OBJECTIVES: Demographic change, rising co-morbidity and an increasing number of emergencies are the main challenges that emergency 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 engineers 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.
OBJECTIVES: Demographic change, rising co-morbidity and an increasing number of emergencies are the main challenges that emergency 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 engineers 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.
Entities:
Keywords:
Emergency medical services; healthcare; tele-consultation; telemedicine
Authors: J C Brokmann; R Rossaint; S Bergrath; B Valentin; S K Beckers; F Hirsch; S Jeschke; M Czaplik Journal: Anaesthesist Date: 2015-06-03 Impact factor: 1.041
Authors: Sebastian Bergrath; Jörg Christian Brokmann; Stefan Beckers; Marc Felzen; Michael Czaplik; Rolf Rossaint Journal: BMJ Open Date: 2021-03-24 Impact factor: 2.692
Authors: Jörg C Brokmann; Clemens Conrad; Rolf Rossaint; Sebastian Bergrath; Stefan K Beckers; Miriam Tamm; Michael Czaplik; Frederik Hirsch Journal: J Med Internet Res Date: 2016-12-01 Impact factor: 5.428
Authors: Ana Stevanovic; Stefan Kurt Beckers; Michael Czaplik; Sebastian Bergrath; Mark Coburn; Jörg Christian Brokmann; Ralf-Dieter Hilgers; Rolf Rossaint Journal: Trials Date: 2017-01-26 Impact factor: 2.279
Authors: Andreas Follmann; Marian Ohligs; Nadine Hochhausen; Stefan K Beckers; Rolf Rossaint; Michael Czaplik Journal: J Med Internet Res Date: 2019-01-03 Impact factor: 5.428
Authors: Hanna Schröder; Stefan K Beckers; Klaudia Ogrodzki; Christina Borgs; Sebastian Ziemann; Andreas Follmann; Rolf Rossaint; Marc Felzen Journal: Sci Rep Date: 2021-07-13 Impact factor: 4.379