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IN THIS ISSUEOn Board is published quarterly to serve you, the Georgia EMS community, with information that will help you maximize the value of your Automated Vehicle Location System.

In this issue, the AVLS Program Update highlights the upcoming Phase Four orientation and equipment deployment at the end of this month, which will welcome eight new agencies and distribute 126 AVLS units.

Our Feature Article focuses on the mission and goals of the Georgia Trauma Communications Center, with emphasis on its supportive role to Georgia EMS agencies to help get the right patient to the right hospital at the right time.

Other articles include updates on trainings and presentations at the 2012 CHANGES EMS Conference in Atlanta, upcoming Advanced AVLS User Trainings in May, upgrades to Phase Three equipment, and the ongoing investigation of curious speed excess alerts in some but not all AVLS-equipped vehicles.

As always, we welcome your feedback, questions, and ideas.

AVLS Program UpdateEquipment delivery and initial orientation training for Phase Four of the Georgia EMS AVLS Program will take place on April 30, 2012 at the GTRI Conference Center in Atlanta. Eight EMS agencies new to the program will receive 113 AVLS units, and five currently participating agencies will receive another thirteen units for vehicles added to their fleets. The agencies receiving AVLS units in Phase Four are shown in Table 1.

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# Name of Service # Vehicles1 City of Hapeville Fire Department 22 City of Morrow Fire Department 53 Clayton County Fire Department 174 Forest Park Fire and Emergency Services 55 Grady EMS / Grady Health System 456 Greene County EMS 97 Puckett EMS 248 Ware County EMS 6

New Agency AVLS Units 113

# Name of Service Additional Units1 Angel EMS 22 Hall County 13 Laurens County 14 MCCG 25 Mid-Georgia Ambulance 7

Supplemental AVLS Units 13

Total Phase 4 AVLS Units 126

Table 1. Phase Four AVLS Participants and Units Distributed

With Phase Four deployment, the program total will include 675 equipped vehicles across eighty-three EMS agencies, making Georgia’s program the largest of its type in the country. Figure 1 shows the headquarters of the eighty-three participating EMS agencies, and Figure 2 shows a snapshot of over 500 vehicles online across Georgia in early April 2012. These figures illustrate the significant extent of Georgia now served by AVLS-equipped EMS vehicles.

En Route with Georgia’s Automatic Vehicle Location System

No. 5 April 2012

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Featured Article: The Georgia Trauma Communications CenterThe Georgia Trauma Care Network Commission launched the Georgia Trauma Communications Center (TCC) in January 2012 as a centralized communications resource to assist EMS and hospital providers with their transport decisions for Georgia’s critically injured trauma patients. The center, located on the campus of Georgia Public Safety Training Center (GPSTC) in Forsyth, stands ready to assist

with transport destination recommendations for the most seriously injured trauma patients–those patients that meet Trauma System Entry Criteria (TSEC). The center is also a resource for hospitals needing to transfer trauma patients requiring definitive care at a designated trauma center.

The core function of the TCC is to help get the right patient to the right hospital at the right time by maintaining up-to-the-minute trauma center status and service line information, using AVLS information to determine distances from the vehicle’s current location to designated trauma centers; using patient triage information as provided by EMS personnel to match patients with the closest, most appropriate available trauma center; providing a direct communications link between EMS units in the field and receiving hospitals; and electronically forwarding patient information received from EMS units in the field directly to the receiving hospital.

The TCC also provides information about Georgia’s TSEC, assigns a unique system identification number for each patient meeting TSEC, and provides secondary triage destination recommendations based on state guidelines and approved regional protocols. For medical surge during mass casualty incidents or public health emergencies, the TCC collaborates with the GA Department of Public Health Division of Preparedness and Response and with the Georgia Emergency Management Agency (GEMA) to coordinate communications and ensure the best use of resources based on state guidelines and regional protocols.

When an EMS provider calls the TCC with a trauma patient report, the TCC software system quickly finds the provider’s location through the vehicle’s AVLS data and determines the most appropriate and closest available trauma center. This information, along with patient-specific triage information and real-time hospital resource availability, allows the TCC to assist EMS providers with their transport decisions.

The TCC only makes recommendations among transport location options. The recommendations are based on up-to-the-minute hospital status, triage of the patient as reported by EMS or hospital staff, and incident location as provided through the AVLS program or EMS providers. The final transport decision is left to EMS personnel in the field or the hospital currently caring for the patient.

As part of its use of the AVLS system, the TCC does not constantly monitor ambulance locations. The system queries for an ambulance location only when that ambulance crew contacts the TCC. The TCC does not monitor, track, or record the location of any ambulance outside of that “quick

(“Program Update” continued from page 1)

Figure 1: Georgia AVLS EMS Agencies

Figure 2: April 2012 Snapshot of AVLS-equipped vehicles throughout Georgia

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look.” The TCC only uses that snapshot location to find the closest available trauma center.

The TCC itself does not dispatch ambulances. It can, however, provide a communications link between EMS personnel already at or en-route to a scene and the most appropriate designated trauma center.

Contact the TCC when you have a patient you suspect meets the TSEC. The TCC will provide you with critical trauma center status information, a trauma center destination recommendation, and will connect you directly to the receiving facility you choose. The TCC may be reached at (404) 229-6405 (free mobile to mobile), (866) 556-3314 (statewide toll free), or (478) 993-4478 (emergency landline). The TCC operates twenty-four hours a day with at least two agents. There will always be an agent on duty ready to assist.

If you have further questions, contact Georgia Trauma Communications Center Coordinator John Cannady at john@gtcnc.org or (478) 993-4459.

AVLS Activities at the 2012 CHANGES EMS ConferenceDuring the 2012 CHANGES EMS Conference in Atlanta, Tim Boone and Kirk Pennywitt of GTRI presented participants with an overview of the GA EMS AVLS Program, including an introduction to the statewide initiative, the system and its technology, and the extent of deployment to date. They demonstrated how the system can be used for both day-to-day operations and mutual aid coordination in the event of a Mass Casualty Incident (MCI). Questions from the audience indicated interest and one additional county EMS agency asked to join the program.

In Motion Technology and GTRI also provided an Advanced AVLS User Training at the conference for fifteen participants from eleven Georgia EMS agencies.

Upcoming Advanced AVLS User TrainingsTwo Advanced AVLS User Trainings will take place May 1-2, 2012:

• Tue, May 1, 2012, 9:00 AM to 4:00 PM, at the GTRI Conference Center, 250 14th St. NW, Atlanta, GA.

• Wed, May 2, 2012, 9:00 AM to 4:00 PM, at the Westin Savannah Harbor Golf Resort, 1 Resort Drive, Savannah, GA (in conjunction with the EMAG conference).

All participants in the GA EMS AVLS Program are eligible and encouraged to attend these free trainings. Topics will include advanced reporting, geofencing, automatic system alerts, and diagnostic capabilities of the In Motion equipment.

In Motion Technology Updates Phase 3 AVLS Units in Preventative Maintenance ProcedureIn Motion Technology sent a two-person team to visit every Phase 3 EMS agency during the first week of February, 2012 to perform a preventative maintenance upgrade to correct a potential problem in the solid-state memory used in the onBoard™ Mobile Gateway (oMG) of the Phase 3 AVLS units. Only oMGs beginning with “H09” or “H10” serial numbers required the procedure. All upgrades were successful.

In Motion Technology Continues to Investigate Garmin Speed Limit Alert SoundsSeveral Georgia EMS agencies have reported that their Garmin GPS Personal Navigation Device (PND) sounds an alert whenever the vehicle exceeds the speed limit. Some users find this to be a useful feature, while others find it distracting. There is no way to turn the feature off other than to completely mute the sound, which also mutes the turn-by-turn navigation voices and all other alert sounds. Other users report no such speed alert from their PNDs. Garmin states that the nüvi 1350 model PND used in Phase 2 through 4 AVLS deployments does not support a speed alert function.

Advanced AVLS Training at 2012 CHANGES Conference on Apr 2, 2012(continued on page 4)

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WEBLINKSGeorgia Emergency Management Agency/ Homeland Security - www.gema.ga.govGeorgia Association of Emergency Medical Services - www.ga-ems.comGeorgia Trauma Commission - www.georgiatraumacommission.orgEmergency Medical Services - www.ems.ga.govGeorgia Hospital Association - www.gha.orgGeorgia Tech Research Institute - www.gtri.gatech.edu

multitude of vehicle parameters including, but not limited to, throttle position, brake fluid level, coolant temperature, fuel level, distance, speed, mileage, battery voltage, and air temperature.

Asset Manager: Track mobile equipment using Radio Frequency Identification Device (RFID) tags attached to the equipment. An alert is shown on the oMM and an email can be sent whenever the equipment moves out of range of the oMG to warn you not to leave the equipment behind. If the equipment is left behind, its last known location is recorded. The warnings can be sent to phones, email addresses, pagers, and other mobile devices.

CAD/AVL Integration: Allows the vehicle AVLS data to be transmitted directly to the Computer Aided Dispatch (CAD) system and shows ambulance positions on the CAD map. However, it typically does not allow CAD dispatch messages to be sent back directly through the AVLS into the Garmin PND; that is, dispatch messages must still be sent using the existing CAD communication mechanism, or by entering the messages separately into the In Motion onBoard Mobility Manager (oMM) web-based software.

In Motion also offers additional options for Remote Access Services, Web Content Filtering, and VPN Support. For more information and details on any of these options, contact Tanya Morrison, In Motion Technology EMS Sales Manager, at (602) 714-6464 or tanya.morrison@inmotiontechnology.com.

In Motion has discovered through experimentation that the issue affects some Garmin nüvi 1350 units but not others. Apparently the Garmin Fleet Management Interface (FMI) protocol language spoken between the In Motion onBoard™ Mobile Gateway and the Garmin PND activates the speed alert in some PND units depending upon the firmware version. In Motion is continuing to investigate and diagnose this issue and hopes to have a control method for affected units in the near future.

Other AVLS Features Available From In Motion TechnologyThe equipment deployed by the Georgia EMS AVLS program provides many powerful capabilities. In Motion offers additional features for purchase. There is a one-time $1,500 fleet activation fee associated with each feature (in addition to per-unit costs), but if more than two additional features are purchased at one time, In Motion typically will waive the activation fees beyond the second option (i.e., a maximum total activation fee of $3,000 for two or more option packages). Additional features include:

ECG/EKG Connectivity: Provides connectivity with most major 12-lead EKG monitors, including those from Physio Control, LifeNet, ZOLL, and Philips.

Wide Area Wi-Fi: Requires a custom factory configuration, and therefore cannot be added afterwards without replacing the oMG. It adds an embedded Wi-Fi module within the oMG to let the oMG connect to a wireless (Wi-Fi) network within an agency’s garage area. This allows the oMG to connect to the agency’s internal network and use the agency’s internal Internet connection rather than the one provided by the oMG cellular modem.

Telemetry: Provides extensive vehicle diagnostic and management information, and its benefits include improved maintenance efficiency, increased vehicle availability, reduced dependency on crews to track maintenance and report problems, and reduced roadside maintenance calls. The telemetry module monitors a

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Produced at the Georgia Tech Research Institute. For further information, contact Erik Oliver at 404-407-7625 or erik.oliver@gtri.gatech.edu.