Karl Fischer: Telematics saves lives: where every second and every bit of information counts

When rescue services are involved, every second in the transport and a decisive information advantage that hospital emergency rooms receive makes a difference. The innovative Telematik II project underway in Bavarian rescue ­services increases the chances for patients’ survival and recovery thanks to the digitally recorded chronology of each rescue mission and the patients’ physical status.

Whether heart attack, stroke or traffic accident: quick help is required whenever people are injured or in life-threatening situations. After dialling 112 (the EU-wide emergency number), the emergency calls land at one of the 26 integrated control centres in the Free State of Bavaria. The centre in turn alerts the appropriate rescue services and supplies the rescue teams with vital information.

In emergency rescue missions or when providing ambulance services, a considerable volume of information is collected, which is important for the operation documentation and the hospital which will treat the patient later on. This information includes, for example, the logistical data and medical measures, which were previously documented on paper with three carbon copies. Transferring the patient to the hospital was done by a conversation between ambulance and hospital staff and turnover of the respective documentation. The accounting data was transmitted to the central accounting unit which is responsible for all rescue services in Bavaria.

In order to standardise and improve the data flow, to prevent system breakdowns and thus prevent incorrect entries and misunderstandings, it makes sense to record and transmit all data electronically in a timely manner. To achieve this goal, the Bavarian Red Cross and the working group comprised of the parties responsible for rescue services in Bavaria, in cooperation with the Bavarian Ministry of the Interior, launched the Telematik II project. The LKZ Prien GmbH was commissioned with the project management; medDV supplied the data recording system.

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The idea of providing paper documents in electronic form on a PC, thus making the information available as legible and error-free as possible to everyone who has to subsequently work with it, is as old as computing itself. For a long time, this was only possible in areas with a suitable “permanently installed” infrastructure in an office with protected networks and Internet access.

Notebooks and tablet PCs, which now satisfy these requirements for mobile use through suitable operating systems and corre­­s­­ponding data communication, are increasingly eliminating paper documents when “on the road”. As rescue service mis­­sions are often carried out under difficult conditions, they also pose special challenges to mobile data recording systems. For example, the hardware must be protected against spray water; it must be robust and must be impervious to disinfectants. The software must be intuitive and must be operable even when wearing gloves. High failure safety is a requirement, as is a wide network coverage (particularly in rural areas) and compliance with applicable data protection guidelines. Another important aspect is that the medical data can be loaded di­­rectly into the protocol. This not only means that blood pressure and heart rate can be transferred, ECG data can be re­­cord­­ed and transmitted directly to the hospital, if necessary.

Rescue services in Bavaria were faced with the task of equipping all of the nearly 1,500 public rescue vehicles with mobile tablet PCs. This included providing the hardware and the corresponding charging options in the vehicle as well as training all full-time and volunteer staff members active in rescue services in the operation of the equipment software. The electronically recorded data makes it possible to fulfil statutory requirements concerning statistical data, quality management and scientific evaluation.

The roll-out has been successfully launched, following extensive preparatory work by the project group and a test phase, and has already been largely completed. All aid and relief organisations active in public rescue services will have live operations available by mid-2015.

The project has already been called a flagship project thanks to the very positive progress of the system launch and was awarded the silver medal at last year’s international eGovern­­ment competition, under the patronage of the Federal Minis­try of the Interior, in the category eHealth.

This project provides a unique opportunity for further ex­­pand­­ing health care research across Europe with the help of a tre­­men­­dous amount of data, while providing a way to im­­par­­tially assess and continually improve the high standards of rescue services. It is now the desire of all those involved in the project that as many hospitals and clinics in Bavaria partici­pate in this concept, thus making it possible to have all pa­­tient-re­­lated data available immediately upon admittance of the patient.

The author has been managing director of the LKZ Prien GmbH since 2000. Prior to that, he was managing partner at Simssee-Transport and RO-Sped GmbH. Karl Fischer was honoured with the Deutscher Logistik- und Umweltpreis (the German logistics and environment award) in 2000 and has received numerous other awards.