This document discusses the use of telemedicine in emergency medical services (EMS) in Baton Rouge, Louisiana. It describes how EMS telemedicine allows emergency responders to send medical images and data in real-time to hospitals using wireless networks. Baton Rouge has implemented a program called BR Med-Connect that connects ambulances to local hospitals via a Wi-Fi mesh network or cellular network. This allows paramedics to consult with doctors, transmit diagnostic information like EKGs, and improve treatment of conditions like heart attacks and strokes during transport. The program aims to expand coverage across the city and parish.

1. Linking Pre-Hospital EmergencyCare in Baton Rouge

2. What is EMS Telemedicine? TELEMEDICINE is defined as the delivery of health care at a distance. But isn’t that what EMS has ALWAYS done?

3. What is EMS Telemedicine? So why is “EMS” telemedicine something “new”? What’s “new” is the ability to send large amounts of data at low costin a mobile wireless environment.

4. What is EMS Telemedicine? So where will this take EMS? Because sending images and data is becoming as commonplace as the home computer, EMS has already begun to move in this direction.

5. SO WHAT WE HAVE LEARNED? The nature of EMS is such that communications and technology has, and always will play a defining role...

6. SO WHERE IS ALL THIS TAKING EMS EMS will improve itself by capitalizing on the capabilities offered by advanced communications and information management technologies … You can call it EMS telemedicine (or whatever you like)!

7. Patient Care Applications Cardiac Care Trauma MCI & Disaster Stroke Patient Refusals Pediatric & Other Specialty Care What will EMS telemedicine mean for the Hospital?

8. Operational Improvements Management of Patient Data Risk Reduction Alleviate ED Overcrowding Training & QA Medical/Legal Documentation Resource utilization What will EMS telemedicine mean for the Hospital?

9. Benefits Enhance Hospital Stature EMS Included in Pt. Medical Record Staff Training Community Relations Reimbursement??? Homeland Security & Disaster Response What will EMS telemedicine mean for the Hospital?

10. ExtremeExample…

11. Practical Example …Baton Rouge EMS “BR Med-Connect”

12. Answering the Call

13. Demo

14. How Does it Work? E-Bridge Ambulance Equipment CarePoint System Hospital Equipment Connectivity Wi-Fi Mesh Network Cellular Air Card (Verizon, AT&T)

15. How Does it Work? E-Bridge Ambulance Equipment

16. How Does it Work? CarePoint System Hospital Equipment Controls Data & Communications Displays & Controls Video

18. Once in Session – Doctors Control Cameras from control panel

20. How Does it Work? Connectivity Wi-Fi Mesh Network

21. How Does it Work? Connectivity Wi-Fi Mesh Network Cellular Air Card (Verizon, AT&T)

22. Issues with Technology Is This High-Def TV?? No – We cannot expect mobile video to be crystal clear moving 60 mph down the interstate – At least not yet!

24. Has More bandwidth – very good video, audio, and data transmissions

25. Downside – fewer mesh locations available across the city/parish because of the cost of equipment and deployment

27. Video quality can be choppy- audio can be broken up

28. Sending data is reliable

29. No maintenance necessary

32. Ability to share data between hospitals

34. EMS Pilot Program STEMI Patients “Patients having ST-segment elevation myocardial infarction, or STEMI, heart attacks have the best chance of a good outcome if they get primary percutaneous cardiac intervention (or "angioplasty") within 90 minutes of arrival at a hospital, recent research confirms.”

35. EMS Pilot Program Process Acquire 12-Lead Establish video call with hospital and connect all diagnostic equipment - ready to send data Send 12-Lead to receiving hospital PDF version goes to CarePoint system Raw data from Zoll Monitor goes to pick up point on city server to be retrieved by Southern Medical – to be included with previous patient record ED staff conducts patient evaluation Voice, Video, EKG, SpO2, BP Monitoring, Breathe Sounds, Pulse Session can continue in-route to hospital All data along with voice recordings are part of patient record

36. EMS Pilot Program Future Planned Studies Identifying severe sepsis patients Provide early antibiotics treatment Stroke Patients Early Thrombolytic Treatment ? Trauma Using portable sonogram technology

37. Funding Multi Agency Project Police Crime Cameras, Reporting Fire Reporting, Inspections DPW Inspections EMS Telemedicine, Reporting Total City Investment to Date $200,000 Federal Grants Health & Hospitals Homeland Security Federal Stimulus Money Department Budget Dollars

38. Questions?? Chad Guillot (225) 389-5155 cguillot@brgov.com