Through the looking glass

Dec 1, 2007 12:00 PM, By Jim Barthold

As in every hospital emergency room, Oct. 31 was no treat for the staff of the University Medical Center in Tucson again this year. It was a typical Halloween, given the parade of hobgoblins and ghouls who — having been “cursed” with one or more of the ailments typically associated with fright night, from stomach distress to cuts, bruises and sprains — “haunt” large metropolitan emergency rooms every year.

Then the stabbing occurred.

“He was a clerk in a convenience store that has a bulletproof booth so nobody can get to the clerks. He got into an argument with a patron and had somebody buzz him out so he could go out and confront the guy. That was when he got stabbed,” said Dr. Terence Valenzuela, an emergency physician at the medical center and medical director of the Tucson Fire Department.

The stabbing provoked a red-alert response within the emergency ward, where the trauma team joined attending physicians and emergency doctors preparing for the clerk's arrival. This time the emergency room crew had it a little easier: They had an up-close, all-angles look at the stab wound even as the ambulance raced through Tucson's streets on its way to the ER.

The medical center recently started using ER-Link, a video-based emergency medical services (EMS) mobile telemedicine system that links in-vehicle cameras running off an in-vehicle router to a Wi-Fi wireless mesh network with nodes strategically placed on traffic lights around the city.

“You can get a huge amount of information by being able to see [the wounds],” Valenzuela said. “We get a sense of the patient before they arrive, what kind of personnel and resources they'll need on our part when they arrive … and you can see how they're doing.”

The deployment is the first to offer the ability to transmit video to the hospital while ambulances are en route. Emergency physicians can analyze patient conditions and review telemetry data, including heart rate and other vital signs, said Denise Barton, marketing director for Tropos Networks, which built the mesh network and supplies the in-vehicle equipment.

When Tucson officials first sought to build a municipal Wi-Fi network, the hospital's needs, or even those of the police and fire departments, weren't at the top of the list. The city wanted to improve traffic control, but when officials sought federal or state funds, they found the cupboard was bare. Funds for emergency operations, however, were more plentiful. The city eventually received $1.9 million in federal grants for the ER-Link application and another $1 million from the state of Arizona.

Thanks to this funding, Tucson ended up paying just $100,000 for a wireless system that should save $200,000 annually by eliminating the T-1 lines currently used to backhaul traffic-management data.

“We're dropping all our phone lines, and we're going to use radios,” said Francisco Leyva, project manager for the city of Tucson's transportation department. “As an extra, we're also going to be able to watch the video.”

Everybody, it seems, will be watching something in Tucson via the 230-square-mile broadband wireless network. With zoom-and-pan video cameras mounted on the city's light poles, the traffic department can receive a “second-by-second status of who has green, who has yellow, if the pedestrian signal is activated and what detectors are seeing cars,” Leyva said.

The city's police have installed equipment in seven vehicles and are testing the system as the department's primary data communication platform, although they'll hang onto their 800 MHz radios. Ambulances already are feeding back information while traveling city streets, and emergency room personnel can adjust angles, zoom and perform other maneuvers to obtain a picture that rivals computer streaming video.