The Critical Illness and Trauma Foundation (CIT) of Bozeman, Mont., installed desktop video conferencing equipment in ambulance services across Montana to provide a link between prehospital care providers and doctors to improve the quality of service performed by Emergency Medical Technicians (EMTs).

Montana citizens and visitors die from trauma at a 30% greater rate than the national average because of deficiencies in some phase of medical care. This project focuses on overcoming the challenge of providing medical direction by using computer technology to link remote medical directors to Montana's prehospital care providers -- primarily to volunteer EMTs who are often hampered by lack of training opportunities, time, fiscal resources and medical support.

The program was funded by a $300,000 grant from the U.S. Department of Commerce's Technology Opportunities Program. CIT was one of 46 grant recipients chosen from more than 750 applicants.

The Critical Illness and Trauma Foundation collaborated on the IDVC project with the Emergency Medical Services and Injury Prevention Section (EMSIPS) of the Montana Department of Public Health and Human Services of Helena, Mont., and the Burns Telecommunications Center (BTC) at Montana State University in Bozeman.

"In a rural state like Montana, the treatment an accident victim receives from an EMT who arrives on the scene may mean the difference between life and death," said Larry Irving, assistant secretary for commerce in charge of the National Telecommunications and Information Administration. "This grant will help ensure the EMTs out on the front lines get the medical direction they need as effectively and efficiently as possible. We believe the CIT Foundation's creative approach of using desktop video conferencing to provide this medical direction will become a national model for improving the quality of EMT services."

Montana Sen. Conrad Burns said, "CIT and its partners are doing a great service to Montanans, especially those in rural areas who don't have immediate access to doctors. This is the kind of program the Burns Telecommunications Center was made for. It improves the quality of life for Montanans and really lets us reap the benefits of the Information Age."

Upon receiving the grant, CIT President and CEO Nels D. Sanddal said, "The Critical Illness and Trauma Foundation is pleased to have the opportunity to contribute in this way to the improvement of rural emergency medical care in Montana. With this project, Montana can serve as a model for other states that plan to invest in infrastructure and programming that will create top-notch Emergency Medical Services systems."

The Interactive Desktop Video Conferencing project uses as its foundation a unique existing resource: the Montana TENKIDS electronic community. TENKIDS was established in 1996 through a public-private partnership with CIT, Montana EMSIPS and the BTC that placed a multi-media computer platform in more than 100 licensed ambulance services in Montana. This electronic community allows prehospital providers to exchange information, access the latest in high-quality training and participate in computerized patient record keeping and data collection activities. The TENKIDS computer infrastructure represents the most sophisticated and complete network in EMS anywhere in the country.

The Interactive Desktop Video Conferencing project builds on this valuable TENKIDS electronic infrastructure by adding desktop computer video technology (a small video camera linked directly to the PC) and by demonstrating how to best use electronic technology to improve rural emergency medical care through stronger quality improvement and medical direction activities. With IDVC technology in place, ambulance services can hold conferences in which they can see the other party, as well as exchange computer files (such as visual patient care records). Before now, IDVC technology had not been explored in the EMS arena, and in a remote state like Montana, offers an exciting new means of distance learning to improve the knowledge and skills of the state's ambulance service personnel. The IDVC project serves as a "field test" not only for EMS but for applications in other professions across Montana and the nation.