A first responder on the cutting edge of tech: Interoperability matters

By: Catherine Lester
author

Catherine Lester is a certified EMT at the cutting edge of health care, where tech is tested to explore how drones can help to drop defibrillators, autonomous ambulances can cut transit times and mobile ERs could come to you.

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Original photography. Caption: Photo credit: Daniel Brenner with permission from the Fairmount Fire Rescue, Golden, Colorado

A cyber breach just released 500,000 gallons of water into a small city, and I’m watching several people scramble to the rooftops for safety. One of those people is diabetic and needs insulin, but the roads are washed out. As an EMT, my priority is this patient. I need a drone.

I usually tell folks I’m a reformed engineer. I’ve got a master’s degree in engineering but decided that I’m really more of a “people girl.” So why am I dropping insulin via drone to someone standing on a rooftop? Because I wanted more experience in my field— finding different ways to bring 5G and multi-access edge computing to the telehealth realm—so I went back and got my EMT certification.

Now, I’m working on the Verizon Frontline Team and help run exercises and tests like these to discover the impact of interoperability with connected devices. Interoperability is the ability of groups—such as an EMT, a drone pilot and a 911 operator in this example—to exchange and make use of information.

And the diabetic on the rooftop? He’s an actor. This is all a drill. And let me tell you, this work is magical.

Daniel Brenner with permission from the Fairmount Fire Rescue, Golden, Colorado

Bringing tech together in new ways

I believe we’re on the cusp of a renaissance in drone telehealth and connected medicine in emergency situations. We can help evolve out of silo-based thinking by removing some of the informational barriers that created it.

When you’re lowering insulin from a drone in an emergency situation, everybody needs access to the same information at the same time: the drone pilot, the EMT techs and the 911 operator. There’s not one higher priority over the other. And it requires interoperability of all things, like real-time video access from body cams—not just voice communications. It’s not easy. Using real-time information everyone can see at the same time, we can make better collective decisions in life-threatening situations.

So we run drills like this across the country to explore new uses of this technology and gain experience in bringing it together in new ways. In the cyber breach exercise I shared earlier, water floods a mini-city in a controlled environment at the Guardian Center in Atlanta—a 1,000-square-acre facility designed for running disaster exercises like this. We push our skills and technology to the limit. These drills give us a glimpse into the future of drone telehealth and connected ambulances and really show what we can achieve, while we test new approaches.

But tech without interoperability is like a drone without a pilot. You need both.

Interoperability in drone telehealth

We also run drone-based drills in other places, to test different scenarios with the technology. For example, delivering medicine and lifesaving equipment like defibrillators for cardiac arrest at the Wellness House built on Information and Technology in Lake Nona, Florida (or, as we call it, the WHIT home).

In one drill, a patient named Frank is sitting at home and suddenly has chest pains. His wife calls 911. They’ll dispatch EMS and a drone carrying a livestream video camera plus a defibrillator. While EMS is on the way, they can watch a livestream video en route as the drone drops the defibrillator to the patient. The 911 operator is watching, too, and she can walk Frank’s wife through how to use the defibrillator.

To achieve this, it takes getting information in near-real time. That includes the person flying the drone (a certified pilot), the command and control team—whichever department is orchestrating the total response to a disaster, such as the fire or police department—and additional support to fly a drone in a densely populated area.

Everyone involved needs access to the same information at the same time. This creates the opportunity for faster, and more informed, decisions.

With real interoperability, a connected ambulance could help keep you out of the ER

We’re also developing and testing ways to bring more telehealth to the back of the ambulance. Here’s why: As an EMT, a big part of the problem is that I don’t always know where I’m taking the patient when I pick them up. It’s not a predetermined course. It all depends on what we find out about the patient when we get there. We’ll make a decision based on where that patient needs to go, because not every hospital facility has a Level I trauma center. Not every facility has a stroke unit.

Daniel Brenner with permission from the Fairmount Fire Rescue, Golden, Colorado

As an EMT, I don’t have a really good way to solve for how to exchange information electronically with the receiving hospital. When you’re trying to save someone’s life, it’s really tough to make a phone call to all the local ERs and ask if they have any room available. And COVID taught us that the ER isn’t always the next best place to take a patient.

So my team asked: How do we improve that communication between hospitals and first responders?

The answer: Put telehealth capabilities in the back of an ambulance to allow a patient to be seen by the receiving hospital en route. That means adding some artificial intelligence to heart monitors in the ambulance to predict an irregular heart rhythm. There might also be a voice-activated scribe that’s doing the writing as you call out the vital signs of the patient: Here’s what I saw when I picked this patient up. This is what I did and what the vitals are.

We’re working towards installing telehealth capabilities in the back of the ambulance so the receiving hospital already has vital information about that patient before they arrive.

If we can make pre-hospital care more effective, that means you could potentially skip the emergency room and go straight to the next level of care.

What if the emergency room comes to the multi-car pileup?

We’re pretty proud of the tests we’re running with a connected ambulance at MCity in Michigan, but what if we could bring the emergency room to the scene of an accident—like a 10-car pileup on the highway?

With my EMT experience, I’m asking: Am I better off rolling in a mobile ER and taking care of people on scene, or am I better off sending in 10 ambulances and moving them out of scene? It all depends.

With my engineer experience, I’m thinking: Create a mobile ER. If we can put more technology in a mobile ER, we could save lives and drastically cut the time it takes to get a patient to the next level of care.

Daniel Brenner with permission from the Fairmount Fire Rescue, Golden, Colorado

We’re working on things like this with another innovation partner out of Pacific Northwest National Lab (PNNL), where we find better ways to coordinate care across all services. The police, fire department, EMS, anyone who is a first emergency services provider who needs to make real-time decisions in these situations.

These questions, these drills, all require interoperability in terms of exchanging information, ideas and solutions. It’s not easy. There’s policy, there’s funding, there’s politics. We’re not going to be able to do this tomorrow, but we are on a trajectory and a path that will lead us forward.

Verizon Frontline supports real interoperability and understands from customers and their experiences just how critical cross-agency communication and collaboration is during emergencies and natural disasters, which is why we’ve spent years building out capabilities to deliver it. Verizon Frontline is the advanced network and technology that has been built for first responders to meet their unique needs, providing comprehensive, end-to-end technologies they need to accomplish their missions and better serve their communities.

Learn more about the importance of real interoperability.

About the author:

Catherine Lester is a certified EMT with a master’s degree in engineering on the Verizon 5G/MEC Innovation team.

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