Ambulance Data Transmission: Requirements and Systems Available

1. Ambulance Data Transmission • Requirements • Overall considerations: FAX,Circuit,Packet. • Systems available • Mobitex • GSM & GPRS • 3G(UMTS) • TETRA • Satellite • Mixed Systems • In Hospital systems • Sussex example • Conclusions

2. Requirements • Country-wide coverage • Security • Availability • Data volumes - 10Kb for ECG • Expandability • Integration • Data transfer at hospital

3. Fax versus Data • FAX Advantages - Easy communication with Fax in hospital . - transmission supported by several current radio systems • Data advantages • Higher transmission speeds • Better error protection • Integration into overall Ambulance data systems supporting several applications • Much increased support for data in mobile systems now coming to market

4. Data Transmission: Circuit vs Packet Circuit Switched - Continuous path - Typically pay for connection time - Continuous holding leads to greater congestion - Continuous path leads to better performance for voice and video Packet Switched - Individual packets sent separately only use the path when there is something to send - Typically pay for amount of data sent - Bursty occupation leads to better sharing of capacity in peak times - Always connected operation leads to fast data transfer

5. Mobitex • Mobitex: specialised Packet Radio system for data • Mature system(in operation for 10 years) • Good coverage in England Rural Wales/Scotland/Northern Ireland not so good • Data rate 2.5 kb/s • Already installed in some ambulances • Packet system with little high-volume use gives little contention

6. GSM • Good coverage - some rural gaps • In-built security encoding • High availability and good resilience • some tendency to local flooding when major movements of people • Data Rate • GSM Circuit Switched Data 9.6 Kb/s High Speed Circuit Switched Data (HSCSD) 19.2-28.8 Kb/s • Widespread roaming

7. Data connection in car for Ericsson R320 The R320 sits in the car kit. The HCD -10 data cable plugs into car kit control box. The phone system connector at the other end of the cable can then be connected to the DRS -10 (RS232 cable) which then is plugged directly into the laptop. The in built modem supports data transmission External vehicle antenna Car kit control box ata Cable HCD -10 D RS232 Cable DRS -10

8. What is GPRS? • General Packet Radio Service bringing higher bit speeds • GPRS is a GSM service for end-to-end packet switching • Reuse of existing infrastructure • Interworks with existing circuit-switched services • Based on standardised open interfaces

9. Radio Network Characteristics • On demand or dedicated GPRS channels

10. GPRS • Packet Based system using the same radio bearer as GSM • In-built security • Good coverage - works across whole GSM network with no adaptation of radio and relatively small additions to central network • Availability - more resilient due to channel sharing characteristics of packet • Data rate up to 50Kb/s in practice (Headline rate 115Kb/s) • System just coming on-stream this year • Specification includes simultaneous voice and data but most terminals will only do one at a time(Class B terminal)

11. 3rd Generation Network Capabilities • High bit-rate services • 384 kbps in the wide area • up to 2Mbps in indoorenvironments • Optimized for packet data transfer • Multimedia support • Simultaneous sessions • Dynamic user bandwidth • IP connectivity from end to end • Data and voice • Seamless roaming

12. 3G - What Does it Mean for the End User ? • Access to the “Mobile Internet” • A wealth of information,always available • New ways to communicateand be entertained • Image-based communication • Advanced messaging • High-quality audio and video • Personalisation • My own set of differentiatedservices • Service convergence • Across networks, usage and countries

13. The Corporate 3G User Real Mobile Data applications …. • “Always connected, always online” • High-speed intranet extension • Remote LAN access • Advanced messaging • New types of communication - still image and video • Workforce management • Seamless user experience -fixed and mobile

14. 3G(UMTS) • System designed for Mobile Multi-Media (“Mobile Internet”) • New spectrum round 2GHz • Simultaneous voice and data • Data : both Circuit switched and Packet switched • Data rates: • Circuit: up to 386 Kb/s • Packet: up to 386 Kb/s • Systems will come on-stream in 2002 • Early terminals will be dual-standard UMTS/GPRS/GSM so there will be coverage to GSM limits but with enhanced data rate and coverage in populated areas. • Increased capacity and data rates will lead to higher availability

15. TETRA Phase1: Coverage Dolphin 90% PSRCS ? Voice Data - up to 28 Kb/s (interface spec not currently available) Priority and security systems Phase 2: “3G compatible” Higher data rates Commonality of SIM with UMTS Tends to become 3G access type Date not known

16. Satellite Systems Type Equipment Per min Subscription Inmarsat 2.4Kb/s £2000 £1.3 £10 per month Inmarsat 64Kb/s £6000 £4.5 £10 Iridium 2.4Kb/s £670 £0.97 £10 Globalstar 9.6Kb/s Thurya 9.6Kb/s £750 £0.9 £10 note Thurya has dual GSM /satellite mode Aerials Inmarsat 10cm globe others similar to GSM car kit

17. Joint Systems Scenario with a parallel low-speed and high-speed data channel eg Mobitex + UMTS Tetra + UMTS

18. Data transfer at hospital • The wide area transmission techniques may not give sufficient bandwidth for rapid in hospital data transfer. • Systems designed for wide area use have relatively high output power and should not be used near medical equipment. • Use of Wireless LAN or Bluetooth systems would solve this. • System choice should be on the basis of wider in hospital requirements. Either would provide adequate transfer rates. • Wireless LAN is widely available now and would be the system for current installation. • Bluetooth will be widely fitted as standard to data systems in one to 2 years and could meet the need at that point. • Wireless LAN has higher data rates and longer reach.

19. Sussex Situation • Using MRL PIC • Currently has Fax port • Initial trials with Fax using GSM look promising as a short term measure • Data port being developed for MRL PIC. • Mobitex has been adopted with Terrafix for maps etc. • Data solution based on Mobitex looks the best way forward. • Use of data system will allow separate applications to share the same transmission mechanism.

20. Afterthoughts • I did not mention SMS over GSM as a technique.This has the advantages of security and resiliencev as SMS messages are guarunteed to travel across the network.large data file can be sentb as a series of linked SMS messages. • Another technique fir increasing availability in a GSM solution is to use a Guernsey subscription which gives accessto all of the UK GSM networks and thus gives best possible coverage and availability. • For any further questions please contact me.MartinHills email martin.hills@etl.ericsson.se Tel 01444 234 800 Mob 07831 146 064

21. Conclusions • Data system should be preferred to Fax • Procurement of data hub in ambulance should be priority. • Ambulance service will use a variety of the systems described due to differences in current equipment and specific geography • High speed packet based transmission systems will be available this year giving the basis for extensive data oriented systems