SatCare targets the improvement of first-aid services using remote diagnosis and treatment of patients on board ambulances. The objective of the project is to extend the capabilities of the first responders, allowing live interaction with remotely-based doctors and equipment, and the team in the field to deliver the correct treatment immediately, at the place of intervention or en route to the hospital.
The SatCare activity is based upon integrating satcom into remotely connected medical terminals and demonstrating the systems in operational trials over 12 months. The operational trails will provide quantitative cost benefit analysis that will result from the two pilot studies will be a key component of commercializing the SatCare system.
Figure 1 Connected ambulance
The main blocks of the SatCare connected ambulance architecture are:
- Diagnostic tools that include an ultrasound machine, video-conferencing unit, vital data sensors and a PC unit.
- The communication management system, which will route the communication channels and collect and store data.
- The communication equipment, which is made up of a mobile satcom terminal, LTE modules, WiFi system, and a positioning receiver.
- The Network Access will be through subscription and capacity of KaSat satellite network, broadband mobile networks and WiFi networks.
- The Hospital will have the data storage centre, which will be comprised of a bonding server collecting data through the Internet and operator stations for doctor interaction with the patient and for data analysis.
Benefits of real-time treatment:
- Reduce healthcare costs
- Saves lives
First aid diagnosis of patients and routing to the right care structure is time critical. In the example of stroke, there was 33 million worldwide cases in 2010, with stroke accounting for 11.13% of total deaths worldwide. Stroke is the leading preventable cause of disability. The earlier the patients are treated, the less likely they are to die or be left with long-term disabilities. Many stroke victims fail to arrive at the hospital within the necessary timeframe. If emergency medical personnel had a way to differentiate ischemic from hemorrhagic stroke in the ambulance, treatment could be started sooner, leading to more lives saved and less long-term disability.
Another use case could involve major internal bleeding, such as from a ruptured spleen. This will commonly kill a patient in 1-4 hours and little can be done in terms of treatment in the ambulance. Bleeding is easily identified with the FAST scan and information about the presence of blood in the abdominal cavity can be transmitted to the hospital emergency department, together with data about blood pressure, pulse rate and other vital signs. This information will be sufficient for the surgical team to be ready when the ambulance arrives, typically cutting 45 minutes off the time it normally takes to get someone into theatre for emergency surgery. This can have a major positive impact on the survival and recovery rates of the patient.
As recovery rates are improved, the financial costs of treating patients are also reduced.
The commercial benefits of the SatCare system include:
- Reduced cost of operations
- Increase business for first aid service provider
- Improved quality of treatment when it counts
- Improvement of workflow
The commercial benefits to the customer of the SatCare system can be seen in the improved outcomes for patients reducing the long-term care costs. For ambulance providers having an onboard ultrasound system gives them a unique selling point and can allow them access to other markets like civil or military applications. The addition of broadband satcom will also allow the transfer of large amount of data at a higher speed and lower cost than other satcom alternatives. For the satellite provider the communication system developed in SatCare can become a standard communication system for many remote connectivity applications and increase the market of broadband satcom.
The emergency response vehicle will be equipped with a mobile broadband satcom link that will improve the usage of current medical systems offering higher speed, better coverage, and a continuous communication link.
The use of broadband will enable the deployment of diagnostic tools requiring the transfer of heavy data like ultrasound scans, video-conferencing between hospital and emergency response vehicle.
The more robust communication link and increased quality of data will allow for supported clinical decision making. The SatCare activity will contribute data about the potential cost savings to patient care that could be generated through the use of pre-hospital scanning with satellite transmission of the imaging data.
The SatCare activity starts with a review of the user requirements from stakeholders. This informs the final product and service requirements.
From this initial task, the communication system is developed and the preparation for the clinical trial begins. This stage includes: developing a mobile satcom terminal and communication management system, system integration and validation.
The next task sees the preparation for the pilot campaign with the installation of the system in the ambulances included in the trial.
The operation trials last 12 months and are run in three European countries.
Following the trial, data collection continues and informs the commercialisation plan for the service.
Developing a communication system that works across multiple channels.
The SatCare activity will allow for video rich data to be used to transmit scans to the hospital from the vehicle on the scene of the emergency and en-route to the hospital. Through the addition of satcom it is possible to broaden the coverage of this service to include areas where LTE (Long Term Evolution i.e. terrestrial mobile broadband) is unavailable or over-subscribed. Thus a major challenge for the activity is the development of a communication management system that can efficiently and seamlessly bond multiple communication channels.
Integration of a satcom system on ambulances
The original aim of the SatCare activity was to provide a live feed of ultrasound from an ambulance on the move. The satcom terminal size and weight did not meet the Scottish Ambulance Service’s requirements, meaning the satcom terminal cannot be integrated currently on their ambulance fleet. The challenge for the SatCare project was to re-design an activity for telemedicine integrated with satcom in rural Scotland using a satcom terminal that was acceptable to the ambulance service This challenge has resulted in SatCare having two different satcom system architectures on trial, meeting the differing requirements of two ambulance services. This will allow the SatCare system to demonstrate a wider range of requirements widening the potential customer base.
Coordination and performance of operational pilots in different countries.
The operational pilots of the SatCare system will take place in Belgium, Spain and Scotland. The co-ordination of pilots in multiple countries can provide challenges including language barriers, differences in protocols, different health service requirements. For example, the initial users requirements assessment confirmed that the ambulance services of different countries have different requirements with regards to hardware integration on their ambulance. Considering this aspect, the SatCare activity has evolved to demonstrate two different pilot cases of ultrasound transmission.
The Satcare Zebra Site Acceptance Tests review meeting was successfully held in Belgium on 19th November 2019. Passing smoothly through the SAT tests procedure, the Zebra Telemedicine system, combined with ViaSat Ka band satcoms solution, proved that mobile satcoms could be used to effectively provide doctor to patient care “on-the-move”. The project will now go into the trial phase for a few months where the Satcare Zebra solution will use mobile satcoms to extend the coverage range of the Zebra telemedince remote doctor to patient system.
KaLMA (Ka band Land Mobile Antenna) mounted on the roof of the ambulance
View of ambulance fitted with KaLMA
Orientation of Zebra system head unit (monitor, camera & mic) to gurney
Simulated doctor log-in to Zebra telemedicine system
Logged-in to Zebra platform with view of gurney in wide-angle mode
Zebra head unit as it appears to the patient