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A wireless network assists doctors treating heart attack patients.

With heart attacks, timing is everything. Left undiagnosed, the consequences can be fatal. A wireless system in Winston-Salem, NC, however, is giving physicians a head start in treating heart attack patients.

The network connects local ambulances with caregivers in emergency departments at two local hospitals. It enables emergency medical technicians to dispatch EKG readings and vital signs directly to ED staff. "Getting an EKG from the field really cuts down on the time" needed to prepare for an incoming patient, says James Bryant, RN, director of emergency outpatient and transport services at Wake Forest University Baptist Medical Center.

The 1,100-licensed-bed integrated delivery system runs a busy ED that handles some 89,000 patients annually. When patients show up with chest pains, making a prompt diagnosis and launching standardized treatment protocol is critical, Bryant says. The communications network puts caregivers in touch with some 27 ambulances and quick-response vehicles dispatched through the Forsyth County EMS. Going on some 34,000 emergency runs annually, the fleet dispatches EKG readings directly to the participating hospitals about a dozen times a day, says Rodney Overman, compliance officer with Forsyth County EMS. "It prints out on a reader in the hospital," he says. "The physicians can say, 'Yep, he's having the big one,' and the EMS crew will bypass the ED and take the patient straight to the cardiac cath lab."

Getting the wireless network to function properly was a time-consuming affair, recalls Bryant. In the late 1990s, Forsyth County attempted to build a wireless communications system that linked its central dispatcher to the county's ambulance fleet. The system was intended to work in tandem with the county's computer-aided dispatch and automated vehicle locations system. The network relied on WiFi hotspots, transmitting data across the county's UHF radio system.

But the network could not handle the data load, Overman says. In January of this year, Forsyth EMS deployed an onboard mobile router from In Motion Technology that resolved the bandwidth problem. Now, data traveling between the dispatch command and the hospitals to the ambulances moves across the area's Verizon cell phone network. "Anywhere you have Verizon coverage, you have data coverage," Overman says.

The network accomplished two goals. First, it let EMS dispatchers make full use of the county's ambulance location software; now, dispatchers can tell where the fleet is located without contacting individual drivers.

Second, the network set the stage for clinical data to be dispatched directly to the two EDs. For the county, the initial outlay for the mobile system was about $680,000, says Overman. In contrast, Baptist Medical shelled out about $14,000 for a dedicated receiving station, says Bryant. In addition, the hospital splits the monthly cost of the cellular service with 800-staffed-bed Forsyth Medical Center, the other hospital in the wireless network.

At Baptist, the EKG graphics are converted into PDF format and stored in the hospital's electronic medical record system. Baptist is working on accepting the EKG feed as a direct data feed into the EMR, Bryant says.

Thanks to the advance notification, Baptist has expedited getting heart attack patients into the cath lab. "From our door to the cath lab used to take 120 to 150 minutes," he recalls. "Now we are doing it in 54 minutes."

-Gary Baldwin

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