First Responders, Hospitals Need More Bandwidth

A recent report on the state of U.S. emergency management and hospital systems found that they were lacking in modern communications and that little or no information sharing existed between first responders, hospitals and the military.

The United States’ emergency medical communications and computer networks are on life support. This is the conclusion of a recent report to Congress by a committee of experts from the telecommunications and emergency response industries.

Researched and written by the Joint Advisory Committee on Communications Capabilities of Emergency Medical and Public Health Care Facilities (JAC), the report found the nation’s emergency communications capabilities were outdated, limited to voice and unable to adequately respond to a major disaster. It stated that first responders and health care professionals “…must practice 21st century medicine with 20th century communications technology.”

Established by Congress to implement the recommendations of the 9/11 Commission, the JAC is a bipartisan task force of experts from the communications, emergency medical and public health care sectors.

The JAC identified the need to develop integrated, interoperable broadband networks, both wired and wireless, to allow critical health care-related information to move rapidly, reliably and securely. It also stressed the need to improve interoperability through better interagency coordination and the use of common protocols, the use of mobile broadband services and applications to create virtual hospitals at the scene of accidents and disasters.

To advance these goals, the committee offered a range of recommendations. Key among these was the need for policy makers to encourage the deployment of interoperable, standards-based broadband networks built on common standards and protocols that can transmit bandwidth-intensive information, enhanced coordination between existing systems to share real-time data across systems and to allow common patient and emergency vehicle tracking for better situational awareness for all emergency medical and public health care facilities.

The document recommends a systematic strategy to improve emergency communications from first responders to public health care facilities.

“For the first time we have an official report saying the issue is all emergency communications—all on broadband, all on IP [Internet protocol], everybody linked together,” says David Aylward, director of the ComCare Alliance, a nonprofit organization dedicated to improving emergency response with modern communications and information systems. ComCare was one of the advisory groups to the JAC.

Although the report stresses a network-centric approach, Aylward notes that the report does not condone tearing out existing networks and technologies. Instead, the document advocates supporting the core of the network by using open-software architectures to link groups and organizations. “There are already lots of networks out there. What you need to do is connect the ones that exist,” he says.

The JAC report recommended that first-responder and health care organizations must be connected to each other via broadband wired and wireless networks. The report downplayed the need to build new networks, but cited the need to link groups to existing infrastructure.

Outdated technology is a key weakness in the nation’s EMS chain. The report found that first responders and hospitals use technologies that are now mostly obsolete in the private sector.

Among the deficiencies listed by the JAC report were a lack of integrated, interoperable communications; insufficient broadband spectrum and the lack of a common operational picture.

Aylward shares that a key network-centric aspect missing from U.S. emergency response systems is a directory of members. “The absence of a registry of organizations involved in emergency response and the absence of a federated rights management system are two key missing links,” he says.

Alyward notes that the Washington, D.C., metro area alone hosts 31 separate 9-1-1 facilities, a poison control center, a number of traffic management centers, homeland security entities and dozens of police forces.

But there is no directory of these entities. Even if some hospitals and groups are on directories, there are few if any electronic links to them, and there is no database of operational standards. Aylward notes that there is no system in place for an organization such as a local police force to send out a regional public health alert. “Today it would have to be done by a series of phone calls,” he says.

These common, shared tools are called core service. Aylward notes that groups such as the Network Centric Operations Industry Consortium (NCOIC) and ComCare are working on projects such as Net Enabled Emergency Response (NEER) to provide this piece of the EMS network that the report says is lacking. NEER focuses on two service gaps, the lack of a national electronic directory of response organizations and no corresponding system to confirm user identity and authorize information transfers.

Data transport is a key weakness because many health and EMS organizations are not connected to redundant high-speed data networks..

Military support also is important for major disasters and emergencies. The report notes that although the military is not usually involved in emergency response beyond major disasters, an efficient standards-based communications and data system would allow the services to plug into it during disaster relief operations.

Despite the challenges facing the nation’s emergency communications infrastructure, the JAC report described several promising projects promoting next-generation IP-based networks. These efforts include Washington’s Capital Wireless Integrated Network, a state-of-the-art wireless IP network providing integrated data, images and conferencing linking EMS and first responders in the region; Virginia’s Commonwealth Link to Interoperable Communications project leveraging voice over IP technology to allow a variety of radios from different agencies and jurisdictions to communicate; and Tucson, Arizona’s video-based EMS telemedicine system, ER-Link, which provides patient data and real-time video on trauma patients before they arrive at the hospital.