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April 11, 2006
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Unique mobile communications solution transforms disaster emergency response capabilities in the Netherlands

Improving public safety is high on the political agenda in the Netherlands, as in many other countries, not only to ensure effective crisis management but also to provide cost-effective and efficient emergency services at all times. Recognising the need for a networked approach to communications, the Dutch Government has decided to deploy nationwide an innovative application that was developed in Utrecht using Cisco mobile and wireless routers.

Business Challenge
Public safety and crisis management are high on today’s political agenda throughout the world, in relation to day-to-day events, to disasters or to potential terrorist threats. As a result, the emergency services in many countries are under pressure to improve their responsiveness, efficiency and ability to co-operate.

Communications play a vital role in the work of the emergency services and they are at the heart of Network-Centric Operations (NCO), a concept developed in the US that is attracting a great deal of attention in Europe and beyond. NCO is about transforming the hierarchical structure and culture of the emergency services with a networked model based on information sharing and collaboration.

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NCO will only succeed, however, where the appropriate, standards-based technology is in place to support it. The Oosting Committee, reporting to the Dutch Government on the explosion at a fireworks factory in Enschede, the Netherlands, on May 13th 2000, highlighted this issue when it said: “Crisis management is first and foremost information management. Before anything else, this imposes demands on the technical infrastructure.”

In an ideal scenario, the different emergency services would not only share information at the scene of an incident, they would also be able to transmit it to headquarters and distribute it to public officials in other locations, such as staff at hospital emergency rooms and the appropriate government authorities. This truly networked public safety operation would also ensure that correct information was delivered in a safe and timely manner to all citizens and to victims’ families in particular.

Yet the police, firefighting services and ambulance services tend to use proprietary, often voice-based systems that can neither interoperate nor transmit and receive other types of information such as data and video. This severely limits their ability to work together effectively and with situational awareness – reacting quickly and appropriately to events as they unfold.

Solution
Psychologist Dr. Luc Taal has professional experience of the challenges that face the first responders at the scene of an accident or disaster. He is based at the Major Incident Hospital in Utrecht, the only hospital in the region that is dedicated to the treatment of disaster victims. If a disaster takes place within its region, the Trauma Centre – one of 10 in the Netherlands – is responsible for sending specialist mobile medical teams to the site. As Manager of Special Tasks, Luc Taal coordinates the activities of these teams.

He also worked at Volendam, where 14 young people died and 250 were seriously injured in a restaurant fire on January 1st 2001. The survivors were treated in several burns units throughout the Netherlands, Belgium and Germany. Due to fragmented communications, some relatives had to search for days to find their loved ones, or to travel long distances to visit family members who were being treated in different locations.

These experiences showed Luc Taal that a more coordinated approach to information gathering and distribution was needed, so he stimulated the development of a Trauma Information System. The prime contractor was the leading Dutch telecommunications provider, KPN, who integrated and bundled solutions from Cisco, Crossing Channels, In Summa and Symbol into a Web-based system that provides a comprehensive, centralised database for use in major incidents. It also contains a module specifically designed for data collection and onward transmission at the ‘injured nest’, the first collection point for victims where medical staff assess the seriousness of each person’s injuries.

In order to be effective, however, the application needed mobile communications functionality. In August 2004, Luc Taal turned to Cisco Systems whose leadership in networking for the Internet offered the possibility of creating secure, efficient IP networks in the mobile domain.

Discussions with Cisco soon showed that the Cisco 3200 Series Mobile Access Router would deliver the necessary functionality. Cisco went on to design the mobile infrastructure and, just three months later, the Victim Tracking and Tracing System (Slachtoffer Volgsysteem, or SVS) was ready for its first trial on November 1st 2004.

“Cisco is a world leader in intelligent Internet solutions that offer excellent price/performance ratios,” Luc Taal comments. “Cisco immediately saw the potential of SVS to save lives and improve communications among the emergency services, and they provided technical and design expertise free of charge.”

SVS works by placing a Cisco 3200 Series Mobile Access Router in one or more of the emergency services vehicles attending a disaster site. The router contains a Cisco 802.11b/g access point which effectively turns the site into a hotspot by creating a wireless local area network (WLAN). Medical staff at the scene can use a range of wireless devices such as personal digital assistants (PDAs) to enter patients’ personal and medical data and send it over the WLAN to the Cisco Mobile Access Router.

The router can use a variety of wireless networks to send and receive information to and from other locations. These include 802.11 outdoor coverage area networks such as General Packet Radio Service (GPRS) or TETRA (a private mobile radio system in the Netherlands) to transmit the data from the injured nest to the Trauma Information System. At this point the data moves from a wireless to a wired infrastructure and travels over secure virtual private networks (VPNs) to hospitals and to the appropriate local, regional or national government agencies. Using SVS, data can be transferred from the injured nest to a City Hall or hospital within one minute of being captured.

The Trauma Centre in Utrecht began using SVS after its first trial in 2004. However, it was clear that the solution could only be fully effective if it was used nationwide. A second trial held on October 1st 2005 showed its potential for enhancing communications not only among first responders in the medical profession, but also among the emergency services as a whole.

The second trial was so successful that the Ministry of the Interior and Kingdom Relations in the Netherlands decided to adopt SVS nationally. As part of this rollout, the Trauma Information System will be deployed to emergency departments in every Dutch hospital.

Business Results
Although it was originally developed as a disaster-response application, the mobile, standards-based infrastructure of SVS means that it can also be deployed cost-effectively for the day-to-day activities of all the emergency services.

Integrated, real-time communications between those services would improve the efficiency of their response, enable them to react with true situational awareness, and improve public safety. Many organisations are already looking with interest at the potential of SVS, within a broader set of applications, to enhance their effectiveness.

This networked approach to communications will also save lives. “The first hour after a serious injury is called the ‘golden hour’. While it’s often critical to a disaster victim’s survival, it also applies to the three broad categories of emergency care – cardiac, cerebral and vascular, and injuries – that all health services handle on a daily basis. A generic solution like SVS can easily be deployed in ambulances as a life-saving measure,” Luc Taal explains.

The standards-based approach of SVS means that it is extremely cost-effective. By creating a WLAN at the scene of a disaster, it becomes compatible with existing wireless devices already being used by the emergency services. It transfers data over existing networks such as GPRS, TETRA or satellite, instead of proprietary links. It can also use any available mobile consumer network, if necessary. And, as wireless technologies improve over time, it will be possible to incorporate new developments seamlessly into the solution.

The capital investment required to equip one vehicle with SVS is estimated to be 1,000 euro. An additional 100 euro per month would cover service and maintenance costs on the equipment. By contrast, KPN has calculated that it currently costs approximately 40,000 euro per year to equip one police car with a range of separate, often incompatible communications systems.

The potential cost savings become even more significant over a longer period. The emergency services typically use several different applications and devices, each with their own networks. The ability to deploy these applications alongside SVS, over the system’s single, scalable, IP-based infrastructure, would dramatically reduce the budgets required for this important area of public sector communications. The resulting integration would also generate substantial improvements in the productivity and effectiveness of the emergency services and in public safety.

In the medical arena, an important benefit of SVS is the potentially life-saving improvements in care that it enables. Staff at hospitals closest to an incident need to know what is happening at the site, in order to be properly prepared when patients arrive. SVS allows them to receive patients’ personal and medical details very quickly. It also uses an individual’s Citizen’s Service Number, a unique identifier that hospital staff can use to download any Dutch citizen’s complete medical file. This reduces the possibility of errors occurring during treatment and helps to improve standards of care.

Since SVS provides two-way communications, hospitals can tell the emergency medical staff at the scene how much capacity they have to treat victims. Ambulances can then be directed to the nearest hospital with available resources, thereby avoiding delays in treatment. It is particularly important that seriously injured patients – for example, those with neurological trauma – are given correct treatment as quickly as possible. SVS also allows images to be transmitted to hospitals from the incident site, so that medical staff can be better prepared to treat the wounded when they arrive.

More timely delivery of appropriate care can also bring longerterm benefits such as faster or fuller recovery. Not only is this better for the patient’s quality of life, it also reduces the societal costs of trauma – for example, when patients are able to return to work more quickly after injury. That is an important consideration because the societal costs of trauma can be significant: in the Netherlands, they are currently estimated to be higher than the country’s expenditure on oncology services. Providers of health insurance are also very interested in the potential for SVS to reduce their costs.

Importantly, the Victim Tracking and Tracing System will help to improve crisis management capabilities at the local, regional and national level in the Netherlands. Call centres set up in government buildings, for example, will be able to use data provided by SVS to give regular information bulletins to the community. They will be able to ensure that victims’ relatives are better informed than ever before about their loved ones.

“SVS has huge potential to cut costs and improve the effectiveness of the emergency services,” Luc Taal concludes. “At the same time, it offers secure, fast and accurate mobile communications that will save lives and reduce the effects of trauma for many people.”




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