New Mobile App Designed to Improve Emergency Response in Third World

Remote communities around the world are often the most vulnerable during times of disaster. Poor infrastructure, inadequate communication systems and an all-around lack of resources can plague medical response operations and jeopardize countless lives.

University of Miami trauma surgeon Carl I. Schulman, M.D., Ph.D., M.S.P.H., professor of surgery in the Divisions of Trauma & Surgical Critical Care and Burns, has set out to change that by giving disaster responders a lightweight, wireless solution.

Partnering with the Telemedicine and Advanced Technology Research Center (TATRC), a lab within the U.S. Army Medical Research and Materiel Command at Fort Detrick, Maryland, Schulman helped develop an Android-based app that can capture data gathered by medical responders working in the field. Using a personal or military-issued smartphone or tablet, medical responders can share that data from remote locations.

“We have been conducting research for years with assistance and guidance from TATRC on ways to improve healthcare systems using mobile technology in both civilian and military situations,” said Schulman, who also serves as Director of the William Lehman Injury Research Center, the research arm of the Ryder Trauma Center at the University of Miami/Jackson Memorial Medical Center, which has a long-standing successful relationship with TATRC.

“There’s really not any organization out there that’s doing what we’re doing, especially in a mobile environment,” said Schulman, a burn specialist who is based at the Ryder Trauma Center and was a first responder to the 2010 earthquake in Haiti.

The multi-year project and grant from TATRC, titled Mobile Solutions for Disaster and Mass Casualty Events, was focused on improving the U.S. military’s ability to respond to disasters more efficiently and in real time. Most of the military’s response operations require heavy equipment with limited communication functions or still relying on paper-based forms.

“Some of the real benefits of using mobile technology during disasters is that solutions are lightweight, portable and relatively inexpensive compared to larger complex systems, which take much longer to package and deploy,” said Schulman, noting that the tablets and compact servers needed to power the app and wireless network fit into a small duffle bag. The application can support up to 100 mobile devices or more depending upon the mobile server that’s used.

The mobile data capture solution is part of a larger project called Global MedAid, which also includes a language translator and a digital library of education manuals and video tutorials designed to be viewed on a mobile device to guide responders through medical procedures, such as inserting chest tubes or stabilizing head injuries.

“So if they are in the middle of nowhere and don’t know how to do a particular procedure and there’s no one to help them, they’d be able to pull it up, review the information and do it better,” said Schulman.

A similar grant awarded by TATRC to the Lehman Center previously supported the development of a mobile technology platform called MobileCARE, which is designed for use in the U.S. and is being used by medical staff at the Ryder Trauma Center to input patient data, view test results and communicate among team members using mobile technology.

Seeing the benefits of real-time data processing and mobile technology in a trauma setting is what spurred the idea to replicate and adapt the system for military and international humanitarian disaster responders.

If a devastating hurricane or other disaster strikes, emergency crews using the app and other lightweight equipment will be able to conduct intake more efficiently and create patient records that can be shared with the local health ministry or hospital system. Moreover, if health workers need assistance with a medical procedure they can get live consultations with physicians elsewhere.

The mobile app also aids in the ability to provide real-time reporting capabilities on mass casualty incidents including number of patients seen, medications prescribed, and other vital metrics.

TATRC and UM conducted a field test of Global MedAid to validate that it can be a useful tool for patient care in remote areas.

With support from the United States Southern Command, which is responsible for all U.S. military activities in the Western Hemisphere, and an ongoing partnership with the Joint Task Force Bravo, Medical Element at Soto Cano Air Base, Honduras, the system was incorporated into a hurricane response training exercise in June.

As part of the test operation, the project team trained military and civilian personnel who were activated for the exercise.

“Instead of documenting as they normally would during one of these training exercises, they used the entire collection of Global MedAid apps and saw the real difference it makes,” said Kevin Miller, a project manager for research support at the William Lehman Injury Research Center, who helped coordinate the project and the trip.

Honduran cadets acted as volunteer patients and were also eager to learn the new system, he said.

“They didn’t speak a word of English and we didn’t want them to because it allowed us to test the language translator,” said Miller. “We gave them written translated scripts so they could act out patient injuries, and they were great to work with.”

The mobile documentation app was developed by Orlando-based Allogy Interactive. It was created as a free, open-source tool, further reducing the economic barriers for countries and organizations with little means to invest in technology.

“The equipment for using the app is very low cost and wouldn’t require paying a large corporation or anyone to run their electronic medical records,” said Schulman, who showcased the app and wireless system to various agencies involved in disaster response at an Expert Consultation Workshop organized by the Global MedAid project team in Washington, D.C., in July.

Pascal J. Goldschmidt, M.D., Senior Vice President for Medical Affairs and Dean of the Miller School, and CEO of University of Miami Health System, and Barth Green, M.D., professor and Chair of Neurological Surgery, President and Co-Founder of Project Medishare, and Chairman of the Global Institute, also spoke at the event.

“If we are fortunate to have the resources and technology to save lives under extreme conditions in the United States, it is our responsibility to help countries with fewer resources, especially those in our own back yard,” said Schulman.

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