Medical diagnostic firms join in market dogfight

 - June 30, 2008, 11:13 AM

A new inflight medical diagnostic system is being launched here at the NBAA show, claiming to be cheaper and easier to use than existing equipment. EMS-Link (Booth No. 2079) is priced at $9,980 per aircraft annually and, according to company CEO Paul Egan, requires absolutely no training for cabin crew.

However, established diagnostic system suppliers TeleMedic Systems (Booth No. 671) and Remote Diagnostic Technologies (RDT, Booth No. 3868) have expressed skepticism about both the price and performance claims of their new competitor. They are displaying their respective VitalLink 1200 and Tempus 2000 systems here in Orlando this week.

West Bend, Ind.-based EMS-Link claims to have overcome the limitations of the narrowband satellite communications used to relay vital signs to ground-based medical support teams. Egan told NBAA Convention News that its software prevents transmissions from being garbled and allows simultaneous real-time voice and data relay. The wireless system has so far only been tested on the ground and has yet to be subjected to fully operational airborne tests. Egan claimed that existing systems can function reliably only with more costly new-generation broadband satcom links, but both RDT and TeleMedic flatly denied this.

The new diagnostic kit measures blood pressure, heart rate, air volume in lungs and oxygen concentration. It uses a five-lead electrocardiogram (ECG), and EMS- Link is working on a 12-lead version such as those used by TeleMedic’s VitalLink and RDT’s Tempus. That said, Egan–a former fire chief and paramedic–suggested that a 12-lead system might actually prove too complicated for most non-medical people to operate.

EMS-Link’s boldest claim is that its products can be operated with absolutely no prior training. Egan argued that the training required by his competitors is needlessly elaborate and expensive. He cited research by British academics suggesting that most laypeople lose 80 percent of their knowledge of medical procedures within six months of training.

According to Egan, EMS-Link users need to do no more than connect the system’s telephone line to the aircraft’s satcom system. Once connected, the medical support team at the University of Texas, Medical Branch in Galveston, Texas, directly controls all operations, instructing the crew how to attach monitors to the patient.

The EMS-Link package includes an automatic external defibrillator from U.S. manufacturer Zoll. According to Egan, the system’s display tells users whether they are correctly administering CPR treatment.

EMS-Link is being marketed on five-year leases at $9,980 for a full-service contract. Compaq has supplied the service with a new computer, which can be viewed here at the show. Egan said that upgraded features developed by Hewlett-Packard are to be introduced by the end of this month.

Tempus Enters Corporate Service

Executive charter and management operator PrivatAir is now installing Tempus 2000 on its three Boeing Business Jets (BBJs). In June, it fitted VitalLink 1200 to its Bombardier Challenger 604 and Cessna Citation X aircraft.

Tempus transmits medical data, as well as voice and video feeds over satcom connections. According to RDT executive director Kate Murphy, the UK-based firm’s patented advanced data robustness (ADR) software overcomes transmission problems caused by noise and signal fade. “ADR fools the modems at each end into thinking that the connection hasn’t been lost,” she explained. “Any data that does not get through is stored until the transmission is restored.” ADR has also been licensed to an undisclosed major avionics firm to support its Internet-in-the-sky service.

Unlike EMS-Link, the equipment cannot use a wireless connection to the aircraft’s satcom system, instead relying on an extension cable to the telephone ports. Murphy said that the new 64-kilobits-per-second broadband connection will definitely speed up ECG and video transmission, but she does not expect a fast take-up rate for the technology among corporate operators.

Tempus 2000 monitors pulse rate, blood oxygen levels, temperature, blood pressure, capnometry (breath gas analysis) and has a 12-lead ECG. It can perform multiple readings simultaneously but cannot transmit ECG and video pictures at the same time. For the most part, medical support is provided by MedAire’s MedLink global response service in Tempe, Ariz., but customers are free to choose alternative services such as International SOS or Britain’s The First Call.

The ground-based medics guide cabin crew through the diagnostic process. They are also helped by clear instructions and symbology on the Tempus display, which prompts them if a step has been missed or an error made.

Customers can have baseline medical data stored with the service as well as a full history of pre-existing conditions. Their personal physicians can participate in the consultation via a real-time Weblink. Video images are automatically stored for future reference.

Tempus can also be used for off-line monitoring. This might be useful if an aircraft is flying above polar regions where no satcom connection can be made or if the doctor wants the patient to be monitored for a prolonged period.

The system’s battery provides power for up to four hours of continuous use and can be recharged while the aircraft is on the ground. Once in sleep mode the battery will last up to 12 months without recharging, losing just an hour of power after six months. RDT said that, unlike competing systems, the Tempus can be used right next to a defibrillator without causing electrical interference.

Training Needs Disputed

Murphy rejected EMS-Link’s contention that cabin crew training is unnecessary. In her view, the operators need to be fully engaged in the diagnostic process. Similarly, TeleMedic marketing manager Kara Gooding questioned whether a so-called “intuitive display” and verbal instruction via telephone would suffice in a crisis situation. “In an emergency, panic is very real, and relying on instinct seems a little wishful. Our unit shows and tells the user what to do,” she concluded.

Following about a half-day’s initial training with RDT, up to six crewmembers can complete recurrent training for the Tempus system in about four hours, although this is not required by the supplier. Customers are encouraged to conduct test transmissions to MedLink about once a month.

The standard purchase price for Tempus 2000 is approximately $50,000 and the drop-proof kit is expected to last at least seven years. The annual cost of the MedLink service is around $3,500 for an operator’s first aircraft and $2,500 for each subsequent aircraft. For a single corporate aircraft this would make the approximate annual cost around $10,000.

EMS-Link’s Egan claimed that the annual full cost of Tempus and MedLink actually totals $40,000 to $50,000. This estimate assumed a MedAire requirement for 16-hour recurrent training per year and the resulting loss of productivity for employees who earn at least $50 per hour. RDT dismissed this estimate out of hand.

Tempus has been in service with UK airline BMI British Midland for more than a year and has been used to treat numerous medical emergencies, as well as avoiding several needless diversions. RDT has estimated the cost to an airline of each diversion at between $45,000 and $70,000. The system is also to enter service with Virgin Atlantic Airways later this year.

Murphy maintained that there is at least as much potential for inflight diagnostic systems in the corporate sector, if only because statistically, a doctor is not as likely to be aboard a business jet as an airliner. Tempus has been supplied to several Middle East head-of-state transports, and Jet Aviation has agreed to market the equipment through its completion and refurbishment centers.

VitalLink Set To Add Video

VitalLink 1200 takes ECG, blood pressure, pulse oximetry and temperature readings. By year-end, TeleMedic Systems intends to add video capability. “VitalLink has a very intuitive user interface with visual and audio prompts,” said TeleMedic research and development v-p Matthew Burke. Initial training is supposed to take no more than one hour with the support of a CD.

The voice and data output goes through a single telephone line, with the voice being recorded and digitized for transmission. A wireless separation between the system and the satcom outlet will allow the video to be fed through the same line.

VitalLink also has its own error checking and correction protocol to guard against transmission problems caused by factors such as sun spots. Connections can also be made via the Internet, which Burke feels can be more reliable, especially for sending video pictures.

The base price for a single VitalLink set is $19,995 with one year’s support included. Customers can lease or buy the system, which is also available through dealers such as Thrane & Thrane, whose booth TeleMedic is sharing here this week. TeleMedic has offices in London; Charlotte, N.C.; and Auckland, New Zealand.

Also exhibiting here at NBAA is Air Care International (Booth No. 5059), which provides 24-hr telemedic support for corporate operators, but not inflight diagnostic equipment. President Doug Mykol argued that systems such as Tempus are “overkill” because most medical problems occur on the ground.

Air Care customers can talk to doctors at the George Washington University’s emergency medical department in Maryland, via either an inflight satcom or a landline. The company also provides concierge and security services.