COLLEGE STATION, Texas — A consortium of The Texas A&M University System and The University of Texas Health Science Center at Houston has placed one of its advanced technology ambulances with St. Joseph Regional Health Center in Bryan. With funding from the U.S. Army, Disaster Relief and Emergency Medical Services (DREAMS™) has outfitted five ambulances with specially designed digital emergency medical services (Digital EMS) systems that enable EMTs to consult with emergency room physicians at participant hospitals. DREAMS™-equipped emergency vehicles, known as Interact™ ambulances, have been operated by Liberty County EMS since 2004. Three ambulances are currently in operation in this East Texas county, with a fourth to be delivered in October. Two of these ambulances are owned by the consortium, and two are owned by Liberty County and outfitted with DREAMS™ technology. "The Interact™ ambulance represents a dramatic transformation of the treatment available in a traditional ambulance, in which EMTs have a limited set of treatment options. In an Interact™ ambulance, EMTs can be authorized to use more extensive treatment options administered under the watchful eye of the remote ER physician," said one of the co-principal investigators for the Digital EMS part of DREAMS™, James A. Wall, director of the Computing and Information Technology Division of the Texas Center for Applied Technology (TCAT) in the Texas Engineering Experiment Station, a member of the A&M System. "Additional procedures are made possible when DREAMS™ technology delivers high-quality video and real-time patient data to the remote ER physician, greatly enhancing the physician’s situational awareness in the ambulance to support the medical decision-making process." The hardware and software used in these advanced systems has been developed by the DREAMS™ Digital EMS project team. The ambulance hardware integrates specially developed communications and computer systems with commercial, off-the-shelf medical and computer devices such as digital video cameras, GPS navigation systems, ruggedized laptops, signature pads, bar-code scanners, vital signs monitors, 12-lead EKGs, portable blood analyzers, ultrasounds and more. At the hospital, a companion system including communications and computer devices allows the ER physician to receive video, audio, real-time medical data and text from the ambulance and transmit audio, text and video annotations to the ambulance. "DREAMS™ Digital EMS was funded to support rural America where distance translates to ’time en route,’ and ’time en route’ directly affects ’The Golden Hour,’ that time period in which a medic or physician can significantly affect the medical outcomes of the patient," said the other co-principal investigator for Digital EMS, Larry D. Flournoy, associate director of the Academy for Advanced Telecommunications and Learning Technologies at Texas A&M University. The software for the Digital EMS systems presents a unified graphical user interface (GUI) to the paramedic, driver and ER physician. "Through pursuing nondisclosure agreements with multiple companies, we are able to integrate a wide variety of medical technologies behind a single DREAMSTM user interface, offering medics and physicians an intuitive application without the need for third-party software," said TCAT’s lead software engineer for Digital EMS, Christopher J. Kocmoud. The DREAMS™ systems can streamline the pre-hospital stage of a patient’s treatment, Wall said. For example, EMTs in an Interact™ ambulance may input the patient’s driver’s license using the card reader to transfer the information to an electronic form that is transmitted to the hospital. The EMTs can alert the hospital to the need for physician intervention with voice, video, text messaging or a special audible alarm on the DREAMS™ system at the hospital. The ER physician can remotely control the multiple video cameras in the ambulance to pan, tilt or zoom to view the patient’s injuries. With colored, on-screen markers, the physician can coach the EMTs through treatment that extends beyond normal EMS protocols. And all along, the EMTs and physicians can monitor on-screen the patient’s vital signs and the ambulance’s location. The two principal investigators for the DREAMS™ consortium bring together the expertise of both the A&M System and UT Health Science Center at Houston. The A&M System’s principal investigator is Richard E. Ewing, vice president for research at Texas A&M. "Texas A&M is well-positioned to lead with the University of Texas on this project," he said. "We have the breadth and depth of research to accomplish and further this life-saving work for Texans. We are so pleased that St. Joseph is able to use the technology right in our hometown." The principal investigator for the UT Health Science Center at Houston is Dr. James H. "Red" Duke Jr., professor of surgery and John B. Holmes Professor of Clinical Sciences at the UT Health Science Center at Houston and director of trauma and emergency medical services at Memorial Hermann Hospital. Duke is also the medical director of Memorial Hermann Life Flight, a renowned medical evacuation helicopter service. The consortium is now customizing its unique Digital EMS systems for use in Life Flight helicopters under its sister project, Texas Training and Technology for Trauma and Terrorism (T5), also funded by the U.S. Army.
