10 Jun Hastings-Quinte Paramedic Services Innovative Smart Glasses Technology
Paramedics are limited to voice communication when relaying medical information to receiving hospital emergency departments. The ability to transfer data to and from hospitals or emergency operation centres is very limited. In addition, paramedics are limited to bulky laptops in the ambulance for patient documentation. This impacts patient care as the paramedic is not in continuous visual contact with the patient and is limited to the amount of medical information they can share. There is no visual data being transmitted of emergency scenes to either the receiving hospital, or in the case of large scale emergencies the Emergency Operations Centre (EOC). This could be injury sites on a patient if sending to an emergency room, or it could be a visual photo or video of a large-scale emergency.
Hastings-Quinte Paramedic Services launched the Innovative Smart Glasses Technology to engage wearable smart glasses technology to improve situational awareness and increase decisions support tools for paramedics. The scope of this technical demonstration was to develop a series of experiments that showed visual information sent through the “eyes” of the paramedic through wearable technology. Three experiments including a medical, trauma, and large-scale emergency were developed and tested in a simulated environment to relay patient information, photos and videos of emergency situations to various key officials and expand upon voice activated charting. The technology increased situational awareness for those paramedics while treating a patient, increased patient safety, and also helped in providing key decision makers for vital information in real time, in an effort to mitigate large scale emergencies.
To our knowledge, this is the first time in Canada that this type of technology has been tested in the paramedic environment to this scale. Hastings-Quinte Paramedic Services does not know of any paramedic service in Canada that has used smart glasses technology to access standing orders, explored the option of voice to text documentation, and used smart glasses to see through a drone camera and relay this visual information to a hospital or emergency operations centre.
This new technology has the potential to have a positive impact on patients because the paramedic will have access through the smart glasses to standing orders and medical protocols. In addition, the smart glasses were able to capture photos of the patient, injury or emergency scene, and relay that in real time directly to the receiving emergency room or emergency operations centre (EOC). This now gives the receiving centre a visual of the patient conditions which improves the quality of life of the patient and increases the effectiveness of the paramedic, and the entire healthcare system.
Access to visually observe placards from the drone through the smart glasses were able to increase paramedic safety, as the responder would not need to entre dangerous areas. There was also the ability to triage with great situational awareness by viewing the scene through the smart glasses form the camera of the drone. The experiment was developed with the following objectives:
Objective 1: Test connectivity between the smart glasses and the Panasonic Toughbook tablet in the front of the ambulance.
Objective 2: Demonstrate that photos and simulated patient information taken from the smart glasses can be transmitted to receiving emergency room staff.
Objective 3 Design three scenarios to test the connectivity of the smart glasses.
Objective 4 Capture the patient care data through voice prompts.
Objective 6: Conduct simulated experiments.
Objective 7: Write a final report.
There were several partners that were engaged in this project including Indro Robotics, Interdev Technologies, Defence Research Development Canada, Hastings County Information Technology Department, Epson, Microsoft, Paramedic Program for Eastern Ontario, and Tyendinaga and Hastings County emergency control group. The diagram below shows the technology linkages that were used in the experiments:
The results of this innovative technology showed a major impact on patient care, paramedic situational awareness and safety, and other healthcare partners and emergency officials. By connecting the paramedic with smart glasses, the paramedic was able to access medical and trauma standing orders without taking their eyes of the patient. Typically, paramedics reference these documents through pocket books or turning their head to view on a laptop. With the smart glasses, the paramedic was able to connect and view the medial directives without looking away from the patient. Paramedics are required to memorize complex medical calculation some which are not used that often (e.g. pediatrics). This technology allowed the paramedic to access these in real time, decreasing the potential for patient safety errors to occur.
Because we were able to attach a microphone and open the medical record, the paramedic through voice activation was able to populate the medical record in real time. This increased the accuracy of documentation because the procedure was timestamped at the time of administration, decreased workload for the paramedic who no longer needs to fill this in manually at the end of the call. This would increase availability of ambulances to respond back into the community.
With the ability to send photos and video directly from the scene, the paramedic was able to show the receiving emergency room exactly what the patients injuries looked like in real time. This was beneficial from a healthcare system as emergency rooms could then better prepare for the patient, plan for operating rooms if required, or call in staff based on the needs of the patient prior to the patient arriving at the hospital.
From the emergency management benefit using the smart glasses, paramedics looking through the camera of the drone were able to assess the scene from a distance for greater situation awareness. This included determining the number of patients, who was moving or not, the ability to read hazard placard, and take video of the scene. All of this competed without having to enter or other first responders to enter a potentially hazardous scene. The time saved to gain this information allowed for a better coordinated response. By identifying the hazard placard, the smart glasses could then be used to access the emergency response guide and display the information on the glasses. This was then communicated to others on scene increasing safety and coordination.
The video that was captured was then sent in real-time to municipal emergency operation centres (EOC) so what the paramedic was seeing through the smart glasses was displayed to control group members. By having this real-time information, the extent of the emergency and the community response was better equipped to deal with the emergency. Finally, the ability to document a scene and prepare lessons learned, after action reports, or use in a litigation was increased by having this technology. By establishing greater access to information in real-time on the front end, all of the above listed challenges were lessened.
This technology was specifically designed to help further and advance innovative technology benefits to the paramedic profession. Many paramedic services already have existing electronic medical reporting platforms, internet structures, EOC operations, standing order electronically, and computer information technology infrastructure. From the experiment the technical mapping of how each of the objectives were completed has been documented.
With the ability to take photos and video, the application of this technology goes beyond emergency response. The ability to use this technology in a community paramedic or remote patient monitoring setting could also be exploited. Paramedics in rural and remote settings could link primary healthcare providers with patients through this type of medium which has not been fully exploited. Cost saving of long transport times of patients who could be “seen” through smart glasses and a paramedic linked to other healthcare partners is there for expansion.
Finally, the ability for this technology at a large-scale MCI, or emergency allows greater operational situation awareness for all first responders. Linking and sharing this technology with other first responders, and healthcare partners could be consulted to increase options for an expanded use of smart glasses and how the paramedic could be the link that connects everyone.