Keeping Their Fingers on The Pulse

When someone in Israel calls 101—the emergency phone number for reaching Magen David Adom (MDA)—it takes only two to three seconds on average until someone answers the phone, significantly less time than in most developed countries. Even more remarkable is that MDA’s cutting-edge Command and Control System ensures that the response to that emergency will be extremely fast and efficient, with logistic decisions handled by artificial intelligence (AI).

“As soon as we get a call, our system analyzes the requirements and locates all the relevant resources in the area—automatically dispatching the most suitable vehicles and personnel,” explains Ido Rosenblat, MDA’s Chief Information Officer. “The computer can make important decisions in milliseconds and reduces both response time and errors. Since in many cases every second counts, this is a game-changer.”

Cutting-edge technology

Following the Second Lebanon War of 2006, MDA’s CEO, Eli Bin, took the courageous decision of developing an innovative high-tech command and control system internally. During that war, it became clear that no off-the-shelf solution would be sufficient, especially since Israel constantly faces new threats and challenges that impact the emergency services.

The result is that MDA’s next-generation AI-based Command and Control System connects over 40,000 devices all over the country: ambulances and other vehicles, defibrillators, MDA’s entire staff including volunteers and more. Furthermore, it also connects MDA with Israel’s other principal emergency services, including the Fire and Rescue Service, Police and the IDF’s Home Command. As a result, all relevant organizations can coordinate their efforts in an efficient manner during large-scale emergency events.

The System uses Machine Learning to constantly improve its abilities. Sixty software developers and 25 additional tech experts work persistently on these high-tech operations, enhancing the system’s features, providing support and ensuring data security.

“We felt it was important for our system to be integrative so that everyone could share information. We searched for existing solutions all over the world, but no other country had an integrated IOT (Internet of Things) system that covers all elements of the organization—volunteers, headquarters, vehicles, cell phones, etc.—so we developed our own,” Rosenblat elaborates. “Our system is very robust and can operate in stand-alone mode if necessary. The information never gets lost.”

One of the system’s most useful features is that it includes vehicle telemetry. Specifically, it doesn’t only know in real time where each ambulance, helicopter and motorcycle is precisely located; it also knows how much gas the vehicle has in its tank, whether the driver is wearing a seatbelt, whether it is using a siren and other parameters. It is also connected to the dashboard cameras on all emergency vehicles.

When MDA responds to cases of heart attacks or other acute heart conditions, the Command and Control System not only locates but can actually control thousands of MDA defibrillators spread out around the country. The system gives instructions to civilians seeking to help someone in cardiac arrest, guiding them through the process of administering potentially life-saving shocks, with additional phone assistance from MDA's dispatcher.

Another practical feature of MDA’s sophisticated system is that paramedics and volunteers in the field are able to send information and pictures to hospitals, so that the medical teams can prepare in advance to treat patients urgently upon arrival. Stroke victims, for example, can be rushed straight to the Stroke Unit without going first to the Emergency Room and undergoing 30 minutes of tests—thereby increasing their chances of recovery.

An even more futuristic example of MDA’s advanced technology can be seen in every hospital. When paramedics complete the process of evacuating a patient to the hospital, they submit a computerized medical report on their tablet. They can then go to the special MDA “vending machine” located in every hospital to renew the supplies they used while treating their last patient. The vending machine dispenses the exact supplies that the paramedic just used based on the report they submitted electronically. By resupplying at hospitals, paramedics no longer need to waste time returning to MDA stations to renew their supplies.

Proactively innovating

In order to provide the most efficient and cutting-edge care as possible to the population of Israel, Magen David Adom is constantly searching for new technologies that could help improve the level of service it provides. Dr. Refael Strugo, Director of Medicine at Magen David Adom, explains that MDA proactively seeks out relevant developments around the world that could be applied in Israel. “We always keep our fingers on the pulse,” he puns. “We go to conventions and events around the world to see what’s new in our field, and then we decide which new inventions we want to test in pilot projects.” In addition, MDA’s scientific arm always stays abreast of the latest scientific literature.

Two or three times a year, MDA convenes a committee of experts to discuss new technologies and treatments, and then recommends several to the management for further discussion. For example, an article about a new type of plasma for treating injuries was recently brought to the attention of the committee and, after its benefits were proven, the new plasma became part of the supplies routinely available to all MDA paramedics.

In the past two years, MDA has introduced pocket-sized ultrasound devices as a new and important tool in its arsenal. Ultrasound scans can be extremely useful for diagnosing various medical conditions, but until recently the machines were very large and not mobile, so that scans could only be carried out at medical centers. Today, they are smaller than a hand and easy to carry around. The only drawback is that they require training and experience in order to be used properly.

“Until now, if a patient presented with shortness of breath and low blood oxygen levels, we could mainly ask questions and use a stethoscope to try to determine the reason. Using a portable ultrasound device, we can see the person’s lungs and understand exactly what’s going on. It’s a very efficient tool,” explains Dr. Strugo.

Portable ultrasound devices can also be used to diagnose heart conditions before the patient reaches the hospital. “If someone is in deep shock with no pulse, we can check blood pressure, do an EKG or use a stethoscope to diagnose the situation. However, these methods are not sensitive enough and not completely reliable. With an ultrasound, we can see within 20 seconds exactly what the problem is and treat it accordingly,” Dr. Strugo continues.

MDA recently trained 100 paramedics to use portable ultrasound devices, and a pilot is currently in progress. Thirty ultrasound devices were distributed around Israel and MDA will evaluate their effectiveness over the next year before deciding on a larger roll-out.

Another exciting pilot project underway involves the use of drones to deliver defibrillators and EpiPens to patients in remote locations. The drones use advanced GPS technology to reach people in need of urgent help.

“MDA provides excellent care using cutting-edge technologies. We are now focusing on extreme improvements to save even more lives,” Dr. Strugo concludes.

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in collaboration with American Friends of Magen David Adom