Public Safety Gets the D Block: What it Means for EMS

On February 17, Congress officially allocated 10 MHz of the 700 MHz radio band to public safety.

Known as the D Block, this spectrum had been much sought after by wireless carriers for commercial service. But in a move that could restore one’s faith in politics, Congress put public service over profit and gave the D Block to police, fire and EMS, along with $7 billion to build a national first responder broadband network.

Once in place, this network will provide EMS, fire and police agencies with broadband, interoperable two-way communications nationwide. With the right equipment—likely hardened smartphones and tablets built to the commercial wireless carriers’ 4G/LTE standard—EMS staff will be able to send and receive data, video, audio and medical instrument readings from their ambulances directly to receiving hospitals. The system lacks voice capability, but this may be overcome with VoIP or mixed broadband/voice bandwidth in the same device.

“The significance of this for EMS communications capability cannot be overstated,” says Kevin McGinnis, communications technology advisor for several top national EMS associations. “It can be compared to what happened when ambulances were first equipped with two-way radios back in the early 1970s. It is that big a jump.”

The 700 MHz D Block network will be built by, licensed to and managed by the First Responder Network Authority (FirstNet), an independent body to be formed under the National Telecommunications and Information Administration. FirstNet’s 15-member board of directors will include the secretary of Homeland Security, the Attorney General and the director of the Office of Management and Budget, plus three members representing state and tribal governments and three public safety professionals (active or retired). The other six members will likely include representation from wireless manufacturers and carriers. Under the Middle Class Tax Relief and Job Creation Act (H.R. 3630), which included the D Block decision, FirstNet’s board must be established by August 20.

“Once FirstNet’s board is in place, the process of building out the nationwide broadband network will begin,” says Chief Jeff Johnson, CEO for the Western Fire Chiefs Association. “There’s a lot of work to be done before we actually see broadband equipment in the nation’s first responder vehicles, but at least we’ll finally be on the right course.”

Imagining the Potential

It is easy to spout technical platitudes regarding 700 MHz’s capabilities for EMS. But what will it really mean for an EMS technician responding to a crash? McGinnis offers a scenario.

“Let’s say you’re the first EMS responder on the scene, approaching the scene of a two-car collision on foot,” he says. “You are wearing a small camera and lip microphone, both connected by your LTE first responder handset to your state’s FirstNet network. As you approach the first car, you start giving a voice description of your impressions. Beyond going to dispatch, your audio is automatically converted to text and begins to be compiled in an accident database.”

As the scenario continues, you get to the first victim, who is injured but conscious, breathing and not bleeding. You connect a multi-vital sign monitor, and its data is relayed through the FirstNet network to a second database. It is also reviewed by dispatch for use in assigning a receiving hospital. Meanwhile, live video of the victim and their condition is captured and stored in a third database for immediate and later access by other medical professionals, as need be.

On to the second car. Again you describe what you see, with the information stored automatically in the first database. You apply a second monitor, again recording live video that streams to dispatch for real-time assessment and storage in the appropriate database. As you work, dispatch uses the time to access the victims’ medical records and send their data to you to help inform treatment decisions.

“In some cases, patients may be wearing medical alert-type necklaces, except their medallions contain USB drives or chips with their medical information right at hand,” McGinnis says. “With modern RFID technology, it is possible to equip EMS responders with devices that will actively query the immediate area for patient-worn RFID-capable storage drives loaded with such information—and to download that data wirelessly to the EMS provider’s own handheld.”

The result: In the space of one minute, rather than 5–10, a patient’s advanced assessment and clinical notes, diagnostic data and history are made accessible to hospital staff, all responders arriving on scene and other authorized users of the data.

Now fast-forward: A second ambulance has arrived, and the victims, having been fully assessed, are being loaded for transport. While this occurs, their medical information, vital signs and conditions are assessed by hospital physicians. In the ambulances, EMS providers can videoconference in real time with these physicians and conduct further tests to provide more data. By the time the victims get to the hospital, they have already begun to receive treatment under the physicians’ direction.

This is a fundamental paradigm shift as far as EMS is concerned: Responders will be able to move from maintaining life support to beginning the healing process while en route.

The Nitty-Gritty

Everything you’ve just read represents the potential of 700 MHz for EMS. However, there’s a lot of work to be done to translate this potential into reality. The work begins with getting FirstNet up and running. That’s where H.R. 3630 comes in.

“Under the act, FirstNet will present each state governor with a plan for constructing their state FirstNet network,” says Johnson. “If the governor has plans of their own to make it happen, they can do so. But if the governor does not respond, FirstNet has the authority to proceed and build the state network itself. This provision should prevent these buildouts from becoming mired in state politics.”

This said, many issues will have to be tackled to launch these buildouts. These include creating a functioning, qualified bureaucracy to get the process moving, getting plans drawn up, and hiring contractors and equipment suppliers to actually build the infrastructure. And before shovels go into dirt, there’s a fundamental decision that has to be made: Should FirstNet build its own 700 MHz LTE network, or work with commercial carriers to tap into and expand their existing networks?

This is not a slam-dunk decision. Building a separate system ensures it can be built to public safety standards, but it could take years to accomplish. In contrast, working with commercial carriers would make it possible to get FirstNet on air sooner. But the network, no matter how hardened and customized, would be a public safety/commercial hybrid at best, and a poor compromise at worst.

“This is a fundamental strategic decision that has to be made by the FirstNet board once it is in place,” says Johnson. “There are pros and cons to each option; neither one is perfect. But the choice made will dictate not just how FirstNet rolls out, but how its equipment evolves and is deployed, from handsets to transmitter sites and network design.”

Time to Get Involved

If H.R. 3630 restored your faith in politicians a bit, remember what Ronald Reagan said: “Trust, but verify.” Given that $7 billion is on the table, plus billions more to be made through equipment sales to first responders, there will be a lot of competing interest groups trying to steer FirstNet’s decisions to their advantage. “This is the time for EMS, fire and police to make their voices heard in the FirstNet process, and to make sure the decisions being made truly serve the public interest,” says Johnson.

He’s right: The choices that will be made will truly dictate the face of public-safety communications for the 21st century. Here are some of the issues EMS agencies need to think about, take positions on and lobby for.

Interoperability

The creation of a national broadband first responder network is intended to avoid the radio incompatibility issues that prevented fire/EMS and police being able to talk to each other on 9/11. That said, there is always the temptation for manufacturers to create proprietary features that give their products an advantage over the competition. If FirstNet is to achieve its goals, public-safety agencies must be on the lookout for potentially incompatible features and insist that every piece of equipment on the network, no matter who makes it, be truly interoperable. Function must trump profit.

Equipment Design

Given the 700 MHz band’s suitability for 4G LTE traffic, it will be tempting for equipment manufacturers to adapt commercial 4G smartphones for use by public safety. (Should FirstNet decide to work with commercial wireless carriers, this temptation will be almost overwhelming.) The danger for EMS and other public-safety agencies is that this equipment may lack sufficient ruggedness and mission-critical functionality, while offering features from the consumer space that really don’t matter to us. To keep this from happening, public-safety agencies must make their voices heard at FirstNet and at every forum where they deal with equipment manufacturers. It is vital that the broadband equipment sold to public safety be designed for public safety, not adapted from a consumer design simply because it can be.

Coverage

The concept of FirstNet is to provide a national broadband footprint. For the sake of first responders in rural and remote areas—the people who need remote access to expert support the most—the network must be truly nationwide. There will doubtless be horse-trading on the part of some players in the process. They may argue that because there are so few people in some parts of some states, extending coverage there isn’t worth the expense.

The problem with this argument is that the FirstNet buildout is a unique and perhaps singular opportunity to remedy such gaps. Congress doesn’t allocate $7 billion to public safety every day. In fact, chances are it never will again, on the grounds that FirstNet was funded to fill the holes, and that’s that. So if coverage gaps are not addressed now, they may never be.

Ongoing Funding

It’s one thing to build a shiny, high tech new network. It’s another to pay to keep it maintained and upgraded. It will be vital for public safety agencies to demand and ensure that FirstNet is funded on a long-term, sustainable basis and that the network is built to be modernized and expanded as populations grow and technology advances.

“The D Block and FirstNet represent a historical opportunity for EMS and other first responders to get communications right for the first time in our history,” says Johnson. “Yes, it will take a lot of work to make FirstNet happen, and much effort required to make it happen to the public’s benefit. But the potential for lives saved in the future is incalculable. As first responders, we have a chance to make a profound contribution to public safety for decades and generations to come.”

James Careless is a freelance writer with extensive experience covering public-safety technologies.

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