Technology needed to help ambulance services cope with increased demand

The future of the ambulance and emergencies services needs more investment in networking

Ambulance and emergencies services need more investment in networking, and joined up services between health and social care, a former ambulance service executive has said.

Hayden Newton, former chief executive officer of the East of England Ambulance Service, said ambulance and emergency services still need improve clinical quality, efficiencies, patient safety, performance and costs, while struggling to deal with the increased demand from an ageing population. 

But there are many technologies the emergency services can use to meet efficiency goals.

“After a long time working in the ambulance service, I’ve seen a great deal of progress over the last number of decades, and technology has played the part, particularly Tetra,” said Newton, referring to Airwave Solution’s emergency services communication network.

Newton now advises Airwave and said the next step is to develop LTE and 4G services for Tetra by providing it with dedicated spectrum so emergency services do not have to fight for bandwidth at times of critical operational or safety need.

But beyond networking, there is still a great opportunity for technology to help make the Ambulance Service more efficient.

“Services are changing, and there is a great pressure with the population getting older and with health and social care needing to work together more effectively. And certainly, the Labour party wants to merge it as part of the NHS, but there needs to be a lot of enablers to do that, and one of those is new technology.”

This week, the BBC reported that the London Ambulance Service (LAS) has had to ask paramedic teams across the country to help with the increase in demand. Last week LAS had 11,008 call-outs, an increase of 15% year on year.

Newton explained it costs £250-£300 to respond to every 999 call and the Ambulance Service gets called out around seven million times a year. 

“That’s a lot of money tied up in sending ambulance calls out to when sometimes they don’t need to go," he said.

Newton suggests a greater integration of health and social care, as well as electronic health records, could prevent these unnecessary trips. Currently, some paramedics have access to tablets and digital forms, but integrated electronic patient records are still not available.

“Clinicians should be given greater information on the patient, as well as information on alternative care pathways,” said Newton.

Mobile workforce

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He explained that if an elderly person has a minor fall in their house, paramedics should have access to information on a digital device that would instruct them on who can help patient recover in their home. 

“It’s not always appropriate to take patients into busy A&E and care at home is often more suitable,” he said. 

“But clinicians struggle to have information for appropriate services in the community, because it’s not all joined up yet.”

Smartphone devices could also help reduce administration costs, improve accuracy and streamline services without compromising quality and patient safety.

The Ambulance Service could benefit from the technology behind paperless policing which has been adopted by Surrey Police Force.

Surrey Police Force first signed a contract with Airwave in 2009 to deliver eNotebook Pronto to gather data on the beat. This eliminated the need to constantly carry heavy leather-bound folders around. 

Surrey first rolled out Windows Mobile Motorala PDAs, but they are currently being replaced with Samsung Galaxy Note 3 devices.

Surrey has 300 Samsung smartphones in use, but hopes to have another 500 by the end of the year – and up to 1,000 in 2015.

Body-worn video cameras will help clinicians at the scene link patients to a more senior or specialised practitioner

The devices use Vodafone 2G and 3G services. 4G is not a consideration as yet because its use is limited in Surrey.

In September 2012, probationary training went mobile only, meaning new recruits are no longer taught how to take handwritten notes or record on paper.

Other technologies

As well as LTE services and mobile devices, Newton said other technologies that may be beneficial to the Ambulance Service include wearables, vehicle videos and telemedicine.

North Wales plans to buy body-mounted video cameras, while Gwent and South Wales police are developing an £837,000-mobile application that will allow officers to record and send witness statements to a shared system while on the beat.

For the Ambulance Service, Newton said body-worn video cameras will help clinicians at the scene link patients to a more senior or specialised practitioner so telemedicine can be undertaken to more accurately triage patient.

Telemedicine can also be used to reduce hospital admission. It these are reduced by 1%, the NHS could save £1m. In addition to savings, telemedicine will help solve challenges faced by healthcare providers in rural areas.

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