higher bandwidth, system performance
for most features was also acceptable under adequate 2G (second generation) test conditions.
Conclusions: An innovative concept for the use of telemedicine for medical consultations in EMS
was developed. Organisational and technical aspects were considered and practical
requirements specified. Since technical feasibility was demonstrated in these technical
field tests, the next step would be to prove medical usefulness and technical robustness
under real conditions in a clinical trial.
Keywords
Emergency medical services - telemedicine - healthcare - tele-consultation
