There was no better glaring example of the effects of a poor emergency communications system in a disaster than September 11, 2000 at the World Trade Center. Emergency personnel utilized antiquated and previously questioned technology. Wireless technology has already been shown to be of increased benefit in the emergency setting. Emergencies may be large-scale or personal, and both benefit from advances in mHealth tools.
Recently a new program called PLAN (Personal Localized Alerting Network) was announced by FEMA and the FCC, being instituted in Washington, DC and New York City. Cell phone customers will receive text messages (at no charge) of local emergencies. In a recent report by the World Health Organization based on the second global survey of eHealth services, 55% of members had a mHealth initiative for emergency toll-free mobile phone service, and 54% had one for managing emergencies and disasters. (http://www.who.int/goe/publications/goe_mhealth_web.pdf). Wireless health technologies in emergency situations have been utilized to diagnose heart attacks by wireless transmission of electrocardiograms by paramedics to emergency room personnel to expedite treatment even before the patient arrives. Remote monitoring of implantable defibrillators alerts physicians to device malfunction or ineffective delivered therapies. One excellent discussion on the important components to be included when developing an emergency medical response system states that many may be enhanced if not totally addressed with wireless technologies. The components include manpower, training, communications, transportation, consumer participation, access to care, patient transfer, coordinated patient record‐keeping, public information and education, disaster planning, and mutual aid. (VanRooyen, M.J., Thomas, T.L., Clem, K.J. “International emergency medical services: assessment of developing prehospital systems abroad.” J. Emerg. Med. 1999; 17(4):691‐69).
Emergency access to electronic health records in the setting of a personal or large-scale emergency is important. The destruction of hospitals, clinics, and medical offices with the loss of massive paper files as a result of hurricane Katrina highlighted the need for EHRs (with remote servers or Cloud sourcing) which would outlast such a catastrophe.
So when considering mHealth, we must include emergency services as a part of the development and implementation processes. We should learn from mistakes and take the recommendation of The 9/11 Commission and ramp up quality in our utilized technologies.
An interesting overview of the topic may be found at: http://seacorn.cs.ucy.ac.cy/papers/files/Pattichis_ITAB07.pdf and:
Some excellent general information on barriers and gaps in mHealth solutions in low and middle-income countries with a section on emergency services may be found at: http://www.globalproblems-globalsolutions-files.org/pdfs/mHealth_Barriers_White_Paper.pdf.