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A new system for transmission of on-line information from scene of accident and ambulances to hospitals
Linköping University, Department of Biomedicine and Surgery.
Centre for Prehospital and Disaster Medicine, Göteborg, Sweden.
Linköping University, Department of Clinical and Experimental Medicine, Katastrofmedicin . Linköping University, Faculty of Health Sciences.
2003 (English)In: International Journal of Disaster Medicine, ISSN 1503-1438 (print), 1651-3037 (online), Vol. 1, no 2, 127-131 p.Article in journal (Refereed) Published
Abstract [en]

Objective. The 'Swede information system' was introduced in a county with approximately 450,000 inhabitants in April 2000. The implementation of this information system, intended to be operative in major incidents and disasters, has included the introduction of new technologies as well as new standard operating procedures for both ambulance crews and hospital staff. The objective of this study was to see how this information system with digitally mediated transmission was used as a daily routine during a 2-month period, 1 year after its introduction. Methods. The Swede information system sends on-line information from ambulances to emergency wards in the county. The technique used is a LAN (local area net) for communication within the site of the accident, Mobitex® from the ambulances to a data server and from this by Internet to the hospitals. During March and April 2001 all events when an ambulance was dispatched were recorded. All cases when the system was used to notify the receiving hospital were recorded as well as all cases when the ambulance crew alerted the hospital through the alert function. All technical problems and any period of time when the system was 'out of use' were noted. Results. During the period of the study, the system was successfully used to transfer data from the scene to hospital in a total of 3353 missions, including transport of a patient from the scene to an emergency department. Of these, in 150 transports the transferred data served as a base for immediate support on arrival at the hospital that was of critical importance for primary management in the hospital. In all, 2883 different kinds of medical data were transmitted. The local help-desk was notified of problems with the system on 11 occasions; six of these were technical problems and the rest were user-related. The IS Swede system was not operational during parts of 3 days (<5%) of the time. Conclusions. Despite the introduction of new equipment and new standard operating procedures, IS Swede was accepted within the organization to a degree which could be considered operational in major incidents. Technical problems with IS Swede caused only minor disturbances during the study period.

Place, publisher, year, edition, pages
2003. Vol. 1, no 2, 127-131 p.
Keyword [en]
communication, ambulance, internet, Mobitex®, on-line information
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-14196DOI: 10.1080/15031430310031366OAI: diva2:22882
Available from: 2007-01-04 Created: 2007-01-04
In thesis
1. Disaster medicine- performance indicators, information support and documentation: A study of an evaluation tool
Open this publication in new window or tab >>Disaster medicine- performance indicators, information support and documentation: A study of an evaluation tool
2006 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The science of disaster medicine is more a descriptive than analytical type. Research, in most instances, has not employed quantitative methods and there is very sparse knowledge based on analytical statistics. One consequence of this is that similar mistakes are repeated over and over. Lessons that should be learned are merely observed.

Moreover, there are almost no practical or ethical ways in which randomised controlled studies can be performed.

The management, command and control of situations on different levels of hierarchy has eldom been evaluated and there have been no standards against which performance can be evaluated. Furthermore, the documentation of decisions and staff work is rarely sufficient enough to evaluate command and control functions.

Setting standards that may be used as templates for evaluation and research is an issue that is constantly being addressed by leading experts in the field of disaster medicine and this is also an important issue that is expressed in the Utstein Template.

Swedish National Board of Health and Welfare, templates of performance indicators were developed. These were tested on reports available from incidents, and our conclusion was that documentation in this form was not adequate enough for use in this method of evaluation.

Documentation must be improved and data probably need to be captured and stored with the help of information systems.

A template developed for the evaluation of medical command and control at the scene was tested in standardised examinations. When using this template in this setting it was possible to obtain specific information on those aspects of command and control that need to be improved.

An information system using on-line Internet technique was studied twice. The first study concluded that in spite of technical disturbances the system was acceptable to the organisation but could not yet be recommended for use during major incidents. The second study concluded that the retrieval of information was, in all respects not as good as the control system, a conventional ambulance file system.

In a study of staff procedure skills during training of management staffs in command and control it was concluded that documentation during training sessions was not adequate and this lack of staff procedure skills could possibly be a contributing factor to the fact that lessons in command and control are not learned from incidents.

Conclusions in thesis are that measurable performance indicators can be used in the training of command and control. If performance indicators are to be used in real incidents and disasters, functioning information systems have to be developed. This may lead to a better knowledge of command and control and could possibly contribute to a process where lessons are learned and mistakes are not repeated.

Place, publisher, year, edition, pages
Institutionen för biomedicin och kirurgi, 2006
Linköping University Medical Dissertations, ISSN 0345-0082 ; 972
disaster medicine, performance indicators, evaluation, information system, documentation, staff skills, command and control, management
National Category
Anesthesiology and Intensive Care
urn:nbn:se:liu:diva-7990 (URN)91-85643-55-6 (ISBN)
Public defence
2006-12-14, Aulan, Katastrofmedicinskt Centrum, Campus US, Linköpings Universitet, Linköping, 10:30 (English)
Available from: 2007-01-04 Created: 2007-01-04 Last updated: 2009-06-01

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