Tucson to Launch Ambulance to Hospital Video Conferencing

Jun. 19--A new live two-way video link between University Medical Center and the city's 17 paramedic units is expected to put Tucson at the cutting edge of medical technology when it goes online in August.

The system allows real-time videoconferencing over the city's public safety and public works wireless Internet system -- a wireless mesh that links the city's traffic signals and other public safety wireless functions.

Dr. Rifat Latifi, interim medical director of UMC's Level 1 trauma center, said the video link will be the first of its kind in the country and the world.

"We think it's an incredible thing," Latifi said. "Wherever a patient is, we're there."

It is an extension of the Southern Arizona Teletrauma and Telepresence Program, which provides a live link -- including videoconferencing, telemetry, digital X-rays and ultrasound -- between the trauma doctors at UMC and rural emergency rooms and doctors and nurses in Southern Arizona, to assist in the care of traumatically injured and critically ill patients.

Although the system does not yet have the ability to transfer X-rays and ultrasounds, the two-way video quality is top-notch, and UMC and the paramedics can see and hear each other in real time.

Each paramedic unit is equipped with a video camera just above the back door that looks down at the patients and paramedics in the back of the vehicle. The camera can be manipulated from both ends -- meaning the doctors at the hospital can zoom in and pan the camera remotely while the paramedics do their work.

The paramedics can see the doctor in the hospital on a computer monitor installed on the back wall of the vehicle.

Some of the units are also equipped with an outside camera on top of the back door, which can give doctors a firsthand view of a crash scene while also giving a fire department a live look at what it is responding to if more than one unit is arriving at a scene.

The camera's zoom is very powerful. It can enhance images up to 22 times, said Francisco Leyva, the video-link project manager for the city. The project is funded by a $1.9 million federal grant, matched by the city with salaries and the existing wireless system.

During a demonstration of the cameras' capabilities last week, the outside camera was manipulated from the hospital to easily read lines of very small type on a poster 10 feet away from the ambulance. The inside camera, also manipulated from the hospital, was able to zoom in close enough to count the hair follicles on a hand.

In Europe, Latifi said, doctors normally ride along in ambulances, but there aren't enough doctors in the U.S. to do that. "Now we can transport visually a surgeon, neurologist or cardiologist," he said.

But the system also has some potential pitfalls: paramedics who don't want to be micromanaged; a potential video record for malpractice lawyers; and concerns about privacy because of the video records of the ambulance ride.

Leyva said privacy issues are allayed because the city has no access to the videos and the videos are protected by federal privacy laws that prohibit the release of personal medical information.

As for malpractice, Latifi said the teletrauma program has been shown to cut malpractice suits because the doctors make fewer mistakes.

Micromanagement of paramedics is a thornier issue. A similar program in San Antonio was derailed partly because paramedics objected to having "Big Brother" in the back of the ambulance, Leyva said.

Firefighters union President Roger Tamietti proposed a work-around that allows the paramedics to simply turn the system off if they wish. Leyva said he has heard some minor grumbling at fire stations about the cameras.

"Obviously, any time something new comes along, people will be skeptical," Tamietti said. "The paramedic would have the option to turn it on or off. That would eliminate the 'somebody's watching.' "

Tamietti said the potential of the technology is unbelievable, as it can help the doctors, patients and the Fire Department by showing what's going on at a scene live.

"This has the ability to have a major impact on people's lives," Tamietti said. "Tucson should be proud of being on the cutting edge of medical technology."

Find our archive of medical news from and about Tucson's hospitals at azstarnet.com/health

The Tucson Fire Department was first organized in 1881. The town's first fire hydrants were installed two years later, in 1883.

When the department began operating paramedic units in the early 1970s, it was a controversial move because of the cost and because it was seen as competition for the established ambulance companies. Today, paramedic service is considered a staple of what the department provides the community. The Tucson Fire Department now operates 17 paramedic units, along with its 21 engine companies and nine ladder companies.

--Contact reporter Rob O'Dell at 573-4240 or rodell@azstarnet.com

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