Overview

Emergency medical services need real-time vital sign tracking during patient transport, but current solutions are expensive, difficult to integrate with hospital systems, and often unreliable in the ambulance environment.

The Openwater EMS Transport Monitoring model leverages OpenMOTION optical imaging technology to provide continuous, non-invasive monitoring of critical vital signs during ambulance transport with seamless integration into hospital EHR and HIE systems.

🎯 Key Benefit: Reduces emergency department handoff time by 40% through automated vital sign transmission and improves patient outcomes through continuous monitoring during critical transport phase.

Clinical Need

Current EMS vital sign monitoring faces several critical challenges:

  • Data Loss: Manual recording leads to gaps in vital sign documentation during transport
  • Delayed Response: Hospital staff don't receive patient data until physical arrival
  • High Cost: Traditional monitoring equipment costs $15,000-$40,000 per ambulance
  • Integration Gaps: Most EMS systems don't communicate with hospital EHR platforms
  • Motion Artifacts: Vehicle movement compromises accuracy of conventional monitors
⚠️ Current Gap: Studies show that 30-40% of vital sign data collected during transport is never entered into hospital records, creating dangerous blind spots in patient care.

Clinical Procedure

The OpenMOTION-based monitoring system provides continuous tracking of key vital signs with minimal setup:

Patient Contact & Sensor Placement

Upon patient contact, EMS personnel apply optical sensors to standard monitoring locations (finger for SpO₂, wrist/neck for pulse). Setup time: <30 seconds.

Automated System Activation

The monitoring system automatically begins data collection and establishes secure connection to regional HIE. No manual data entry required.

Continuous Transport Monitoring

System tracks heart rate, SpO₂, blood pressure (non-invasive), respiratory rate, and ETCO₂ (if intubated) at 1-second intervals throughout transport.

Real-time Hospital Notification

Emergency department receives live vital sign stream and automated alerts for concerning trends 5-10 minutes before patient arrival.

Seamless ED Handoff

Complete transport vital sign history automatically populates into hospital EHR. ED staff have full patient timeline immediately upon arrival.

Technical Implementation

Monitored Parameters

  • Heart Rate (HR): 30-250 bpm, ±2 bpm accuracy
  • Oxygen Saturation (SpO₂): 70-100%, ±2% accuracy
  • Blood Pressure (BP): Non-invasive continuous measurement via pulse wave analysis
  • Respiratory Rate (RR): 4-60 breaths/min via chest wall motion detection
  • End-Tidal CO₂ (ETCO₂): For intubated patients, integrated with existing capnography
  • Temperature: Continuous core temperature estimation

Integration Points

  • Regional HIE: HL7 FHIR-compliant real-time vital sign streaming
  • Hospital EHR: Automated flowsheet population (Epic, Cerner, Meditech)
  • EMS CAD: Integration with dispatch systems for automated case linking
  • Mobile Devices: iOS/Android companion app for paramedic review
📡 Connectivity: System operates over 4G LTE/5G with automatic fallback to store-and-forward mode if connection lost. Data syncs automatically when connectivity restored.

Implementation Roadmap

Phase 1: Requirements Assessment (Months 1-3)

Objective: Conduct field requirements assessment with EMS partners to identify minimum viable vital sign metrics and integration points.

  • Partner with 2-3 EMS agencies representing urban, suburban, and rural environments
  • Shadow EMS crews for 50+ transports to document current workflow
  • Interview hospital ED staff on critical data needs for incoming patients
  • Map EHR/HIE integration requirements and authentication protocols
  • Define success metrics and clinical validation criteria

Phase 2: Prototype Development (Months 4-9)

Objective: Develop working prototype with core vital sign monitoring and basic EHR integration.

  • Build optical sensor array optimized for ambulance vibration/motion
  • Develop real-time vital sign extraction algorithms
  • Create HL7 FHIR integration layer for hospital systems
  • Design rugged ambulance-compatible hardware enclosure
  • Implement data security and HIPAA compliance measures

Phase 3: Pilot Deployment (Months 10-18)

Objective: Deploy in 5-10 ambulances across partner agencies for real-world validation.

  • Install systems in diverse ambulance fleet (different vehicle types, ages)
  • Train EMS personnel on system operation and troubleshooting
  • Collect 500+ transport episodes with full vital sign data
  • Validate accuracy against gold-standard monitoring equipment
  • Document integration performance with hospital EHR systems
  • Gather user feedback and identify improvement priorities

Phase 4: Validation & Scale (Months 19-24)

Objective: Complete clinical validation study and prepare for broader deployment.

  • Conduct IRB-approved clinical validation study (n=200+ patients)
  • Document patient outcome improvements and workflow efficiency gains
  • Refine system based on pilot feedback
  • Obtain necessary regulatory clearances (FDA 510(k) pathway)
  • Develop commercialization and scaling strategy

Expected Outcomes

Clinical Outcomes

  • Complete vital sign documentation for 100% of transports (vs. current 60-70%)
  • 40% reduction in ED handoff time through automated data transfer
  • Earlier identification of patient deterioration during transport
  • Improved ED preparedness with advance vital sign visibility

Operational Outcomes

  • Eliminate manual vital sign transcription (saves 5-7 minutes per transport)
  • Reduce equipment costs by 60% vs. traditional monitoring systems
  • Enable quality improvement through complete transport data analytics
  • Support regional EMS coordination with real-time system status

Get Involved

We're seeking partners to help validate and deploy this critical EMS innovation:

  • EMS Agencies: Pilot sites for system validation and field testing
  • Hospital Systems: EHR integration partners and clinical validation sites
  • Developers: Contributors for HL7 FHIR integration and mobile apps
  • Researchers: Clinical validation study collaborators
  • Funders: Support for development and pilot deployment

Contact: ems-model@openwater.health