Bay Area Research Wireless Access Network (BARWAN)

A Medical Application Enabled by Wide-Area Wireless Overlays

To better understand the role of wireless overlay networks and multimedia applications support technology within this networking context, consider the following scenario, drawn from the domain of "tactical" emergency response.

A police helicopter observes a serious auto accident on Golden Gate Bridge, which immediately calls for an emergency medical team to be dispatched. The helicopter, using a wide-area overlay network, transmits low frame rate digitized video of the crash site to the medical team, to assist them in assessing the severity of the crash and the need for supporting units. They decide to request backup. The helicopter crew also establish a two-way audio conversation with the ambulance driver to direct him to the scene via the least congested traffic route, perhaps forwarding the medical team a street map with a hand annotated route.

At the scene, the medical team and police units free the victims from the wreckage, stabilize their condition, and head them to Mt. Zion Hospital in San Francisco. The victims are identified, and one of the injured passengers has a serious head injury, requiring immediate emergency surgery. The team requests the preparation of a suitable medical facility at the hospital. Critical medical information-such as patient reactions to various medications-is downloaded from a regional medical Picture Archiving and Communications System (PACS) at the UCSF Medical Center to the medical teams in the ambulances via a wide-area wireless network. Simultaneously, detailed patient records and archived neuro-images are forwarded to an image file server at Mt. Zion via a high performance wireline network. The in-hospital wireless network allows the emergency room physicians to retrieve and view the patient's images and records on their portable multimedia displays. They decide that a CAT scan should be performed on the patient upon arrival. The new scan, combined with existing patient information, will support their planning of the proper surgical suite and determination of a course of operating procedure.

After the ambulance arrives at Mt. Zion, the patient is routed to the CAT scanner. PACS automatically appends the new neuro-images with his existing patient information. The surgical team assesses the injury's seriousness based on this new information, and decides that a 3-D reconstruction of the CAT images is needed. Mt. Zion Hospital requests UCSF's high performance computers construct a 3-D visualization of the head trauma and provide a computer-assisted guide for the surgical procedure. These are instantaneously forwarded to Mt. Zion via the ATM WAN, where they are rerouted to the surgeon's portable display via the wireless in-hospital network while he is enroute to the operating room. Its unusual nature prompts him to hold an impromptu video consultation with a distinguished neurosurgeon on his way to a lecture at the UCSF Medical School across town. Just as the two doctors agree on a course of surgery, the stretcher is wheeled into the operating room, and the neurosurgeon steps into his lecture hall.

Although phrased in terms of emergency response, this scenario shares many requirements with other kinds of applications, such as logistics management (e.g., "campus"-area depot and in-building warehouse infrastructures integrated with supply convoys via wide-area/regional area communications networks) or command and control systems (e.g., a tactical operations center with briefing/training capabilities that integrates its in-building network and synthetic training environment with wide-area communications overlay networks to units in the field). These requirements include:

Randy H. Katz, ed.,; Last edited: 22 APR 95