Pre-hospital videoconferencing telemedicine: are we there yet?

Aims  Pre-Hospital telemedicine has the potential to save lives. This study examined the challenges in the development of a mobile audio-visual telemedicine platform for the pre-hospital telemedicine component of the European Commission funded LiveCity project.  Methods  Open source software and off-the-shelf hardware elements were used to build a wearable field unit for the paramedic to communicate from the scene of an emergency via live video with the Emergency Department hub over a Third Generation (3G)/High Speed Packet Access (HSPA) network.  Results  Videoconferencing from the scene was compromised in all but one of thirty-four telemedical consultations. Significant challenges in software and hardware suitability, durability, and reliability were identified. The 3G network was unable to provide for an uninterrupted high-quality mobile video link between the paramedic and the Emergency Department.  Discussion  Improvements in hardware and software design with bespoke telemedicine equipment appropriate to the pre-hospital environment as well as investment in fourth (4G) and fifth generation (5G) networks with more extensive coverage will be required to further enable the widespread adoption of optimal telemedicine in pre-hospital care.</p

The Doctor Can See You Now: A Key Stakeholder Study Into The Acceptability Of Ambulance Based Telemedicine.

Using telecommunications technology it would be possible to link a patient and paramedic to a Doctor in the Emergency Department (ED) at the point of first patient contact. A questionnaire-based study on telemedicine in the pre-hospital environment involving patients, paramedics, doctors and nurses in the ED, was performed to assess if they would want and accept telemedicine in pre-hospital emergency care. When asked 98.5% (55) of patients, 89% (11) of doctors, 76% (14) of nurses and 91% (42) of ambulance personnel saw the potential of an audio-visual link from the pre-hospital environment to the ED. The potential benefits were felt to be in diagnosis of time-dependent illnesses, time management, increased hospital preparedness for incoming patients and increased triage efficiency. Stakeholder enthusiasm for pre-hospital telemedicine must be met with the technological requirements to provide such a service. As noted by one patient a pre-hospital audio-visual link to the ED could be “potentially a life saving service”.</p