First response:
Faster, smarter
pre-hospital
healthcare

Providing vital services within the golden hour—the first 60 minutes after an injury or trauma incident—is often critical to patient survival. In most situations, maximizing the golden hour requires administering the most efficient pre-hospital care as quickly as possible.

Today, with the advent of 5G technology, paramedics, EMTs and emergency department staff can partner in near real-time to deliver first response services during the crucial period immediately after injury. 5G provides the ability to share large amounts of data, including imaging, video, and other IoMT (internet of medical things) between the first responders on scene or in an ambulance to the emergency room clinicians and doctors at the hospital.

As defined by the National Institutes of Health (NIH), National Library of Medicine (NLM), “Pre-hospital care is an essential part of the continuum of emergency health care that is frequently initiated by a 911 call to a dispatch center.” Meaning, what starts with a 911 call continues throughout the patient journey. Per the NIH HLM pre-hospital article, “This continuum of conventional care is provided through a coordinated and integrated emergency health care system with well-trained and well-equipped personnel at dispatch centers, ambulance agencies, hospitals, and specialty care centers…” As a result, large amounts of information is collected and passed across these partnerships.

When considering the first response, a connected ambulance can be outfitted with advanced monitoring and communications equipment that can provide the ability to collect data from the incident, handsfree. With the right network and right systems in place, this information can be shared, breaking down the silos between first responder services and emergency department care.

For instance, the smart ambulance can have the ability to support virtual consultations among clinicians from various specialties using advanced, virtual care solutions. By implementing artificial intelligence (AI), machine learning (ML) and the Internet of Medical Things (IoMT), clinicians can gain a more complete understanding of emergency situations, potentially accelerating the delivery of the most appropriate care.

Enhancing near-real-time connectivity promotes more accurate diagnoses, better decision-making for treatment options and smarter healthcare overall. This type of enterprise intelligence can allow providers in a variety of settings to leverage the latest, most advanced technologies. 

To appreciate the value a connected ambulance brings to smarter healthcare, consider how care changes with near real-time information-sharing.

Traffic congestion, road construction, and unmarked roads are examples of factors that can delay care and can lead to potential negative patient outcomes. When every second counts, improving the efficiency of routes is a basic necessity. Additionally, by using intelligent video, intelligent lighting and traffic signal priority control systems, smarter cities can help move emergency vehicles with as little interference as possible, helping to provide smarter healthcare outcomes.

Dispatchers are responsible to provide instructions over the phone to the 911 caller until medical personnel arrive on scene. They also dispatch appropriate public safety units while maintaining radio contact with fire, emergency medical, and law enforcement services, in addition to other functions. Most emergency vehicles are constantly on the move which can make it more difficult for dispatchers to identify the ambulance closest to an evolving event, possibly leading to costly delays in care. Fleet management solutions can help keep track of ambulance and response vehicles.

5G-enabled video strategically placed throughout a city footprint can gather near-real-time data. By feeding that information back to a central hub, emergency dispatch can use geolocation strategies to identify the emergency vehicle closest to an incident. Dispatch can also use that data to pinpoint the optimal transit route. In addition, the traffic control system has the ability to change traffic signals to help emergency vehicles quickly navigate streets. If necessary, such systems may alert GPS networks to instruct passenger vehicles to avoid the area.

Near real-time patient visualization tools, like augmented reality and extended reality devices, can transmit video from the field or ambulance to the emergency department, allowing clinicians in the hospital to see what first responders on the scene can see. These types of pre-hospital care tools can display patient vital signs, including readings like blood pressure, blood sugar and blood gas levels, as well as any known details about a patient's medical history. Both first responders and hospital providers can see changes in the patient's condition nearly as it happens. This helps to open the door for hospital-based providers to leverage their expertise and answer questions remotely like: Does the patient need to be taken to a Level 1 trauma center or specialty hospital? Can their needs be met through telehealth alone? Answering this question can conserve and correctly allocate valuable healthcare resources.

Many use cases are emerging from the 5G revolution. A 5G-connected ambulance could stream data to hospitals from connected wearables and medical IoT kits. For instance, 5G connected robotic gloves could help remote clinicians "guide" first responders' hands to perform emergency procedures.

Supported by the 5G network's speed and connectivity, an ambulance can transmit critical information to an emergency department ahead of arrival. A 5G-enabled connected ambulance outfitted with IoMT technology can also capture diagnostic images, such as X-rays and ultrasound scans. 5G provides the bandwidth and ability to provide these types of large data files during first response. Similar to EKG results, these images can be sent ahead to the hospital-based providers, helping those in the emergency department or operating room better prepare for care delivery.

In addition to this rapid delivery of vital data, emergency providers also have the connectivity to provide these details to the admitting hospital who can input them directly into the patient's electronic health record. Ultimately, this 5G connectivity contributes to accelerated diagnoses, reduced mistakes and a more well-informed treatment plan once the patient arrives at the facility.

Implementing Artificial Intelligence (AI) as part of pre-hospital care both improves accuracy and increases efficiency. It can also lead to faster diagnosis and helps clinicians have the appropriate resources on hand upon the patient's arrival. The Department of Homeland Security (DHS) established the System Assessment and Validation for Emergency Responders (SAVER) program to collect information to help inform emergency responder equipment selection and procurement decisions. In an ongoing effort, the SAVE Program found the following:

• AI can be used to actively capture data
• AI may be employed to predict response times based on gathered data, locations, and environmental conditions
• Integrating AI into EMS call centers can assist first responders and call center operators in making informed decisions during a medical emergency
• AI systems can be used by dispatch centers to prevent unnecessary emergency room visits, rapidly detect life-threatening situations, strategically allocate resources, and provide detailed location information to those responding