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Methods Inf Med 2014; 53(02): 99-107
DOI: 10.3414/ME13-01-0022
Original Articles
Schattauer GmbH

Employment of Telemedicine in Emergency Medicine

Clinical Requirement Analysis, System Development and First Test Results
M. Czaplik
1   Department of Anaesthesiology, University Hospital RWTH Aachen, Aachen, Germany
2   Chair for Medical Information Technology, Helmholtz Institute for Biomedical Engineering, RWTH Aachen University, Aachen, Germany
,
S. Bergrath
1   Department of Anaesthesiology, University Hospital RWTH Aachen, Aachen, Germany
,
R. Rossaint
1   Department of Anaesthesiology, University Hospital RWTH Aachen, Aachen, Germany
,
S. Thelen
3   Institute of Information Management in Mechanical Engineering, RWTH Aachen University, Aachen, Germany
,
T. Brodziak
4   P3 communications GmbH, Aachen, Germany
,
B. Valentin
1   Department of Anaesthesiology, University Hospital RWTH Aachen, Aachen, Germany
,
F. Hirsch
1   Department of Anaesthesiology, University Hospital RWTH Aachen, Aachen, Germany
,
S. K. Beckers
1   Department of Anaesthesiology, University Hospital RWTH Aachen, Aachen, Germany
5   Emergency Medical Service, Aachen, Germany
,
J. C. Brokmann
6   Emergency Department, University Hospital RWTH Aachen, Aachen, Germany
› Author Affiliations
Further Information

Publication History

received: 20 February 2013

accepted: 12 January 2013

Publication Date:
20 January 2018 (online)

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Summary

Objectives: Demographic change, rising comorbidity and an increasing number of emer -gencies are the main challenges that emer -gency 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 en -gineers 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.

Keywords

Emergency medical services - telemedicine - healthcare - tele-consultation
 

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