Movement is constant inside the emergency department at Franciscan Health Indianapolis.
Nurses, physicians and other staff members are always moving through the main command center, on their way to treat patients dealing with strokes, cardiac arrest or other life-threatening issues.
At any moment, an ambulance could arrive with a new emergency. Even a few minutes of preparation could save a life.
To better connect the ER and ambulances on their way in, Franciscan Health has started using an application called Twiage. Emergency medical technicians can send real-time information, photos and video of a patient while they’re speeding to the hospital, giving ER staff a clear picture of what to expect.
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The program is one example of how new technology is helping first responders and emergency departments treat patients more quickly and efficiently, streamlining communication so that people get the life-saving procedures as soon as possible.
"It’s neat when we get a chance to bring something into the 21st century from the way we’ve always done it," said Jon Kavanagh, a paramedic and EMS liaison for Franciscan Health Indianapolis. "We’re getting 10-, 15-, 20- minute warnings, which for those higher-acuity patients, is a huge improvement."
Mobile devices and apps are a foundational part of modern life. In the U.S., 95 percent of people now own a cell phone, and 77 percent of people own a smartphone, according to the Pew Research Center.
Apps help people do everything from buying groceries to finding dates to binge-watching TV. So it makes sense that tools have developed to help save lives.
Vital ICE — "In Case of Emergency" — is an app that allows people to list information such as medications, blood type, allergies and medical contacts.
Paramedics increasingly have been trained to look for a sticker that has been placed on people’s phones to indicate they have Vital ICE. They know that through the program then can instantaneously get important information about a patient.
When leaders at Jessen Funeral Home learned about the app’s role, they wanted to provide it to the community free of charge.
"A lot of us have medical issues ourselves, and we know what this app does," said Capri Bowles, funeral director at Jessen. "It’s an important thing to let paramedics have. And we want to give back to people."
For the past two years, the funeral home has paid so that people could download it for free. They’ve been set up at community events such as senior expos, health activities and the county fair, passing out information, helping people download it on their phones and showing them how to set it up.
So far, more than 2,000 Johnson County residents have downloaded the app. And Jessen officials are hoping to give presentations at churches and other organizations to ensure even more people know about it.
"Anybody can use it. Everyone has medical needs and medical issues in their family. It’s a free thing we offer to the community," Bowles said. "We want it on as many cell phones as we can get it on."
Before adapting their own Twiage program, Franciscan’s ER relied on a phone call from paramedics as they were en route to the hospital to start preparing for a patient’s arrival.
Emergency medical crews would place a call, hoping to reach a member of the ER staff, to give them a heads-up that they were on the way and needed something. They could describe what the patient was suffering from, allowing them to have equipment or specialists ready.
"If they have difficulty breathing, or someone whose blood pressure is really low, or in cardiac arrest, then we can get the team mobilized," Kavanagh said.
Under the previous system, paramedics would call over their radio or go through dispatch centers to reach the ER. Each radio report would last anywhere from one to two minutes, with paramedics packing as much information as possible into the call.
Increasingly, much of the information they were giving wasn’t necessary to the emergency, Kavanagh said. If a patient’s blood pressure, temperature or other vital signs were all normal, the hospital doesn’t need to know that.
"All of the normal stuff we throw in there adds no value," Kavanagh said. "Twiage lets us take that out, so we’re seeing what we need to see."
Also, personal information about a patient could not be transmitted over the unsecured radio system.
"The patient is showing up as an utter unknown. There were times when a physician would love to open up a patient’s chart or look at old EKG or other information, but they couldn’t get any situational awareness of the patient because they don’t know who you are," Kavanagh said.
Twiage was developed to better connect hospitals and emergency medical services. The software allows paramedics to send patient information over a secure network. By hitting a tab, they can inform ER staff about a stroke, sepsis, trauma or other emergency. They can let the staff know what interventions they’ve already completed, and recommend what will be needed once the patient arrives.
Additional information, such as monitor readings, photos of prescribed medication and video of the patient’s condition, can also be sent digitally.
The information arrives at the ER on a dashboard set up on a computer screen in the department’s constantly monitored triage center. When an ambulance is on the way, the computer beeps to alert staff of a new patient.
Each entry is coded in green, yellow or red, which lets staff know the severity of the patient’s condition. A real-time GPS tracker lets them know where the ambulance is, and provides an estimated time of arrival.
"It’s nice that you don’t have to run back and answer a phone. If an ambulance pops up, you can glance at it, finish what you’re doing and then get back to it, instead of sitting on the phone while you’re trying to triage someone right away," said Emily Dabkowski, a registered nurse in the Franciscan Health Indianapolis ER.
Franciscan Health Indianapolis started using Twiage in July, after Kavanagh learned about the app. He approached hospital leadership about bringing it to Franciscan, and after extensive interviews with Twiage officials, started working with hospital IT and security staff to implement it.
They also reached out to local emergency medical agencies, fire departments and private ambulance companies to get them on board too, Kavanagh said.
The hospital is working with a number of ambulances, including Bargersville Community Fire Department, Whiteland Fire Department and White River Fire Department.
"The success stories have been neat, whether it’s simply getting that patient information and getting the registration process quicker, or getting that extra time heads-up, it adds an amount of relief," Kavanagh said.
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Jessen Funeral Home is providing access to the Vital ICE app for mobile phones.
The app allows people to list their vital information, such as blood type, allergies, medications, medical history and emergency contacts on a secure platform. The information will then be readily available to emergency medical services and first responders when needed.
People can download the program at the Apple App Store or Google Play. Use the codes 6155 or 6880 to start the set-up process.
To get help setting up the app and for anyone with questions, contact Capri Bowles, funeral director, at 317-535-6880.
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