mHealth for Emergencies: because there’s only one device at every single medical emergency

In Ireland this week there are two large events for Emergency Medical and Critical Care professionals: The EMS Gathering in Killarney (@EMSGATHERING / #EMSG16)

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and SMACDUB at the Convention Centre in Dublin (@SMACCTEAM, #SMACCDUB):

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Having lost countless nights sleep and many weekends of my life working in emergency medical services (and having had my own life saved by a paramedics quick thinking and rough suturing handiwork!) to my mind the contribution made by emergency medical professionals to society could never be overestimated so I was doubly disappointed to find neither of the programs featured mHealth content. I heard nothing back on contacting the organisers with the suggestion of presenting a CPD accredited mHealth opportunity for Emergency Medical Professionals course in which I could demo examples of some of the key mHealth opportunities so I thought it might be helpful to list a few here (please use the comments box below to make your own suggestions):

> Proactive approach to Mental Health and Wellbeing

It’s really important we look to the mental health and wellbeing of emergency medical personnel. A large number of the online discussions you can see under the event hashtags #EMSG16 and #SMACCDUB seem to be referring to alcohol fuelled social meetups and while I’m in no way a ‘party pooper’, realise that frontline medics need a release and that this what a lot of people enjoy doing when they visit Ireland we really need to do something to ensure this doesn’t continue to be the standard way for medics to manage their stress because it’s not healthy for frontline workers or their families. A good read on this topic by Dublin based GP Dr Ciara Kelly.

I think we can learn lots from the ground breaking work being done in Aviation (which reminds me I have a draft post waiting to go up on this from the groundbreaking recent Aircrew Mental Health and Wellness event that I video recorded at the Royal Aeronautical Society in London with a great talk by a RAF Doctor (until recently ‘getting wasted on alcohol’ was considered the standard treatment for tragic experiences which are thankfully getting fewer in line with reduced safety failings).

> Mobile Content (for Healthcare Professionals and to help educate/train citizens on first aid and life support)

First Aid App

> Mobile Ultrasound

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> Mobile Cardiac Monitoring

alivecor-mobile-ecg-with-case-for-iphone-5-5s_6872399

> The M2M IoT opportunity for emergency services and critical care

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There’s such enormous scope for this when you realise it doesn’t make sense to a child that we have expensive life saving medical devices like defibrillators in cabinets all over the country and we don’t know a) if they are actually there b) if their battery is charged etc.

> Social Media

Just as you don’t dig a well when you’re thirsty I think (as with the Junior Doctors) it’s really important EMS teams are using social media to support Patients and their Colleagues because cuts to services (and wasteful use of the resources that are made available) lead to the reduction in key services that a functioning society depends upon and doesn’t ever appreciate is missing until they need to call upon it.

> The opportunity for EMS to go Mobile First

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> How would the Born Mobile Generation redesign Emergency Medical services?

mHealth Insights

SMACCDUB starts tomorrow and schedules here mean it’s looking increasingly like I’m not going to be able to get away to it so I thought I’d post my thoughts on checking out the EMS Gathering yesterday in Kerry:

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I found nothing that you wouldn’t love about the design of this meeting with the super comfy informal chairs and small group break out sessions. Location is incredible at the Malton in Killarney, right next to the train station and on the edge of the one of the most beautiful lakes/parks in the world all pale into insignificance when you meet the incredible hospitality of the hotel staff. Is there anything they won’t do for you? Local farms and the race track were opened up for scenario simulation training etc.

Big event organisers could learn lots from the design of this event as it had moved beyond having a speaker/delegate divide and this pad wonderful dividends eg. everyone’s learning and delegates are comfortable getting up and presenting to fellow delegates/speakers.

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Simulations are invaluable for training Emergency Medical staff as most of the scenarios just can’t be taught in standard classrooms and the type of personality that works well in emergency situations very often don’t like or underperform in classroom teaching. The team from iSimulate did an incredible job with some cool props eg. an affordable/portable ambulance simulator equipped with CCTV and vital signs emulators.

Fascinating to see the talent that work at making things all look/feel so realistic so that classroom work can translate into skills in the field so easily.

IMAGE OF EXHIBITION AREA

Where are the mobile operators?????

It’s clear to me that there’s only one device that you can be sure will be at every single medical emergency and that this is a key factor that has underpinned the explosion of the newest trillion dollar industry so I am stunned that there’s not at least one mobile operator with a big booth/sponsorship of this event and gathering feedback for their business development teams.

In many countries around the world Mobile Operators use the “used by Emergency Services” slogan as a valuable direct to consumer marketing message and give ~30% discounts to Emergency Medical Staff who connect their phones with them etc.

The lack of any real competition between the Mobile Network Operators is the only explanation I can think of that explains why isn’t this already an area where the MNOs are prioritising.

Where were the drones?????

University Hospital Helicopter

At the Killarney Horse Racing Track an incident response demonstration was laid on and the details of the design and the infrequency of it’s use in many areas of the country highlight the importance of making staff members familiar with the latest rarely used equipment and procedures. I think it would’ve been great to have groups produce a “How to use the XYZ Equipment in the event of a Special Incident” YouTube video using a 360 degree camera as it would highlight really important human factors etc that need to be considered.

IMAGEs OF THE DECOMTAMinATION DEMO

IMAGE OF Laerdal kit DEMO

I’m a big fan of Laerdal equipment but they really need to go Mobile First with their tech as all the wires and poor user interfaces (Qwerty keyboards etc) are letting their amazing design work down.

IMAGE OF TABLE TOP FULL OF KIT

The range and complexity of kit being routinely used and carried is increasing

IMAGE OF US workshop

No really portable (mobile phone based) ultrasound equipment was being demoed but these were very good sessions and reminded me of how ridiculous the medicolegal/insurance barriers are that are preventing ultrasound being a primary care GP tool here in Ireland.

IMAGE of 3x choppers on the track at Killarney

How was your experience of the EMS Gathering? What did I miss?

*** UPDATE: 10th June 2016 ***

I spoke too early, there will be some mHealth being showcased in Dublin – Clarius (follow them on twitter @ClariusmHealth) have been confirmed as a SMACCDUB exhibitor and will be demoing their mobile connected prototype ultrasound probe:

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Philips have also confirmed that they are exhibiting with their “Lumify Portable Ultrasound” which works with high end Android smartphones and has been shown at innovation events for a year now but still hasn’t been made available commercially which is odd as they have the distribution and the demand is clearly there if it’s priced right:

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*** UPDATE: 12th June 2016 ***

It’s going to be near on impossible to pick up on any mHealth nuggets from following the #SMACCDUB twitter hashtag as every delegate seems to be posting their Dublin arrival/first-pint-of-Guinness/etc selfies (a conference in Ireland is clearly on the top of every medics bucket list!) so I’ve kicked off a little Twitter competition:

#smaccdub #mHealth app competition

Rules are simple: to enter you will need to share a link to your favorite app (or the companies twitter account) and/or a screenshot of your apps.

Here’s an example post that will give you the idea and show you how easy it is to enter:

#SMACCDUB #mHealth BNF https://itunes.apple.com/ie/app/nice-bnf/id523093958?mt=8

We’ll then make a comprehensive listing of the those submitted on this mHealth Insight blog post of the apps suggested and we’ll then raffle at least one Alivecor ECG device amongst the entrants and get in contact with them and post it out to their mailing address. Sound fair?

The GoodSam App kicks off:

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Matthew S Muller has added CirrusMD/cirrusmd.com:

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*** UPDATE: 14th June 2016 ***

In California at the Apple World Wide Developer Conference (follow #WWDC2016) one of the key announcements was an update to Watch OS that turns the Apple Watch into a smart medical ID Bracelet.

Simply press and hold the side button underneath the Digital Crown and an emergency call will be placed (with a handy countdown from three that allows the wearer to cancel it in the event of an error). Not only can the Watch automatically call emergency services but it can do this regardless of country the user is in so it also gets around the international differences that exist, and the call can be made either via the tethered iPhone or directly via a connected WiFi network. I wonder how long it will be before regulators make it compulsory for all WiFi networks to be required to accept an emergency call placed by an Apple device?

Asides from it’s use by Patients can you imagine this on the hand of a first responder, paramedic, fire officer or rural Doctor. So often you need to use both hands with needles/drip bags/etc so I think it’s going to be a great new tool that will help first responders communicate better.

Further more the SOS service that’s twinned with this new feature will also send your location to your emergency contacts, alerting them that you’re in need of help (which I think will open up some interesting call hold/management challenges) and also enable the sharing of the Patients Medical information.

As Ireland builds out a 5 year eHealth €850Million plan to make medical records accessible I think it’s clear that Apple is making all these big eHR infrastructure investments by government healthcare providers obsolete before they’re even built!

If you still don’t think we live in a decade set to be defined by mHealth check out Tim Cook’s recent interview in which he touched on the topic and ask yourself why more important innovations in emergency medicine have so far been launched at the Apple Developer Conference in California than at the world’s biggest Critical Care meeting in Dublin?

I think if the priorities were right we would be reading about this first in the Journal of Critical Care not TechCrunch! 😉

The Apple Watch is now a smart Medical Bracelet

How long before it’s possible to Facetime call emergency services and share your medical information? How long before a deterioriation in your health can be detected and an alert sent to your carers without a Patient having to do anything?

*** UPDATE: 25th January 2017 ***

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The BBC reports that the NHS is wasting as much as £475 Million per year on a new radio system. Imagine how much value for money they’d get if they built on the tools of our time and used their influence with government to get ‘Always Best Connected’ priority access to the mobile networks that have already invested billions deploying infrastructure across the UK?

*** UPDATE: 12th March 2017 ***

I think this fantastic new Broken Toy blog by ER Consultant Dr Simon McCormick does a great job of highlighting the mental health challenges and value of blogging for those working at the coal face of emergency medicine.

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It is a great shame that this hard working Carer probably had to experience a breakdown before the opportunity materialised but I think it will now help encourage more to be active online even if the advice from professional organisations like the GMC is outdated and discouraging.

Healthcare Professionals need to have social networking profiles so that in the very least they can speak out against and support things that are undermining Patient Care and their Colleagues (who are often being harmed because they’re sharing in a society that doesn’t yet understand medics can have mental health problems of their own and can help others greatly by sharing experiences).

It should also be a responsibility of those working in Emergency Medicine to ensure that their teams are provided and made aware of the availability of convenient ways to access independent Mental Healthcare services eg. like 3G Doctorthe BMA’s new Video Call service for Doctors, etc.

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