PHEMS
Pre-Hospital Health Emergency Management System

The PHEMS components provide services for:

  •  Management of emergency records.

  •  Management of involved resources such as mobile units, beds in hospitals, etc.

  •  Ambulance tracking and route guidance

  •  Acquisition, transmission, and visualization of multimedia medical data

  •  Teleconsultation

Management of emergency records.

The Emergency Record Management System (PHEMS/ERMS) supports the personnel at the HECC (Health Emergency Coordination Center) with regard to the handling of emergency episodes. After receiving a call, it allows the operator to create a new emergency episode folder (or record) with the information received from the caller. Hereafter, the dispatcher enters information about the resources allocated to this episode. During the mission, further information is added to the folder, either by direct acquisition (e.g. vital signs) or by means of the ERMS’s user interfaces. All over its lifetime, the folder is kept at the HECC, where it can be used for statistical analysis or as part of a patient’s distributed electronic health record.

The ERMS consists of a database and a set of dedicated client applications, by which the stored information can be accessed locally or over the healthcare provider network. Basic resource management services are provided.

Management of involved resources.

The Emergency Management Assistant (PHEMS/EMA) provides decision support in the form of suggestions, with focus on resource management issues (e.g. which mobile unit should be sent? which hospital should be used? etc.). This ‘added-value’ system is able to learn from previous cases. It has the ability to query the PHEMS/ERMS and to monitor not only incoming vital signs and ECGs from mobile units, but also the resource-related decisions of the operator/dispatcher, i.e. the feedback to its proposed actions.

The EMA is an added-value module contributing to the optimal management of resources at the dispatch center.

Ambulance tracking and route guidance.

The Ambulance Tracking System (PHEMS/ATS) keeps track of mobile units and other vehicles, as far as their location is concerned. Position data are continuously transmitted from each vehicle to the HECC, where they are used to feed a Geographic Information System (GIS), which is responsible for representing all the tracked vehicles as (moving) symbols on an electronic map.

The ATS uses a GPS receiver in each vehicle to be tracked, and a GIS for the visualization of these vehicles on an electronic map.

Management of multimedia medical data.

The Acquisition & Transmission Modules (PHEMS/ACQ) are responsible for the acquisition of multimedia medical data such as vital signs, ECGs, and video images, at the remote units or PCCs. They handle the interfaces to the specific medical or video equipment. They take care of the transmission to the ERMS, and the visualization at the assistance site or at the HECC. Thus, they provide medically relevant information directly from the assistance site at the HECC, where it is visualized at a medical workstation and/or stored in the Emergency Record Management System.

For a number of medical devices used at the assistance site, dedicated adapters will be developed that allow the acquisition and transmission of data provided by those devices.

Teleconsultation.

The Teleconsultation System (PHEMS/CoMed) is an added-value service with regard to PHEMS/ERMS and PHEMS/ACQ. Providing a shared workspace among medical experts at remote and distant locations, is one of the main functions of this teleconsultation service. This service requires the synchronous viewing and manipulation of a common set of multimedia medical data, as well as the real-time exchange of comments among all parties involved in the session. While the services for the acquisition, transmission, and visualization of multimedia medical data are responsible for delivering and presenting the material for a session, the teleconsultation service provides mechanisms for managing a session and for using that material during a session (e.g. graphical annotations).

This teleconsultation system supporting medical images is supposed to be used by the non-mobile nodes, i.e. the HECC, the PCCs, and the hospital departments involved in emergency cases.

Implementation Details

The emergency episode folder has been implemented in  SYBASE SQL Anywhere.The user interface has been developed with Powerbuilder. Finally, the   management of involved resources  and the simulation modules have been implemented in Java.

Mobile technologies (GSM) are being used for the communication  between HECC and mobile units. The electronic map has been implemented with MapInfo a Geographic Information System (GIS).

At present time, the following two devices for acquisition and transmission of data are supported.

  • medical monitor "PROPAQ 106 EL" (Protocol Systems) that provides acquisition and packaging of six vital signs, i.e. systolic & diastolic blood pressure, oxygen saturation, heart rate, temperature, respiratory rate
  • ECG "Excel 106 scp" (Cardiette) that provides acquisition and packaging of 12-lead ECG in SCP/ECG standard format