A touch-screen tablet computer called SafetyPad is a paramedic’s constant companion at Hennepin County Medical Center.

Created by Open Inc. of Edina, the tablet replaces the often late and sometimes incomplete paper reports of ambulance calls.

From the moment one of HCMC’s 25 ambulances starts to move in response to a 911 call, the handheld computer is part of the action. It receives information from the 911 operator, records an emergency patient’s symptoms, heart-rate and blood oxygen, and offers checklists of key questions and treatment options, which vary depending on the type of emergency. Information assimilated, the pad calls ahead to the HCMC emergency room so medical personnel can be ready for the patient who’s on the way.

“We’re pushing the electronic patient record out to the ambulance,” said Robert Ball, operations supervisor for Hennepin EMS, the emergency medical services of HCMC. “Our ambulance staff knows what they’re supposed to do in an emergency, but the SafetyPad reminds them to document it.”

The benefits extend to other area hospitals.

“When that patient chart is closed on the SafetyPad, the data comes wirelessly back to the computer servers at HCMC,” Ball said. “No matter what hospital that patient goes to, a copy of that chart is sent there within minutes of the patient’s arrival.”

The electronic ambulance reports help HCMC in other ways, too, Ball said. The SafetyPad database software at the hospital searches ambulance reports for medical trends. If it finds more than six ambulance calls a day involving flu symptoms, it warns hospital officials of the potential for a flu epidemic.

In addition, the database helps speed up the hospital’s billing cycle. It now takes about 10 days to bill an insurance company for an ambulance run, vs. 90 days when ambulance reports were on paper, Ball said.

That shortened cycle speeds payment. “Some insurance companies aren’t keen on paying once you’re 90 days from the event,” he said.

For many ambulance services, tablet computers are a major step up, said Mike Vukovich, president of Open Inc. “Most of our customers have come from paper-based systems for gathering ambulance information, which were inefficient,” he said.

Added Scott Streicher, Open Inc.’s director of operations, “They spent more time looking at a sheet of paper than at a patient.”

But SafetyPad isn’t the only ambulance tablet computer available. The St. Paul Fire Department, which used SafetyPad for about 10 years, switched three years ago to competitor Sansio of Duluth for its 13 city ambulances. The switch was made because the Sansio product eliminated the need to run an ambulance database; the information was instead sent to an Internet website. It’s a feature SafetyPad doesn’t have.

“That made it a little easier to pull out the information,” said Matt Simpson, St. Paul’s deputy chief of emergency medical services.

But SafetyPad has its advocates. James Salvia, project manager for ambulance computers at Boston Emergency Medical Services, says the tablets make sure records are kept, both for medical and legal reasons.

“A lot of ambulance emergency cases, such as shootings, stabbings and abuse cases, end up in court,” Salvia said. “Everybody in emergency medical services knows that if you didn’t document what you did, it’s as if it never happened.”

Open Inc. wrote the software for the Microsoft Windows-based tablet computer and the database of collected ambulance information. When it was introduced in 1996, portable computers were just becoming powerful enough for ambulance work, said Vukovich, who started the firm in 1993. HCMC bought the SafetyPad system in 2004 for about $300,000 and a $31,000 annual software maintenance fee. Today it’s used in about 20 metro areas.

“We don’t have a tremendous number of customers,” Vukovich said. “But we have those with lots of emergency personnel to train, patient care reports to generate and data to analyze.”

Some, such as Boston EMS, make more than 100,000 ambulance runs a year. HCMC makes about 60,000.

Open Inc. has 12 employees, most of them located close to major customers in case help is needed, Vukovich said. The privately owned company doesn’t disclose revenue.

But Open Inc.’s business model and HCMC’s ambulance automation are only as good as the tablet computers themselves.

“We’re responsible for patient information,” Streicher said. “The computer doesn’t crash.”

But ambulance work is fast and demanding, and the tablet computers do get dropped. HCMC’s tablets come from a Florida defense contractor, and can be dropped from a height of 4 feet about 20 times without breaking.

“But all of our ambulance tablets have been dropped more than that,” Ball said.

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These enhancements to the Red Cross Ready Rating™ program offer steps that organizations can take to be better prepared.

The new features include:

• An Emergency Response Plan Tool, which enables program members to build a customized plan to help their employees know their roles in the first 24-72 hours of an emergency;
• A Next Steps report that recommends specific actions members should take and the level of effort required to execute them;
• A Resource Center that includes preparedness tools including activities and exercises, so businesses, employees, and students can better develop and practice preparedness plans;
• A Ready Rating Store with emergency supplies at the click of a button;
• An enhanced user experience that enables easier sign up and access to all tools available.

“Companies and schools realize that contingency planning is a key element to running a successful operation, but getting started can sometimes be intimidating and overwhelming,” said Jim Judge, CEM, member of the Red Cross Scientific Advisory Council and executive director of Lake EMS Inc. in Mount Dora, Fla. “The new Ready Rating program components make it even easier to get started or to enhance current emergency response plans.”

Emergencies like power outages, water main breaks, and medical emergencies can disrupt daily operations. Disasters like tornados, floods, earthquakes, and fires have the potential to cause workplaces to fold and schools to close. In an effort to better prepare for such events, Ready Rating members complete a confidential assessment of their current readiness level for emergencies and receive immediate, customized feedback with tips and resources for them to improve their readiness scores.

More information about the program and the new components can be found at readyrating.org.

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SHAWNEE COUNTY, KS — The new emergency communications system Shawnee County wants to install sometime next year more than likely will block the general public and the media from listening in.

One of the features currently high on the priority list for the new 911 radio system — which would be used by all law enforcement officers, firefighters and emergency medical responders within Shawnee County — is encrypting emergency radio traffic. That could prevent unauthorized users from eavesdropping.

“We think it’d be wonderful if the media didn’t have access” to radio traffic, sheriff’s Capt. Lance Royer, director of the county’s emergency communications center, said Wednesday. “We all believe that we need some level of encryption for public safety and officer safety.”

Currently, the county’s 15-year-old analog system doesn’t have an encryption. That jeopardizes safety, Royer reasoned, because people listening to emergency radio traffic sometimes go to scenes of crimes.

Others, however, say limiting public access to radio traffic would have the opposite effect.

“When the word needs to get out that something has happened that threatens their safety, the public needs to know, and they need to know as quickly as they can,” said Doug Anstaett, executive director of the Kansas Press Association.

Shutting the public and media out of the emergency communications system not only hurts the public by making people more fearful of what they don’t know, he said, it also hurts law enforcement, which often relies on the public for information.

Royer said the questions regarding encryption were premature because the board tasked with replacing the county’s system hasn’t yet selected a provider, let alone nailed down specifics.

Should the county implement an encrypted system, the media still have the option of calling dispatch for more information or keeping an eye out for news releases from the county’s agencies, said county counselor Rich Eckert.

“I think that the public safety agencies in this area do a great job of working with the press and letting them know about situations when the citizens need to know about them,” he said.

ON ENCRYPTION

Encryption is the conversion of information into a format not easily understood by unauthorized people. Translating encrypted information often requires a digital key, which secures the information. Lower levels of encryption have the potential to be hacked — some more easily than others.

Both companies bidding for the multimillion-dollar contract — Motorola and Cassidian — are offering two encryptions, Eckert said. One is called advanced digital privacy and can, with some work, be hacked, he said. The other, Advanced Encryption Standard, virtually can’t, he said.

AES has a level of security so high, Eckert said, the federal government not only recommends it, but uses it. That level probably is unnecessary for Shawnee County, he said, because the county doesn’t have a major problem with criminals listening in on radio traffic.

The county’s interest in AES encryption, Eckert said, is that it is among a set of standards called Project 25 — standards often required for federal grant money.

Adding AES encryption to the radios could increase the cost of the contract, Eckert said, but he wasn’t sure by how much.

The cost of adding AES encryption alone often runs between $500 and $900 per radio, depending on the manufacturer, said Scott Bradford, chairman of the Project 25 User Needs Subcommittee. The subcommittee reports to the Project 25 Steering Committee, which approves the standards and of which Bradford is a voting member.

PROJECT 25

Project 25, or P25, compliance often is required for federal grants, Bradford said.

The P25 standards are a work in progress but were designed to increase interoperability of emergency communications to allow for a more streamlined response — something the federal government deemed necessary after the Sept. 11 attacks. The P25 standards are voluntary, not government-mandated, Bradford said.

An agency can be P25 compliant, and therefore eligible for more grant money, without an AES system, he said. However, if an agency has encryption, federal grants typically require it be AES, he said.

The discrepancy exists because agencies can pick and choose which of the P25 standards best fit their systems, Bradford explained. The federal government hasn’t yet determined which of the standards — the current version has 53 pages worth of them — are required for compliance.

For that reason, Bradford said, jurisdictions need to be very clear on what the manufacturer is offering. One common mistake agencies make, he said, is requesting a blanket statement for P25 compliance that doesn’t specify which standards the agency wants because P25 compliance hasn’t been specifically stated.

In its request for proposals, Royer said, the county just asked that the system be P25 compliant. Eckert said he didn’t think it would be a problem, but that the issue was above his level of expertise.

Bradford also works as the communication technology manager for Montana’s Public Safety Services Bureau. Where he lives in Helena, he said, the emergency responders use an encrypted system for some communication. The agencies mitigated the public right to know issue by providing certain media outlets with radios and not encrypting dispatch traffic.

“We understand that the public and news media has a right to know about activities that involve public safety,” he said.

Public safety also is contingent upon responder safety, Bradford said, which is one of the reasons some radio traffic is blocked.

Royer said the Shawnee County Emergency Communications Management Board, which is tasked with recommending to the county commission a provider for the new system, hadn’t yet talked about those options. However, he said, he thought the accommodations would defeat the purpose of encrypting radios.

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The Waller County lawyer turned to Facebook, creating a page to receive and disseminate information during the 10-day Riley Road wildfire that burned more than 10,000 acres last September.

Duhon, and his wife Jennifer Duhon, were the keynote speakers at Thursday’s annual MidCoast Hurricane Conference hosted by the American Red Cross Crossroads Chapter.

Jennifer Duhon spoke via Skype from Switzerland.

She was the acting public information officer for Waller County during the wildfire, while Trey manned the Facebook page that exploded with activity.

“It became a real powerful medium,” Duhon said. “I would post and things would happen immediately.”

Jennifer was asked to assist the county with public information from the disaster command center. She had some crisis communication experience through her work with Shell.

Jennifer had originally used Twitter to learn more about the wildfire spreading in neighboring counties and continued to use the social media throughout the event.

“The one thing that got our angst up was that as the fire began to grow, there was no information coming from official sources,” Jennifer said.

Duhon admitted that he is not a disaster expert.

“I am not a first responder. I have nothing to do with disaster response,” he told those assembled at the Victoria Community Center. “But Jennifer and I did team up to do some things during the Riley Road fire that we all can learn from. And it has a lot to do with just creating a Facebook page.”

Duhon found a Montgomery County Fire Info Facebook page and ran with that idea for Waller County.

“All the resources in Waller County were dedicated to fighting the fire. So on day two of the fire, I decided to set up a Facebook page for Waller County,” Duhon said.

By week’s end, more than 12,000 people had clicked on “Like” on the page and it had more than 32,000 active users. Statistics also show that the page had more than 7.2 million post views.

“I spent a lot of time keeping people calm,” Duhon said.

As the page’s activity grew, he recruited help from neighbors and friends.

“At one point, we had four laptops around our kitchen table. That was our command center for our Facebook page,” said Duhon.

His wife said what Duhon was experiencing on Facebook was what they were experiencing live at the emergency command center.

The Duhons’ keynote presentation was part of the training provided at the annual hurricane conference.

More than 270 people attended the conference, taking part in not only hurricane-related seminars and workshops, but also tracks designed specifically for business owners and for homeowners.

“We saw a lot of new faces that we haven’t seen before at past conferences,” said John Johnston, Red Cross board vice-chairman who served on the conference planning committee.

Norma Crockett, emergency management coordinator for Health Force, a Victoria home health agency, said she has attended three of the conferences.

“I was most interested in the business track,” Crockett said. “I also sat in on a first responder session. It was very interesting.”

Duhon hopes their presentation opens some eyes among governmental entities and disaster responders.

“The technology is out there. It’s what people turn to. They have to know now,” he said. “Social media is the way they get that information. You either embrace it or deal with the aftermath of not doing so.”

“What happened in Waller County shows how useful it can be as a highly effective tool during a disaster.”

John Metz, of the National Weather Service, gave the conference’s closing message.

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From now until October 15, the Williston Public Safety Answering Point will accept 911 text messages from Verizon Wireless customers as part of a collaboration among the Vermont Enhanced 911 Board, Verizon Wireless and Intrado. Intrado is a Colorado-based emergency communications technology provider installing the software that will allow the Williston Public Safety Answering Point to accept text messages.

This will be the first statewide trial in Vermont to enable “text-to-911” technology, and is being provided at no cost to the State of Vermont. All text messages to 911 originating from a Verizon Wireless device in Vermont will be routed to Williston, which will coordinate with the appropriate local first responders. In order to do this, people sending text messages should include the location of the emergency in the first message.

Verizon Wireless customers should keep several guidelines in mind when using the text-to-911 service:

• Customers should use the texting option only when they are unable to call 911.
• Sending a text to 911 may take longer than a voice call because someone must enter the text and send it through the system. Then the 911 operator has to enter a text response and send it back.
• Providing location information and the nature of the emergency in the first message is imperative. The Williston call center will not be able to access the cell phone location or speak with the person who is sending the text, and will need to convey the location to local first responders.
• Text abbreviations and slang should never be used so that the intent of the dialog can be as clear as possible.
• Customers must be in range of cell towers in Vermont. If customers are outside or near the edge of the state, the message may not reach the Williston call center.
• Texts to 911 have the same 160 character limit as other text messages.
• Verizon Wireless customers must have mobile phones that are capable of sending text messages. Text messages to 911 will count either against their message bundle or be charged at 20 cents per message.
• The texting function should only be used for emergency situations that require an immediate response from police, fire or emergency medical services.

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Stopgap measures in place for just such an occurrence assured that no call went unanswered during the crisis, and within the week, the sheriff’s office was back in business as before with rebuilt equipment matching the 1993 equipment that was in use before the lightning strike.

Ultimately, the committee agreed to have 911 Tech Manager Mike Smothers electronically forward to all members, public safety principals and dispatchers the proposals and prices for NextGen equipment so that a decision could be made at the regularly scheduled April 19 meeting.

The State of Tennessee Emergency Communications Board has mandated that all counties go to the NextGen technology, which includes enhanced capabilities to aid emergency responders as well as connection to a closed internet-type system designed just for state use. The closed system, called “the backbone,” has been a work in process for the state and should be ready to begin accepting connections by June 1.

Stewart County is one of the few counties with almost everything in place – except the equipment – to proceed with NextGen. Vendors had been coming to Stewart County over a period of weeks to give Smothers, committee members and dispatchers a good look at the equipment, capabilities and ease of use and maintenance.

And then came the lightning strike.

Committee Chairman Steve Douglass gave those present an encapsulation of the April 5 emergency. It was clear that dispatchers had a handle on what was happening and that they followed their procedures so that no calls were missed and all of the proper local and state officials were notified.

It was also clear that Jeff Perigo of Greer Communications had risen to the occasion and had gone above and beyond the call of duty in getting the mobile command trailer set up and getting replacement parts for the main controller, or PSAP (Public Safety Answering Point).

Others were helpful as well, all agreed.

They also agreed that while the outdated equipment was being replaced by insurance at an estimated cost of $210,000, it would be a good time to finalize the NextGen equipment purchase, most of the cost of which will be covered by grants.

However, the tension arose at the meeting when considering the vendors.

Months earlier, the committee had voted to give Smothers, Douglass and Treasurer Jim Darke, who has since resigned, the authority to narrow the search to two or perhaps three vendors after the demonstrations.

Smothers chose AT&T and GeoConnex, but some committee members and the dispatchers wanted Greer Communications considered as well since Perigo had been so helpful during the lightning crisis.

Dispatchers also liked GeoConnex.

A spirited discussion ensued, with Smothers saying that AT&T had superior equipment with a price tag to match, but GeoConnex was good, too, and very user-friendly – and would save about $80,000 per year in maintenance since they already had a mapping maintenance contract with the company.

He had reservations about Greer due to the poor showing and lack of compliance to the guidelines at the demonstration as well as the fact that Greer Communications specializes in radios, not PSAPs.

Dispatchers said that while AT&T was good, they were “too unionized” to be effective, with each worker having such a narrowly defined job that they were not free, under fear of losing their job, to fix what needed to be fixed.

They liked GeoConnex as well, but they were impressed with the dedication exhibited by Greer, and they wanted Greer to be in the running.

Several others present, including Stewart County Emergency Management Agency Director Clint Mathis and EMS Director Greg Barrow, also spoke in favor of considering Greer Communications.

Board member Andy Luton brought out that when Perigo was hooking up the reconstructed PSAP, he asked to be the preferred vendor, a decision that could not be made by anyone but the 911 Committee; therefore, no promises were made.

Committee member Hilda Odom was equally uncomfortable with being held hostage by Greer.

Luton added that if he were in the position of being considered as the vendor for a quarter of a million dollars worth of NextGen Equipment, he, too, would have put his best foot forward during the crisis in order to gain the advantage.

He suggested that since both dispatchers and Smothers liked GeoConnex, perhaps they would be the best choice.

He also stressed the need for better communication between the committee and emergency personnel in order to minimize the tensions that have been inherent in the process.

In a related issue, Douglass expressed his appreciation for the use of the District 7 Homeland Security mobile command trailer for a few days but acknowledged that it might not always be available to Stewart County, depending on the emergency.

Therefore, he said that E911 should update the mobile command trailer that SCEMA currently owns.

Years ago, the committee had discussed but never acted on the proposal to have several other sites in the county that the trailer could hook to.

They agreed to have Douglass contact CEMC and AT&T about the cost of setting up three potential sites, possibly at the Sheriff’s Office, EMS Station #2 at North Stewart and another place in or around Dover with a large parking area.

Once that is in place, they can begin looking into the feasibility of updating the trailer with NextGen equipment.

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A new app called Notifice is designed to assist any first responder, from paramedics to police officers, even the emergency dispatch, in having the information they need to keep people alive.

When first responders arrive on the scene of an emergency, they need to know several important things about the patient, and, if that patient is unconscious, it makes that part of the job much more difficult.

Software developers have an answer to that problem.

“For a first responder, a cell phone has no value for them when you show up on an emergency, and here you have these cell phones that have more power than the space shuttle that took man to the moon. There has to be a way to leverage that power and to help out the first responders and the people,” says Quid Fit CEO Peter Franz.

Franz is hoping to solve that with his new app, Notifice.

As soon as the dialer hangs up after calling 911, the app then sends a text message to all of the emergency contacts listed, stating that they called 911, and pinpointing them on a GPS Google map.

It also displays medical information about the user for first responders to review once they arrive.

Currently all of the information is available only on the patient’s phone, but in the future the designers behind Notifice hope to have everything available for the dispatch center.

That way, first responders can have all of the information before ever arriving on scene.

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Tennessee’s Next Generation 911 network is connected in Brentwood and other Middle Tennessee 911 districts. Officials will begin going Internet based in Bradley County within the next few weeks.

“AT&T will be here in about a month to begin installation of equipment which will help alleviate hard-wire systems which have been in place,” said Joe Wilson, director of Cleveland-Bradley County 911’s district.

“We will be installing and testing in various stages,” he added.

The initial connection, in Brentwood, begins a process that will connect 911 centers across the state to one of the nation’s first statewide, Internet protocol-enabled 911 networks, according to state officials.

“This is digital 911,” said Tennessee Emergency Communications board chair Randy Porter.

“It’s a major stepping stone toward a state-of-the-art network that will improve public safety,” Porter added.

“NG911 will replace the analog network and increase the reliability of the 911 system. The statewide deployment will provide all Tennessee residents with a more responsive emergency communications system that will offer improved function in the case of disaster,” he explained.

Wilson said after installation, the testing will begin.

“We will be getting wireless calls on these new circuits initially. The goal is to provide a better quality and more efficient service,” Wilson said.

Because of the digital network, if one 911 center is knocked out of service, a center from another location will be able to pick up the calls seamlessly. This function is expected to result in saving both time and lives, according to officials.

“We’re excited to be moving forward with the Next Generation 911 project,” said Lynn Questell, executive director of the TECB.

“Not only will this network improve 911 operations, it will also save local Emergency Communications Districts millions of dollars a year in routing and trunking charges. We will be among the first states in the nation to have a truly statewide NG911 network. That’s a testament to the leadership of our board and the strength of Tennessee’s 911 community.”

Wilson said the changeover will include “migrating” the hard-wired lines with the Internet protocol system at first, then switching over to the new Internet protocol system entirely.

The new IP-based system will allow a number of new options including video capture if a crash scene is recorded by a caller. Additionally, there could be other helpful information which 911 dispatchers and first responders can utilize as they respond and approach a scene or situation, according to Wilson.

Questell noted that the TECB has carefully planned for the NG911 project and has partnered with the state of Tennessee’s digital network, NetTN, and with industry leaders AT&T and Telecommunications System Inc. to bring it to fruition.

It’s an amazing process,” Questell said. “It’s been a shared vision and we’re going to do all we can to ensure we get NG911 right every step of the way. The citizens of Tennessee deserve nothing less.”

“If all goes well, sometime late 2013 or early 2014, we will be completing the testing and totally on the new system,” Wilson said.

Many city officials are wondering what would have happened if the system was in place when last month’s EF-4 tornado hit.

On the morning of the tornado, more than 2,100 calls came into the Harrisburg 911 center. There were only a handful of dispatchers on duty, so needless to say, some of those calls went unanswered.

The calls started just before 5 a.m. They didn’t quit for hours.

“I’ve been here 20 years and I’ve never seen it that busy,” said dispatcher Mike Davis. “All of our 911 lines were ringing at the same time. Our business lines were full.”

There were only two dispatchers on duty and another four came in to help. But dispatchers say, it’s nearly impossible for six people to answer thousands of 911 calls.

That’s the problem with the current 911 system, your calls go through the traditional phone system, so if the line is busy, you’re out of luck. But an IP-based 911 system could solve all that, and it’s only about a year away from becoming reality in Harrisburg.

Saline County is one of 15 Southern Illinois Counties chosen to be part of a National 911 test program called Next Generation 911. The key is a fiber optic network that will enable you to send more information to 911 when you’re in trouble.

For instance, if the tornado hit, you could send pictures of your injuries to 911, they can forward it to first responders and the hospital. And if the local 911 center was busy, neighboring counties on the fiber optic network would be able to answer your call.

If it works in Harrisburg, it won’t be long before it’s in St. Louis, which means less of a burden on dispatchers and help can get to you sooner when you need it.

Members of the Harrisburg 911 team are headed out to Washington, D.C. in two weeks to meet with the FCC about the new program. They hope to start testing it in June.

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The Canadian Radio-television and Telecommunications Commission put the onus on VoIP providers like Bell Canada that sublets its lines to resellers to assure that the resellers are informing consumers about 911 service limitations from VoIP home phones during power outages and inadequacies of 911 service when using “nomadic” VoIP phones.

The CRTC ruling makes it mandatory that regulated carriers toughen their contracts with resellers or risk being ordered to disconnect the service of wholesale customers or subordinate resellers.

The CRTC estimates there are 161,000 VoIP phone lines in Canada in 2009, its latest estimate available.

The U.S. Federal Communications Commission last month decreed that interconnected VoIP providers will be required to report major outages, bringing them in line with other telephone service providers and giving the FCC a better picture of how interruptions affect access to 911 service.

But the commission’s decision to not apply the new rule to broadband outages drew fire from some fronts.

The FCC, citing numbers that say almost one-third of the more than 87 million residential telephone subscriptions are now provided as interconnected VoIP service, said the new rules were needed to address the “substantial volume of 911 calls” handled by VoIP. The FCC’s current outage reporting rules, which have been in place since 2004, cover voice services provided over wired and wireless platforms, but not interconnected VoIP.

The FCC’s Report and Order defines outage reporting for interconnected VoIP service, establishes reporting criteria and thresholds and discusses how the reporting process should work, what information should be reported and confidential treatment of the outage reports.

At the same time, the commission deferred requiring ISPs that also offer VoIP services to report outages of the broader network. That means a provider, such as a cable company or some telcos that use VoIP, could have a system-wide outage of its service and be exempt from informing regulators. The FCC, citing technical issues for its decision to exempt those providers, said it would attempt to work with operators to develop a voluntary reporting system.