Physiology-Aware Rural Ambulance Routing

In emergency patient transport from rural medical facility to center tertiary hospital, real-time monitoring of the patient in the ambulance by a physician expert at the tertiary center is crucial. While telemetry healthcare services using mobile networks may enable remote real-time monitoring of transported patients, physiologic measures and tracking are at least as important and requires the existence of high-fidelity communication coverage. However, the wireless networks along the roads especially in rural areas can range from 4G to low-speed 2G, some parts with communication breakage. From a patient care perspective, transport during critical illness can make route selection patient state dependent. Prompt decisions with the relative advantage of a longer more secure bandwidth route versus a shorter, more rapid transport route but with less secure bandwidth must be made. The trade-off between route selection and the quality of wireless communication is an important optimization problem which unfortunately has remained unaddressed by prior work. In this paper, we propose a novel physiology-aware route scheduling approach for emergency ambulance transport of rural patients with acute, high risk diseases in need of continuous remote monitoring. We mathematically model the problem into an NP-hard graph theory problem, and approximate a solution based on a trade-off between communication coverage and shortest path. We profile communication along two major routes in a large rural hospital settings in Illinois, and use the traces to manifest the concept. Further, we design our algorithms and run preliminary experiments for scalability analysis. We believe that our scheduling techniques can become a compelling aid that enables an always-connected remote monitoring system in emergency patient transfer scenarios aimed to prevent morbidity and mortality with early diagnosis treatment.Comment: 6 pages, The Fifth IEEE International Conference on Healthcare Informatics (ICHI 2017), Park City, Utah, 201

An adaptive physiology-aware communication framework for distributed medical cyber physical systems

For emergency medical cyber-physical systems, enhancing the safety and effectiveness of patient care, especially in remote rural areas, is essential. While the doctor to patient ratio in the United States is 30 to 10,000 in large metropolitan areas, it is only 5 to 10,000 in most rural areas; and the highest death rates are often found in the most rural counties. Use of telecommunication technologies can enhance effectiveness and safety of emergency ambulance transport of patients from rural areas to a regional center hospital. It enables remote monitoring of patients by the physician experts at the tertiary center. There are critical times during transport when physician experts can provide vital assistance to the ambulance Emergency Medical Technicians (EMT) to associate best treatments. However, the communication along the roads in rural areas can range irregularly from 4G to low speed 2G links, including some parts of routes with cellular network communication breakage. This unreliable and limited communication bandwidth together with the produced mass of clinical data and the many information exchanges pose a major challenge in real-time supervision of patients. In this study, we define the notion of distributed emergency care, and propose a novel adaptive physiology-aware communication framework which is aware of the patient condition, the underlying network bandwidth, and the criticality of clinical data in the context of the specific diseases. Using the concept of distributed medical CPS models, we study the semantics relation of communication Quality of Service (QoS) with clinical messages, criticality of clinical data, and an ambulance's undertaken route all in a disease-aware manner. Our proposed communication framework is aimed to enhance remote monitoring of acute patients during ambulance transport from a rural hospital to a regional center hospital. We evaluate the components of our framework through various experimentation phases including simulation, instrumentation, real-world profiling, and validation

4G/LTE channel quality reference signal trace data set

Mobile networks, especially LTE networks, are used more and more for high-bandwidth services like multimedia or video streams. The quality of the data connection plays a major role in the perceived quality of a service. Videos may be presented in a low quality or experience a lot of stalling events, when the connection is too slow to buffer the next frames for playback. So far, no publicly available data s

The History and Development of a Consolidated Communications System and an Emergency Medical Services System in Nebraska

•A Chronology of Events •Nebraska Vital Statistics •A Consolidated Communications Concept •A Total Emergency Medical Service System Concept •The Nebraska Adjutant General\u27s Study of Telecommunications •Nebraska State Civil Defense •The Nebraska Consolidated Communications Corporation •Emergency Telecommunications Service: Planning for the State Disaster Plan •Evolution of Ambulance Service in Nebraska •The Nebraska Committee on Transportation and Communication •The University of Nebraska College of Medicine •Extension Service, the University of Nebraska College of Agriculture •The Nebraska State Department of Health •Area Funding •The Department of Health, Education and Welfare •The Six EMS Regions in Nebraska •The Office of Traffic Highway Safety in Nebraska •The Robert Wood Johnson Foundation •Comprehensive Health Planning •Project 20/20 •Operation Sky-Aid •The Use of Helicopters in EMS Services in Nebraska •The Common Emergency Calling Number-911 •Immediate Dial Tone/Coin Free Telephone •Identification of Calling Number and Ring-back Capability •Visit of DOT People to Nebraska to Inspect Communications •The Omaha Fire Department Ambulance Service •A Paramedic Service for Nebraska •The Nebraska Committee on Trauma, American College of Surgeons •Full-time Emergency Department Staffing (American College of Emergency Physicians) •The Lincoln Medical Education Foundation •Categorization of Hospitals •The American Red Cross Handbook •Veterans Administration TV Network •Some Early Day Activities in Emergency Services in which Nebraskans were Involved •Things That Might Have Been •A Few of Lynn\u27s Comments •Mid-America Research Corporation •Interest in Joint Funding Lincoln/Lancaster Pilot Project •Changes in Pre-hospital Survival in Nebraska •People Involved in Early Day Consolidated Communications •People Involved in Early Day EMS •Appendix A-Original Members of Dr. Thompson\u27s Committee •Appendix B-Professional Staff, EMS Division Department of Health •Appendix C-Report by Del Maier in Washington •Appendix D-Joint Funding Report •Appendix E-ETV Network Development •Bibliographyhttps://digitalcommons.unmc.edu/nehist_books/1000/thumbnail.jp

Study of aerospace technology utilization in the civilian biomedical field

The treatment of patients with acute pulmonary or cardiovascular diseases is used to demonstrate the benefits to be derived from a more extensive application of NASA technology in public health care. Significant and rather universal problems faced by the medical profession and supporting services are identified. The required technology and specifications for its development and evaluation are delineated. Institutional relationships and collaboration needed to accomplish technology transfer are developed

Reducing Noise, Contaminants, and Unintended Stresses in Emergency Medical Triage Units

The objective of this Interactive Qualifying Project is to evaluate the occurrence of noise, contaminant, and unintended stress in emergency triage care units and their impact on the patient care. Data are gathered from focus groups, surveys and the literature dealing with these themes to measure the quality of patient care in recovery, efficiency, evaluation, diagnosis, intervention, treatment, and services (REEDITS) system. Implementation of sound insulated machine boxes, smart materials, and sound absorbing ceiling and floor tiles are recommended as potential solutions. Continued effort to eliminate noises, contaminants, and unintended stresses in emergency triage care units is seen as a greater chance to enhance patient comfort, shortening hospital stay and reducing readmissions