30 August 2024
Asignificant and successful pilot study at the East of England Ambulance Service NHS Trust (EEAST) has proved that cost effective improvements in NHS connectivity are available now and can be implemented within days, leading to better quality and more flexible patient care, improved staff wellbeing and the potential delivery of a wider range of healthcare services by NHS providers.
With clarity still lacking on when the long-awaited Emergency Services Network (ESN) will come to fruition, the
Connecting the impossible
Hybrid Connex, available from Excelerate Technology, was developed through a €5.7 million European Space Agency-funded research and development programme featuring the latest technology that goes well beyond 4G limitations and into satellite territory, providing robust connectivity for ambulance crews and vehicles in areas where traditional cellular connectivity has been extremely challenged or impossible to achieve.
During the pilot, four vehicles from EEAST had Hybrid Connex Technology installed. Apple iPads were configured to auto connect to the vehicles’ WiFi bubbles, and this was 99% successful during the trial period. Moreover, crews operating in fleet not equipped with Hybrid Connex have reported being able to access the trial vehicles’ WiFi bubbles when in proximity and therefore receive patient records.
The results showed that, where crews on the trial vehicles experienced stable high-speed WiFi connection, they were able to access data and information while responding to calls in areas of low or no cellular coverage.
“There was very stable Wi-Fi in the middle of nowhere, achieving 150Mbps download. I conducted a Teams meeting in the passenger seat with excellent clarity and connection stability,” noted one paramedic using the system.
The successful trial at EEAST enabled paramedic crews to achieve almost permanent connectivity in areas where they previously had very little, or no internet connectivity at all. During the pilot, cellular connection was utilised in 88% of jobs attended in areas where previously the signal would not have been good enough to achieve a stable connection.
Connection availability was 93% during all jobs carried out in low or no coverage areas throughout the pilot and satellite was utilised in 47% of jobs in low or no coverage areas, which many times was bonded with the cellular to provide a faster internet connection for crews on board.
“The Hybrid Connex technology bonds clever software, cutting-edge hardware and cellular and satellite services into one package combining seamless 4G, 5G and satellite connections that ensure ambulance crews get a fast, resilient connectivity solution and are seldom offline. The hardware is unobtrusive and the technical fit-out can be done in a day, meaning the vehicle doesn’t need to be off-line for long,” said Bethan Evans, chief operating officer at Excelerate. “Patients and staff are the ones who really benefit when strong connectivity enables better clinical technology at the frontline, with new ways of working too. Importantly we also started to see how this technology can support reductions in unnecessary conveyance to hospitals, something which is a key NHS priority.”
While satellite connectivity is not currently ‘the norm’ when it comes to emergency services communications, its inclusion into a single bonded solution, where it is called upon when cellular connectivity is unavailable, will have significant benefits for resilience, especially in a large-scale, mass casualty incident, where experience has proved that one of the first things to fail or become overloaded are cellular communications.
An always-on WiFi bubble around the ambulance allows staff to connect to digital systems such as NHS Spine-connected services, giving them access to patient history and enabling them to identify alternative care pathways, make the right decisions for the patient and provide the opportunity for the best possible clinical outcomes.
New care pathways
Complementing the next phase of the Ambulance Radio Programme (ARP) rollout, part of the ESN, this advanced level of permanent connectivity will open the door to new patient care pathways, taking advantage of digital advances, while increasing the range of point-of-contact diagnostic services and tests that ambulance crews can carry out on-the-spot, without taking patients to hospital. It will also ensure that crews can quickly and easily access immediate clinical information through electronic patient records.
With Hybrid Connex, crew will be able to remain in constant contact with specialists about patients and their conditions while travelling to receiving hospitals and locate patients faster in areas where connectivity is compromised. Helping crews find key information about local health and social care services, enabling them to signpost patients to more appropriate, alternative sources of health and care, will provide a truly transformative effect for patients in need.
“When we lose connection, clinical apps stop being able to pull information from our CAD system, cease being able to pull information from our PDS trace to bring the patient’s NHS number into record and prevent us being able to upload information to our key partners,” said Philip Elvidge, electronic patient care records lead (paramedic) at EEAST. “However, with Hybrid Connex we have been able to access the Summary Care Records and National Record Locator consistently, which gives staff access to patients’ End of Life and Mental Health Plans, giving access to key information any time of the day to help us make the right clinical decisions. As we move forward with the integration of digital technology to ambulance front line care, we have access to more information about our patients than ever before, but we need to be connected all of the time to take advantage of it. Paramedics need to know they can always have the same information available no matter where they attend to their patients. With Hybrid Connex in place, we are already seeing how a guaranteed connection improves our patient care, as we can download information about the patient and access their clinical records whenever needed. We are already starting to use new functionality like video calling to a stroke consultant in a specialist centre, for example.”
The system will further enable fleet managers and financial managers within ambulance services handle the often-complex commercial aspects of connectivity - such as billing - in a much more efficient way. Ultimately, it will also enable users to be better prepared and able to take advantage of developments in telemedicine and video technology.
