It is generally accepted that early and specialized pre-hospital
patient treatment improves outcome in terms of mortality and morbidity,
in emergency cases. The focus of this paper is to present the
implementation and the evaluation of an ambulance located telemedicine
system for pre-hospital patient treatment. The primary emphasis is on
the vital sign transmission from the accident site or the moving
ambulance to the consultation site, using the GSM mobile telephony
network. There, the experts evaluate the patient data, decides about the
treatment protocol and provide directions to the ambulance’s medical
staff concerning on the patient handling until the arrival to the
hospital.
A. Project Design and Equipment. Emergency units such as ambulances,
patrol cars and firevehicles are participating in this project. The
operations are controlled by a small-scale trauma dispatch center,
located in the University Hospital of Rion, Greece. All units are
equipped with Global Positioning System (GPS) devices [14], able to
transmit, via GPRS modems, the vehicle’s current position to the
dispatch center, for vehicle control and management. A “clever
mechanism”, installed both on vehicles and on controller in traffic
intersections, forces in an indirect manner the transition to a “green
light” when the ambulance is in a direction towards the corresponding
traffic lights and in an adjustable radius. This capability makes
possible the road to be free of traffic in the moving direction of
vehicle. Additionally, each ambulance is equipped with: •special medical
devices to acquire vital signs, such as electrocardiogram (ECG), Blood
Oxygen Saturation (SPO2), Non Invasive Blood Pressure (NiBP),
Temperature (Temp), from patients and transmit them to the dispatch
center using the GSMnetwork [13] – [16]. The data can be collected on
the field of accident or en route to the hospital (Fig. 1), •a wireless
LAN (IEEE 802.11) to transmit patient video or still images acquired by a
wireless camera, from the ambulances to the dispatch center. In the
trauma dispatch center is installed: •a Geographic Information System
(GIS) [14] based street network data set, which is managed by a
computer. The GIS operator can observe the exactly location and movement
characteristics of all vehicles, •a server hosting still images or
video transmittedfrom the ambulances’ wireless cameras, •a server
hosting vital signs transmitted from the ambulances. B. Telemedicine
equipment and transmission. The core of the telemedicine system is a
portable device collecting and transmitting vital signs. Within this
project, a market analysis has been performed evaluating diverse market
available vital signs devices constructed by various manufacturers. The
final decision has been based in the following specifications and
restrictions: •fit to the small free space inside the ambulance, •light
and portable, •a compact construction tolerant both to the bad
mechanical and electromagnetic conditions, •waterproof, dustproof, oil
proof, •built in transmission capability, easy connection to the
patients body for vital sign collection, •user friendly, •communication
over the GSM network, which has significant coverage in Greece, •secure
data transmission, •no independent devices for each vital sign butmany
devices integrated into a common package. Independent devices take up a
lot of space, and need a lot of probes and cables for their installation
and operation. Also, the operators need to spend alot of time to
connect them to the patients. The other investigated category was the
medical monitors. A medical monitor includes the measurement of many
vital signs in a small cased device. But the usage onextreme conditions
feeds the measured signal with artifacts, garbling the data. The result
of the above market analysis led us to employ of a defibrillator device
equipped with embedded vital signs amplifiers. This device allows the
ambulance staff to: •measure and transmit of vital signs during the
patient collection and transportation to the first aid center, and
•defibrillate the patient if it needs so (after the experts advice),
•carry the equipment in an accident area away fromthe ambulance. The
selected defibrillator device handles the following vital signs: •Up to
12 lead ECG, •Blood Oxygen Saturation (SpO2), •Heart Rate (HR),
•Non-Invasive Blood Pressure, •Temperature, •Invasive Blood Pressure
(IP), •CO2 measurement. Code Shoppy
The implementation of the other part of the telemedicine system, the
dispatch center, has been organized on the basis of the following
specifications and restrictions: •Demonstration and modification of the
patient demographic data, •Preview and measurements of the received
medical data, •Archiving capabilities, •Capabilities for
computer-assisted diagnosis, •Signaling of any new incoming incident,
•Secure data reception and verification, •User friendly interface. The
software running on any workstation of the dispatch center has to
include a restricted number of different working windows (forms)
demanding the minimal possible users actions. Figure 2,3 and 4 depict
some working windows of the dispatch center. In Figure 2, the expert can
see all events, alarms, the chronological list of the collected data,
curvesrepresenting continuously recorded parameters, values in each
point etc. In Figure 3, up to 12 lead electrocardiogram strips collected
from the patient can be observed. Figure 4 shows the tools provided to
the doctor in order to perform measurements on the ECG strips.
The aforementioned system was designed and implemented in order to
assure that an emergency case will be served on the minimum time. So, if
the vital sign collection and transmission starts being performed by
the paramedics the time needed for in hospital evaluation
willsignificantly decrease. Also, it is possible that the patient’s
therapy begins during his transportation depending on patient’s health
emergency level and the expert’s direction.
Multiple Subjects of College Information Management System Estimate
In each of the categories there are very specific mechanisms which must
exist in a model of information system architecture. Measuring scales
are developed in order to record whether or not the model meets the
criteria in each category. For some conditions a natural scale exists
and is used as a measurement. In all other areas a binary scale is used.
In the case of the binary scale, a zero indicates that the model does
not meet that condition, and a one indicates that the condition is met.
Project Team of Information SystemProject team of information system
develop, implement and control the system, of which the project manager
is the head, and system analysts, programmers, persons participating in
the system development and implementation are the members. Therefore,
what the project team are mainly concerned about are the technology of
the information system and whether the system functions according to the
schedule, budget and goals set. The estimate indexes mainly include: 1)
Index for evaluating system construction: It mainly evaluates the
implementation and management of the information system, such as the
satisfaction degree of users, development efficiency of the system, the
utilization rate of resources, normalization degree of system
construction and whether the overall system is advanced, etc; 2) Index
for evaluating system performance: It mainly evaluates the reliability,
efficiency, adaptability, maintainability, transportability,
expandability, and safety and confidentiality of the system.
College ManagementStaffs College management staffs are usually the
initiator and advocator of information systems, who initiate, plan,
organize, coordinate and support the implementation of information
systems, and whose support is the key to the successful implementation
of information systems. College management staffs are concerned about
the overall interest and long-term development of the college. They
support the implementation of the information system to realize the
strategic goals and sharpen the competitive edge of the college, such as
improving the college image and attracting more clients. Therefore,
College management staffs, when evaluating the system, would take the
tangible and intangible interests the information system brings into
consideration, which mainly include: 1) Operation interest: Saving cost,
shortening time of turnover, enhancing productivity, improving service
quality, etc. 2) Management interest: Optimizing resource management,
etc. 3) Strategic interest: Supporting innovative expansion of business
and e-commerce, etc.; therefore, system progress, whether the system
supports cooperation with external parties, and global expansion of
business and e-commerce, etc are the indexes for estimate. 4)
Fundamental interest of IT: Improving the flexibility of business,
saving IT cost, enhancing basic capacity of IT, etc. 5) Organization
interest: supporting the reformation of the organization, promoting
training and improving skills of staff, and setting up common goals,
etc.
External Entities The implementation of college information system
will affect the partnership with clients and suppliers, etc. Therefore,
external entities like clients and suppliers would also evaluate the
implementation of the information system. Besides, the external entities
also include the estimate agency and consulting agency, etc. [2] Things
that external entities like clients and suppliers concern about fall
into 4 categories: time, quality, performance, service and cost.
Therefore, they are mainly concerned about how the information system
can bring them value and satisfaction from the four aspects mentioned
above. The estimate indexes include: 1) Whether the implementation of
the system shortens the response time, 2) Whether the implementation of
the system improves product and service quality, 3) Whether the
implementation of the system brings larger value, 4) Whether the
implementation of the system reduces product or service cost. Learn More
From those researches, it can be stated that the air conditioning and
appliances (medical devices) have the highest rates in energy
consumption. The reasons for that are: 1-The weather nature in Saudi
Arabia which is generally very hot and dry in the summer and cold and
wet in the winter. 2-The demand to provide maximum comfort and all the
necessary conditions in medical environment to help and treat patients
[20] which is that the main concern for medical staff. 3-Medical
practitioners are giving the energy efficiency low priority so they
behave for that point [10]. Code Shoppy
Fig.5 illustrates not only old information but also information which
lacks breakdown details of electrical energy consumption for different
loads. Such information is very important for any energy management
program to succeed and it justifies the need for the proposed program.
Before carrying out the proposed energy management program, accurate
data is required about the awareness for the need for such program and
if there are any future plans for such energy management proposals. In
order to gather such information, the following points have been
analysed through a questionnaire: 1-The amount of energy consumed within
a year in health service. 2-The amount of energy consumed in Air
conditioning loads in health service. 3-The amount of energy consumed in
medical devices in health service. 4-Number of power failures
(blackouts) within a year in health service. 5-How present UPS systems
respond to power failures in health service. 6-Percentage of critical
loads within the hospitals. From collected data, it can be reported that
the hospitals have heavy loads in air conditioning and medical devices
especially in medical imaging equipments. Also, those hospitals are
suffering from electricity shutdowns. Table-1 and table-2 shows data for
sample of targeted hospitals in the study.
By considering the weather as a factor, it can be realized that air
conditioning loads in summer season is increasing but significantly
decreasing in winter. Regarding medical devices load, it is affected by
number of patients and the demand on treatment. The proposed solution is
focusing on providing framework and action plan for energy management
guided by international standards and increasing the awareness of staff
in hospitals in energy management and how to implement that programme.
https://codeshoppy.com/shop/product/hospital-management-mobile-app/
Also, those action plans will aware top management in hospitals about
the suitable options to make the environment more green and energy
efficient.
The energy management programmes are essential for hospitals
especially in Saudi Arabia where the demand for air conditioning is
increasing due to the hot weather and in the same time the air
conditioning is the highest consumer for energy in Saudi Arabia.
Implementing action plan for energy management in hospitals could not
only save electric energy but it could also save many facilities and
equipments from technical problems. Furthermore, it can be seen that an
energy saving by say 10% in a hospital could be save equipments and
facilities enough for equipping three Hospital Energy consumption (MW)
Number of shutdowns Number of successful responses Number of backup
generators Hospital A 23,217 2 2 4 Hospital B 900 4 4 3 Hospital C 2,552
6 6 3 Hospital D 9,707 – – 1 Hospital E 6,327 18 18 1 Fig. 5. A typical
electrical energy consumption in Petajoule (PJ) in the case study
(hospitals in Saudi Arabia) before the proposed electrical energy
management program.
The energy management programmes are essential for hospitals
especially in Saudi Arabia where the demand for air conditioning is
increasing due to the hot weather and in the same time the air
conditioning is the highest consumer for energy in Saudi Arabia.
Implementing action plan for energy management in hospitals could not
only save electric energy but it could also save many facilities and
equipments from technical problems.
Furthermore, it can be seen that an energy saving by say 10% in a
hospital could be save equipments and facilities enough for equipping
three Hospital Energy consumption (MW) Number of shutdowns Number of
successful responses Number of backup generators Hospital A typical
electrical energy consumption in Petajoule (PJ) in the case study
(hospitals in Saudi Arabia) before the proposed electrical energy
management program. hospitals. Results and findings are encouraging and
within the direction of the research.
