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Issue link: https://emsworld.epubxp.com/i/131347
What a Broadband Network Could Mean for EMS Systems What kinds of things could universal broadband coverage enable for EMS? Think Star Trek. "We've joked about the way the old Star Trek tricorder worked, but the reality is, we're getting to the point where the technology will allow us to do that," says Paul Patrick, Utah's state EMS director and vice chair of FirstNet's Public Safety Advisory Committee. "This network will give us a pipeline big enough to send large amounts of information and let doctors and hospital staff help prehospital providers improve patient care. We'll be able to enhance things like cardiac care, for instance, by recognizing elevated ST waves, transmitting that data from everywhere in our state. We'll be able to improve trauma care by linking prehospital providers to hospitals and letting them send video and other patient information. We've had some ability to do that in the past with things like telemetry, but this takes it to a whole new level." FirstNet board member Jeff Johnson cites anticipated benefts in major disasters, when existing communications infrastructure can be overwhelmed, but also implications for rural trauma care. "In rural America, transport times to hospitals can exceed 30 minutes or an hour," he says. "In parts of rural Oregon, Nevada, Arizona, Texas, you can have two-hour transport times. Creating a connectivity between a paramedic in the back of an ambulance and an emergency room physician can truly make a lifesaving difference in terms of patient outcomes." take a few years, suggests William Jackson of public-sector technology consultant GCN.5 In the interim, we could look at VoIP or mixed broadband/voice bandwidth devices. "We encourage everyone to not make purchases right now with what they have to be able to take care of patients," says Paul Patrick, head of Utah's Bureau of EMS and vice chair of FirstNet's Public Safety Advisory Committee. "As we move into the future, these kinds of new devices will be become available and accessible, and technology a lot of times gets cheaper as more is developed." Unlike police and fre, Patrick adds, EMS has a billable component that can produce some cash fow to direct toward new-age comms tools. It will be up to providers and their systems to pressure manufacturers and keep their devices open and interoperable, rather than propietary, to achieve the network's full potential. Costs On that subject of cost: FirstNet has $7 billion to work with. That includes $5 billion promised from the proceeds of future spectrum auctions. It's not an enormous amount to get started (new towers run $100,000–$300,000 each, and the Congressional Research Service estimates the network will need 40,000 new 4G node installations), and operation, maintenance and upgrades will be required once the network exists (the CRS cites a study pegging operating costs at another $8 billion over 10 years).6 A lot of people fear the money isn't enough.5–7 It's certainly going to put a premium on partnerships and collaboration. "The $7 billion is what we have, and it's FirstNet's responsibility to fgure out a way to make that work—that's what it boils down to," says Johnson. "Our efforts will be focused on spending Division of the Upper 700 MHz Band the money Congress has allocated us in a way that gets the job done. We probably won't know the specifcs until we get farther into the project, but I think initial indications are that it is doable, given a handful of assumptions." Congress also provided $135 million under a new State and Local Implementation Grant Program (SLIGP) administered by NTIA. These funds will help states, localities, regions and tribes work with FirstNet and plan and implement their integration into the network. D Block 758 Public safety broadband 763 Guard band Public safety narrowband B Block 768 769 775 776 Conclusion So there's a lot to do and many specifcs yet to be worked out. That shouldn't dampen EMS' enthusiasm for an advance that could be truly groundbreaking for prehospital care and emergency response in the United States. Instead it should galvanize activity and participation toward overcoming remaining obstacles. Just know that the wheels move slowly. As the network stands up, some areas will be operational before others. Some capabilities come frst, others later. And EMS has to fgure out how best to utilize its new broadband powers in ways that beneft patients. Star Trek may be coming (see sidebar), but as the NPSTC's document suggests, keep those expectations modest at frst. "I think managing our expectations early on is important, because this really is an unprecedented undertaking," says Johnson. "This is the frst nationwide public safety network built in the world that we're aware of. It's going to be an enormous project. So while we're rightfully excited, it will take some time to get up, to get devices built, to get deployed, to get people trained, to get all the human components of C Block/Verizon A Block 787 788 D Block Public safety broadband Guard band Public safety narrowband 793 798 799 805 VISION: Vitals and video stream to hospitals, docs consult remotely, patients are treated fast and appropriately. EMSWORLD.com | JUNE 2013 29