http://www.microsoft.com/TechNet/analpln/cs/careline.htm (PC Press Internet CD, 03/1996)
| Updated: March 14,1996 |  Go To TechNet Home Page |
The second largest EMS provider in the U.S., Careline recently implemented a sophisticated dispatch system based on Microsoft products that not only helps it send ambulances to accident scenes in the fastest possible times, but also positions Careline to reach its goal of doubling in size in coming years.
Careline runs its business with a computer-aided dispatching (CAD) system. As the company grew, it became obvious that the minicomputers that originally ran the CAD system were unable to meet requirements, said Walter Arndt, vice president of Careline information systems. Repairs were expensive and could be performed only by the system vendor. When a minicomputer reached its expansion ceiling, the only option was to purchase a new one--at a cost of more than $72,000. The minimum equipment investment was so large that it was prohibitively expensive for Careline to expand into the smaller communities it wanted to serve.
There were other problems. The minicomputers supported only a text-based interface, and they didn't provide the advanced transaction recording the company needed to analyze response times. Their performance became sluggish when activity was high. And when one minicomputer went down due to a hardware failure, software failure, or scheduled maintenance, every one of its terminals went down with it. In the EMS business, downtime can ultimately cost lives.
To meet its goals, Careline needed a more efficient and cost-effective way to deploy its emergency medical resources.
Careline chose Microsoft Solution Provider American TriTech's solution, VisiCAD-EMS. An open, graphical CAD system developed with Microsoft Visual Basic, Microsoft C, and Microsoft Access, VisiCAD-EMS uses the Microsoft Windows NT Server operating system and Windows for Workgroups. Access is the foundation for the event recording and reporting database.
When an emergency call is received, Careline dispatchers must immediately obtain answers to four basic questions: name, address, callback number, and patient condition. With this information, the system automatically sends the call to the dispatch input queue. "From the time an emergency call comes in, our people have 30 seconds to dispatch an ambulance," Arndt said. As the call goes into the queue, the call-taker continues to gather more information.
To determine which ambulance can respond fastest to the call, VisiCAD-EMS uses visual mapping. Each ambulance has a transponder device that sends out a signal with its latitude and longitude coordinates. Global Positioning System (GPS) satellites or Loran FM-radio antennas track the location of Careline ambulances and feed positioning coordinates back to the server. The system uses an application written in Visual Basic to plot the locations and status of ambulances on a custom vector-based map of the area, using graphical icons. "The Windows-based system lets us see where our ambulances are at any time," said Arndt.
Each dispatcher's workstation includes two 17-inch color monitors. The left-hand monitor displays the queue of calls--those waiting to be dispatched and those in process--and the current status of all ambulances. The right-hand monitor displays the city map with icons showing the positions of all ambulances.
After a call enters the dispatch input queue, VisiCAD-EMS determines whether the address is valid, then assigns it a latitude and longitude. The call appears as a telephone icon on the map monitor. On the queue monitor, the dispatcher clicks the mouse on the call data, and the system indicates the four ambulances closest to the emergency scene. The dispatcher decides which one should respond to the call, and uses the mouse to drag the telephone icon onto the icon of that ambulance. The vehicle's status is immediately updated on the map monitor, indicating that it has been dispatched.
VisiCAD-EMS automatically sends information about the call--including priority, address, and problem description--to the ambulance's two crew members via digital pagers. The crew members inform the dispatcher, by pushing a status button on the transponder, that they have received the call. (Status signals are known as "events.") They push the status button again when they start out for the scene of the emergency, and a third time when they arrive.
Each of these events is recorded in the Access database, to be used for analysis, reporting, and billing. Because Careline is under contractual obligation to respond to emergencies in a given amount of time, VisiCAD-EMS is coded with standard response times for each city. If it takes a crew longer than the stated time to respond to a call, the system flashes a warning and creates an exception situation for later analysis. Careline administrators regularly study call data to determine why problems occur and how to improve response time.
To date, Careline has installed VisiCAD-EMS in Rancho Cucamonga, California, and Birmingham, Alabama; three more cities will soon be up and running on the new system.
The Windows NT-based dispatch system has helped Careline achieve important benefits. Dispatch centers using VisiCAD-EMS now handle more calls with the same number of dispatchers. "Because our people are working more efficiently, we won't have to hire as many new people as we grow," Arndt said.
With its graphical interface and point-and-click functionality, the new system is so easy to use that dispatcher training has been reduced from four months to two weeks. "We had one new ambulance crew member who had never even touched a computer," said Jim Richey, vice president of administration at Careline's ambulance company in Birmingham. "Within two hours, he was dispatching calls. The learning curve is phenomenally low."
Moreover, the system alleviates much of the high stress typical of dispatching work. Dispatchers no longer need to interpret and navigate a long series of text screens. As a result, they have more time to monitor the status of calls in progress.
Careline is also saving a significant amount in hardware expenses. Servers cost about $8,000 each, compared to $72,000 each for the previous minicomputer. "With lower hardware costs and shorter training time, this system is 25 percent less expensive to purchase and maintain than other CADs on the market," said Arndt. Using standard personal computers for clients also means lower-cost repairs and upgrades.
Because it is designed using a distributed computing model, VisiCAD-EMS incurs less downtime than the central-processing minicomputer. If a VisiCAD-EMS server goes down, client workstations continue to run.
The new system's advanced vehicle-tracking system and Access database enable Careline to eliminate tedious manual analysis for reporting. Administrators can use any OLE-enabled application, such as Microsoft Excel or Word, to query the database. Query results are automatically plotted and displayed graphically on the city map. "With Microsoft Access, we can slice and dice the database any way we want," said Arndt. "It's easy to see if there's a problem in one part of town and how to resolve it, such as moving a vehicle to a new position."
Careline will continue installing VisiCAD-EMS in the 13 regions it services nationwide, and in new cities as it expands. The systems will eventually be connected in a wide-area network that will allow smaller communities to route their calls to a larger dispatch center when call volume is low. "In a small town, at night, we may only get enough calls to keep a person busy half-time," Arndt said. "With the network in place, we can send that person home and switch all calls to the nearest city."
The company is also looking into installing Windows-based pen computer systems or mobile terminals in ambulances. With a pen-based computer connected to the VisiCAD-EMS system at the dispatch center, ambulance crew members would be able to download local maps to the console in the vehicle, eliminating paper-based maps. They also would be able to eliminate filling out patient forms on a clipboard during transport, then reentering the data upon returning to the dispatch center; instead, patient data would go directly into the VisiCAD-EMS system from the ambulance.
With the new system in place less than a year, Careline is already pleased with its benefits. "No other CAD system on the market can do what ours does," said Arndt.
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This article is reprinted from the "MicroNews," Microsoft
Corporation's employee newsletter.
Copyright . 1994 Microsoft Corporation
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