Today some ambulances come equipped with telecommunciations technology that allows in-transport contact with physicians. But even the minutes between when a patient is loaded into the ambulance, or out and into a care setting, can leave room for miscommunications, according to one expert.

That is why Hamilton Schwartz, MD, led an initiative to find a technology that would allow his team access to the patient from the moment of pick-up until the patient was physically in the same room with the physician. Schwartz is a board certified emergency room pediatric practitioner, who serves as the medical director of Statline, a division of the Cincinnati Children’s Hospital Medical Center’s Emergency Department that serves as the hospital’s interface with emergency medical service providers and ambulance transport teams. After hearing about Scottsdale, Ariz., based GlobalMedia, Schwartz contacted the telemedicine company and they began a two-year collaboration.

“We didn’t even know there was a need before Dr. Schwartz approached us,” said Roger Downey, communications manager at GlobalMedia.

The result of the collaboration is the Transport AV telemedicine system, which attaches to a stretcher allowing direct contact between doctors and patients while in transit, and all the way into the hospital ER or examination room. According to Becky Baute, senior clinical director, critical care transport team, CCHMC has four AV systems.

Baute has been involved in the development, implementation and evaluation of the AV system and in educating physicians on its use.

“It seems that physicians have a greater confidence in prescribing medications, procedures or therapies based on actually seeing their patients,” said Baute.

 “What we are trying to do is get the patient linked to a physician at the earliest time – at first touch so to speak – when decisions are the most critical,” said Downey.

The system includes a remote control examination camera, about the size of a dry erase marker, and a digital stethoscope, echo-canceling microphone and headset, which all connect via the Internet from the ambulance to CCHMC. The camera sends real-time images to doctors including whole body and close-ups, as well as the patient’s systemic reactions to in-transit treatments.

Although Downey says their 3G/4G communications are at the mercy of telephone towers, the software they developed allows the camera to freeze-frame last images doctors receive if they lose connection and will hold onto the call until reception returns.

Schwartz says the technology allows them to quickly determine how serious the patient’s condition is, and in many cases allows admission paperwork to be done in advance so that patients can be immediately brought in.

“One surprise benefit we didn’t expect was safer ambulance rides,” said Schwartz.

“By seeing the patient, the physician states that they are more confident in recommending that we do or do not travel with our lights and siren,” added Baute.