COLLEGE STATION, Texas — When a 16-year-old boy suffers serious injuries from a car crash in Canton, N.Y., he rides an ambulance from the local hospital to the nearest Level 1 Adult and Pediatric trauma center, Fletcher Allen Health Care, in Burlington, Vt. — more than 3 hours away. "They’re a lot like Texas," said James A. Wall, director of the Computing and Information Technology Division in the Texas Center for Applied Technology (TCAT) in the Texas Engineering Experiment Station (TEES), "because they’ve got people out in remote areas where there’s a long transport time and physicians need to weigh in early on certain serious medical problems." Wall and his coworkers have developed a mobile telemedicine system for a Fletcher Allen Specialized Telemedicine for Supporting Transport and Rescue (FAST STAR) project ambulance that enables the trauma center’s doctors to evaluate a patient like the teenager in the above example and coach EMTs through treating the patient while on the road. Hard-wired into the FAST STAR ambulance, the mobile telemedicine system among other things has two high-tech cameras and six cellular telephone channels for two-way audio and one-way video so Fletcher Allen doctors are able to hear and see the patient and EMTs. "In the first contract, they only wanted video and audio capability, but now they also want to add patient physiological telemetry — the heart rate, the blood pressure, etc. — and the infrared spectrometer and an ambulance navigation system," Wall said. In addition to the mobile telemedicine system installed in the FAST STAR ambulance, Wall and his coworkers have engineered a briefcase-sized kit that equips any ambulance that has the prerequisite hookups with the same sort of system. They delivered the kit to Fletcher Allen in August. "With minimal prep work ahead of time, we’ll be able to take the grab-and-go kit, open it up, plug it in, and it’ll have the same functionality as a FAST STAR ambulance," said Michael P. Caputo, director of telehealth operations at Fletcher Allen. Caputo and his coworkers have tested the mobile telemedicine systems in trial runs. They expect to complete the tests and deploy the systems within the year. TCAT computer scientists developed the mobile telemedicine systems in the InteractTM ambulances that were commissioned by Disaster Relief and Emergency Medical Services (DREAMS), the partnership between The Texas A&M University System and the University of Texas Health Science Center at Houston. "TCAT has expertise they’ve developed over the years doing research for groups like the DoD (U.S. Department of Defense) on mobile transmission of medical images - that’s a critical part of this project," Caputo said. "TCAT has some of the most knowledgeable people in the country when it comes to this." Fletcher Allen, the teaching hospital of the University of Vermont College of Medicine, and the medical school have twice contracted with TCAT for mobile telemedicine systems in behalf of FAST STAR. The project has been funded with an $880,000 grant from the U.S. Department of Transportation. "Our transport times can be anywhere from 45 minutes to 3 hours," Caputo said. The only verified trauma center in Vermont, Fletcher Allen has filled the gap for the most part with stationary telemedicine systems that permit rural doctors to consult the trauma center’s doctors in real time. Yet the EMTs who transfer patients in ambulances from the field to rural hospitals and from the rural hospitals to Fletcher Allen have been on their own — till now. "This is a continuity of care," Caputo said. "It’s our belief that this will improve the quality of care."
