PRODUCT

RTMW Overview

Rapid Triage Management Workbench (RTMW) is designed for use in All Hazard medical triage situations, such as chemical, biological, radiological or nuclear (CBRN) events. It enables first responders to record the needs, treatment and disposition of the casualties, based on identified hazards, and to transmit that data to treatment centres.

RTMW tracks casualty information in one central database allowing all treatment centres, including alternae care facilities and hospitals, to work with the same information. Also with a restricted view, RTMW provides support for family reunification inquiries for a range of NGO providers.

RTMW is available for use by police, fire department, military, paramedic, and treatment center staff.

RTMW Concept of Operations

RTMW Features

RTMW Capabilities

• Accessible through a standard web browser - No software installed on client PC
• Standard PC equipment can be used to run RTMW, eliminating the need to procure and maintain special equipment
• Two components – field portable unit and central database
• Wireless web connection, air cards, satellite
• Rugged design
• Designed by first responders for use by first responders
• Functionality based on user permissions
• Bilingual operation (Multi-Lingual capabilities)
• On-line help facility with supporting documentation
• Can be customized to meet specific customer operational requirements, e.g. triage priority classifications.
• Canadian medication list provided, easily modified for international standards
• Privacy of casualty information protected

             Incident Command

• Usable in single or multiple casualty incident
• All hazards mass casualty management providing comprehensive awareness of the scale of medical impact, medication requirements, Personal Protection Equipment (PPE)
• Proactive ready response at treatment center, available links to CBRNE knowledge bases
• Near Real time information sharing from catastrophe site to treatment center
• Scene Assessment and Disaster Outbreak Detection – RTMW provides the ability to classify the outbreak and track it. RTMW assists the First Responders with scene assessment by enabling them to record and classify the type of CBRN situation, thereby providing live time alerts and tips on associated hazards, PPE & agent class thus enabling the first responders to protect themselves as well as protecting the casualty from further harm.

Sample Screen: Incident Data

             Casualty Information

• Casualty information entered in the field by first responder or EMS/Public Health officials
• Casualty information can be recorded in treatment center i.e. walk in casualty at a remote triage center
• Proven methodology for all hazards casualty management
• Transmission of casualty information to treatment centre
• Data stored according to the Classification of Disease Standards
• RTMW currently supports the Canadian Triage Acuity Scale (CTAS) and the Ontario Disaster Casualty Tag used by Emergency Medical Services in Ontario
• Casualty Treatment Record - RTMW enables users to create treatment records for casualties at the incident scene through to and including the treatment centre. Treatment records can also be created in the treatment centre, e.g. for walk-in casualties. Treatment records can be readily updated/modified as the casualty status changes. All record changes are permanently recorded into the system for auditing purposes.
• The RTMW casualty screen is based on the casualty card/triage tag system. RTMW collects casualty personal and medical injuries information based on the triage tag assessment system.

Sample Screen: Casualty Data

Enhanced Reporting Capabilities

• Multifaceted casualty specific reporting capabilities available to all levels i.e. field tent, Medical Incident Command, alternate care facility and hospitals
• Real time casualty count including unassigned and deceased
• Viewable casualty list
• Casualty cluster reporting – i.e. listing by triage colour code for all disaster scenes
• Multiple item casualty search function
• Wildcard search function

Sample Screen: Search Casualty

Security

RTMW is software that is designed by IT professionals. It was built with the following security features:

• Access Control – Manages privacy protection issues related to medical records, through restricted view functionality, all of which is assignable by the assigned RTMW System Administrator. Tracks users who modified or input medical information on casualties. RTMW is a database application (Microsoft SQL Server ™), which provides a proven platform to control application access.
• Data Safety – Ability to safeguard your data from all sites even in the event of connection interruption. Support for saving data to USB media exists in RTMW. Control of medication lists or treatment lists is limited to authorized administrators such as physicians etc. (Is there any external sources of information we can draw upon?? TRA, PIA)
• SSL - Secure network with browser based access is supported.
• Support for customized access control to support additional security needs can be obtained from AMITA through a consultative process. AMITA employs staff with federal government security clearances to work with you in a responsible manner.
• RTMW has been used on US military networks, including use of air cards, military internet, and satellite infrastructure.

RTMW Benefits

• Rapid triage with up-to-date medical data will increase efficiency in casualty care and transportation.
• Caregivers will provide effective and efficient care because the right people and equipment will have been triaged to where they can do the most good. This will minimize provider fatigue and unnecessarily prolonged exposure to potentially hazardous environments.
• The safety of response team members will be improved because information on potential medical hazards will be communicated to all cluster members more quickly.
• The health care facilities receiving the casualty will receive relevant patient data prior to admission.
• The response team will be able to provide casualties’ families with accurate, up-to-date information.
• Public health organizations will have accurate information and will, therefore, be able to provide advice and directions to the public based on current, pertinent data.
• RTMW will use the current triage marking (code) system used by the EMS. Therefore, all first responders will be familiar with the RTMW triage coding system.
• The CBRN preparedness staff will use RTMW as a teaching tool in the art of triage and it also could be part of first responder curriculum on a national level.
• Information gained becomes historical data record for lessons learned.

RTMW Success Story

 COALITION WARRIOR INTEROPERABILITY DEMONSTRATION 2006 FINAL REPORT

IT05.52

Rapid Triage Medical Workbench
(RTMW)

 warfighter/Operator RESULTS

IT05.52 ASSESSMENT COMPONENTS

PERFORMANCE

Rapid Triage Medical Workbench (RTMW), IT05.52, successfully demonstrated a medical triage software system for capturing information from mass casualties related to natural disasters, as well as chemical, biological, radiological, nuclear, and high yield explosives (CBRNE) situational information..  RTMW assisted first responders and hospital triage workers with rapid identification, categorization, and sorting of disaster scene casualties based on severity of injuries.  RTMW also demonstrated the near real-time entering, updating, and accessing causality information, aiding in medical and logistic decisions.  In addition, RTMW authorized users at different care locations to access incident data on a need to know basis while simultaneously, safeguarding patients’ privacy information.

Assessment Level

Eleven warfighters evaluated Rapid Triage Medical Workbench through JDCAT questionnaire at the following sites:  Camp Jorstadmoen, Lillehammer, Norway (1 warfighter), NSWC Dahlgren, VA (2 warfighters), SPAWAR San Diego, CA (4 warfighters), and USNORTHCOM Peterson AFB, CO (4 warfighters).  All warfighters possessed various occupational backgrounds and had sufficient knowledge to operate and evaluate this trial.

Technical Support/Training

Rapid Triage Medical Workbench on site training took place at USNORTHCOM Peterson AFB, CO.  At NSWC Dahlgren and SPAWAR, training was conducted over the telephone; whereas, warfighters at Camp Jorstadmoen, Lillehammer, Norway received computer based training from the RTMW web site.  All warfighters rated training good to excellent.  The on-line help was rarely used since the training provided during training week was adequate for the warfighter tasks.   Additionally, all warfighters received a trial playbook to support the MSEL events. Several warfighters rated the trial playbook very beneficial for clarifying tasks and events. 

CAPABILITIES/FINDINGS

IMPROVE LOGISTICS DATA ACCESS, FUSION AND INTEGRATION AMONG COMMUNITIES OF INTEREST   MSEL events demonstrated RTMW solutions that integrated and provided for effective logistics.  All warfighters concurred that RTMW successfully demonstrated the ability for authorized users at different care facilities to view and access event information; such as incident location, in-field patient numbers, triage priority levels, and patients in transit.  Warfighters created, edited, and updated information before forwarding to a care facility through the internet. Warfighters thought sharing/updating patient information and providing data to the right medial staff using RTMW was instrumental in improving the commanders’ and other non-governmental organizations (NGO) situational awareness. 

IMPROVE INFORMATION ASSURANCE, HORIZONTAL DATA ACCESS, FUSION AND INTEGRATION AND IMPROVE VERTICAL AND HORIZONTAL INFORMATION DISTRIBUTION  RTMW successfully met these objectives.  RTMW developed software that allowed field personnel to enter and update patient data and medical information.  These records were sent to care facilities, hospitals, relief agencies, NGOs, other organizations.  These agencies gained record access as long as they held proper access permissions from RTMW: access levels were determined on a need-to-know basis, protecting patient privacy.  Also, RTMW software provided capabilities to locate patients regardless of their location.  Warfighters found this resource beneficial to maintain patient status situational awareness.

WARFIGHTER/Operator PERSPECTIVE

Overall, all warfighters deemed RTMW successful for providing responsive solutions and effective mass casualties triage logistics, enhancing the commander’s ability to collaborate and disseminate information on patient locations.  At the same time, RTMW kept patient medical information limited to a need-to-know basis.  Once trained, all warfighters indicated RTMW was easy to learn, intuitive in design, and reliable throughout the demonstration.  Warfighters supported fielding RTMW with some improvements, particularly adding a collaboration tool, and a tool to download large files.

WARFIGHTER/Operator COMMENTS

“Even as a lay person being introduced to RTMW, I feel I could understand this system with no problems.  I really like it.”

“The system walks you thru very easily.”

“It worked perfectly and it is very user friendly."

“There are so many features to the program that I can not say what one I like the most.  I do like the fact that it is easy to use.”

“This is a tool that could help at all levels of command and control, and in the treatment and tracking of casualties during all hazard events.” 

“This needs to be explored further for potential employment in DOD and interagency use.”

CONCLUSIONS

RTMW’s software solutions allowed medical workers and first responder response teams to efficiency and effectively access a central data source to obtain casualty tracking and status information.  RTMW technology promoted increased medical situational awareness supporting HLS/HLD agencies during natural and CBRNE disasters by sharing relevant data to emergency care personnel and field/central hospitals.  Concurrently, relevant data was forwarded to command and control, NGO and other facilities overseeing such disasters.  RTMW also provided control over information agencies, some of which only received name and location, while others received a detail patient medical synopsis.  Most Warfighters using RTMW during CWID execution thought the trial’s software design and capabilities were well developed, but offered some recommendations as documented below.  RTMW worked efficiently throughout the demonstration and warfighters thought the trail accomplished its objectives.

RECOMMENDATIONS

• Provide a feature allowing first responders to correspond with certified medical assistants for medical assistance.
• Provide export capability from RTMW to Excel spreadsheets.
• Create a batch file capability to group similar medical needs from a single incident.
• Provide patient tracking capability from the field to medical care facilities.

 COALITION WARRIOR INTEROPERABILITY DEMONSTRATION 2006 FINAL REPORT