The need for speed

Since the passage of the EMS Act of 1973, emergency medical services in the U.S. have made tremendous strides in their level of sophistication and their ability to provide life-saving treatments to injured patients at remote scenes and en route to hospital emergency rooms.

This evolution is particularly evident in the vehicles used to transport patients to a hospital. Decades ago, ambulance services were little more than “horizontal taxicabs,” with little medical capability on board, said Kevin McGinnis, program adviser for the National Association of State EMS Officials (NASEMSO). In an odd twist for a life-saving service, the local ambulance company in some areas consisted of a hearse driven by a mortuary assistant with limited medical knowledge.

By comparison, today's ambulances are a mobile miracle, featuring monitors and other medical gear in a small space that would have been envied by some hospital emergency rooms in decades past. And these vehicles are staffed by highly trained paramedics with the ability to provide the medical attention necessary to ensure that patients reach a hospital in the best possible condition to receive treatment from doctors at the facility.

However, what has changed little during the last 35 years are the communications systems used by EMS personnel. While some EMS services — primarily in metropolitan areas — are using 800 MHz trunked systems built in recent years, the vast majority still rely on UHF and VHF analog voice systems built with equipment installed in the 1970s.

Although aging in many cases, these voice systems generally are reliable, which has led to a “false contentment” within the EMS community, McGinnis said.

“We're content because these old systems still work pretty well,” he said. “But it's a false contentment because we could do a hell of a lot more for our patients if we had information that could be available, but that requires broadband.”

Mobile broadband connectivity would let EMS personnel provide emergency-room doctors with real-time data about an en-route patient on an ongoing basis, not just during the intervals when the paramedic and doctor have time to speak to each other via two-way radio. In addition, high-speed connectivity would give those in the ambulance an opportunity to query a series of databases — the EMS Resource and Event Management System (EMSREMS) — for key information, such as patient medical records and the nearest hospital that is best-suited to meet a patient's medical needs at that moment.

But such data delivery is rarely available to EMS units, something that a joint advisory committee noted in a report delivered to Congress in February.

“The U.S. is home to the best doctors, the most capable emergency medical workers, and the most capable communications technologies and networks available in the world today,” the report states. “But, somehow, we have failed to marry our health and emergency medical systems with advances in communications and information technologies.”