Requirement Analysis and Implementation of Smart Emergency Medical Services
ABSTRACT
Emergency medical service (EMS) occurs in a high-pressure and error-prone environment, where paramedics must provide prompt decisions in care while recording information with limited time, incomplete data, restricted resources, and competing priorities. EMS requires cooperative workflows between patients or caregivers, paramedics and medical centers in the community. In conventional EMS, they have difficulties in obtaining causes of emergencies and personal medical histories, which are important for rapid and proper response. We analyzed the requirement of a smart EMS (SEMS) system and derived the key components in connected care environments leveraging information and communication technology. A survey of paramedics (n=113) revealed that a SEMS system using IoT technology should integrate personal lifelogs, electronic medical records, and patient monitoring in ambulances into pre-hospital care recording systems. It also addressed context-awareness in EMS accelerates first responder’s activities, while supporting personalized care not only at the scene of the emergency, but also during the entire hospital stay. Based on requirement analysis, we designed and implemented SEMS using health information standards to provide interoperability between devices and systems. As application of SEMS, an example service is introduced lifelog-connected EMS for stroke patients with a real-time location service for managing timeline of treatment.
EXISTING SYSTEM :
A quality of EMS must comply with limits on service times, despite restricted resources. Paramedics and medical staff in emergency departments (EDs) may not receive necessary information, including the patient’s medical history and the conditions at the scene of the emergency. The importance of disseminating the available information of emergency increases in regionalized EMS to provide the appropriate response and patient transport . Information and communication technology (ICT) can provide a significant improvement in the timeliness of treatment for acute symptoms in emergency. Thus, regional EMSs have been early adopters of new communications technology, medical and non-medical devices, and software into integrated workflows . Internet of Things (IoT) technology can enable round-the clock monitoring of medical conditions and provide that to an EMS information. Wireless technology allows acquisition of remote monitoring of pulse oximetry data, blood pressure readings, ECG traces, and the monitoring of patients’ movements. Consequently, IoT-supported EMS connects this daily healthcare information to in-hospital care. In the daily healthcare phase, information is collected about an individual’s health conditions and medical history, lifestyle, and environment. In the pre-hospital EMS phase, emergency service providers obtain information about events at the scene and in the ambulance in the form of electronic-Patient Care Reports (ePCRs). These ePCRs provide hospital staff with collated information: from bystanders, first responders, and paramedics at the scene the clinical history of the patient and pre-hospital treatments administered.
PROPOSED SYSTEM :
As the use of mobile devices and communications technologies improve and become more affordable, new ways of using these technologies will be discovered in the EMS infrastructure that evolve from conventional EMS to patient-centered emergency care. Providing a smart and personalized EMS requires more than the application of technology to EMS, with its emphasis on workflow with limited time and personnel, in a resource constrained environment. In this article, we specify requirement of enhanced EMS systems in connected healthcare environment through the analysis of propositions from paramedics. Reflecting the result of analysis, we introduce the SEMS system, which integrates information about the current emergency with the medical history of patients, and delivers them directly to the appropriate ER and national or regional administration. The SEMS links electronic medical records (EMRs), lifelog and signals from monitoring devices in ambulance vehicles to EMS by a variety of telecommunication methods. We employed a health information standard, integrated health enterprise (IHE), to verify the integration and interoperability of SEMS components. We also discuss example applications of SEMS with a lifelog application for stroke patients and a pathway tracking in a protocol for acute disease.
Life monitoring and connected care environment accelerate smart EMS by leveraging information of current patient condition and medical trajectory. Fast improving technology has facilitated seamless interoperation and integration between sensors, medical records, patient monitoring devices and heterogeneous systems in EMS and hospitals. Observing requirement in EMS, we implemented a smart EMS system integrating contexts in emergency fields into connected care environments reflecting demands of paramedics who proposed to utilize technology to reduce burden of recording and transmitting information. Autonomous collecting, integrating and sharing EMS based on personal profiles enhance emergency activities of paramedics on emergency scene and clinicians in ER, resulting in increased survival rate. We plan to investigate the effect of such composition of personal health records and continuous monitoring in prehospital stage on precision medicine for personalized treatment, especially for predicting treatment outcomes of emergency patients.
CONCLUSION :
Life monitoring and connected care environment accelerate smart EMS by leveraging information of current patient condition and medical trajectory. Fast improving technology has facilitated seamless interoperation and integration between sensors, medical records, patient monitoring devices and heterogeneous systems in EMS and hospitals. Observing requirement in EMS, we implemented a smart EMS system integrating contexts in emergency fields into connected care environments reflecting demands of paramedics who proposed to utilize technology to reduce burden of recording and transmitting information. Autonomous collecting, integrating and sharing EMS based on personal profiles enhance emergency activities of paramedics on emergency scene and clinicians in ER, resulting in increased survival rate. We plan to investigate the effect of such composition of personal health records and continuous monitoring in prehospital stage on precision