Emergency Room Communication Sucks. Could This Twitter-Like Tech Save Lives?

Twiage attacks a big problem by having first responders send tweet-like messages during triage.

There’s a three-car crash on the Williamsburg bridge and emergency medical technicians are immediately deployed to the scene. They get on their radios to prepare emergency room nurses at the nearest hospital for the slew of wounded patients who are about to come in. The problem is, the sound quality is grainy: Should they expect three or four patients? Was that cut to the head or to the neck?

“Think of the static-heavy noisy environments these EMTs are in,” says Crystal Law, a former EMT and CEO of Twiage. “In addition to being limited to words alone–rather than pictures–half the time, the emergency rooms can’t even understand the words that are being said.”

Crystal Law

Last year, Law decided to tackle this problem head on. At the Disrupting Medicine Hackathon sponsored by Brigham and Women’s hospital, Law met YiDing Yu, a doctor who had similar frustrations with emergency communication, and John Rodley, a developer eager to use technology to solve medical problems. The outcome: Twiage, a platform that allows first responders to send tweet-like messages and pictures from their smartphones straight to the emergency room. “Users live-update Twitter with a news event using videos, pictures, and words,” says Yu. “Why can’t that same story be told for patient care by physicians and first responders?” (While Twiage is inspired by Twitter, it is not affiliated with Twitter in any way.)

Twiage has already rolled out in beta at South Shore Hospital and it is expanding into five other Massachusetts hospital this year. In these early test cases, it has proven effective in streamlining communication and reducing misunderstandings, according to Yu. This system seems to work best when conveying straightforward, limited information, rather than complex patient dynamics. “Paramedics have a standardized way of communicating patient details,” says Yu. “They explain the vital signs and they ask for what they need. That’s the most important part of a triage.” She explains that this platform helps to communicate critical information quickly; first responders can explain more nuanced details in person later.

YiDing Yu

Twiage is web-based, so hospitals can just log in to see the streams of incoming triage information; EMTs, on their end, take pictures and send messages via the Twiage smartphone app. They are now rolling out a Google Glass version of Twiage smartphone app, with the added benefit of being hands-free. “While you are trying to stabilize a patient, your hands are probably not free to operate a smartphone,” says Yu. “Google Glass allows you to voice-activate taking the pictures and sending messages.”

No other triage platforms currently use photos; Rhode Island has a text messaging system and several telemedicine platforms offer video technologies, but Yu says not all cases need to be live-streamed to the emergency room doctor. Twiage allows paramedics to take short videos of relevant details, rather than steaming the entire episode. For instance, stroke victims sometimes have fleeting symptoms that later change; Twiage allows a first responder to capture a short episode so that the attending neurologist can make better decision treatments.


The Twiage team is now exploring other emergency scenarios where this technology could be useful. “Twiage was designed to be incredibly lightweight and agile: we’re completely web and cloud-based, with no significant software installment,” says Yu. “We’re just starting in emergency medicine, but we could expand to any other first responders, like those in fire departments, who could alert home base about how many alarms they should call.”

About the author

Elizabeth Segran, Ph.D., is a staff writer at Fast Company. She lives in Cambridge, Massachusetts.

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