By BECKY GILLETTE
Italo Subbarao, DO, MBA, senior associate dean with the William Carey University College of Osteopathic Medicine, is an emergency physician with a specialty in disaster medicine and emergency response. The former director of the American Medical Association Public Health Readiness Office in Chicago is now using his experience to work with Hinds Community College to develop ambulance drones that can deliver medical tools, medicine and telemedicine to victims and\or first responders at the scene of natural disasters or mass shootings.
On Dec. 6, two new Health Integrated Rescue Operation (HIRO) ambulance drones made their debuts at a successful active shooter simulation at the John Bell Williams Airport that was witnessed by officials with the Department of Homeland Security, the United Nations, federal law enforcement officers and the governor’s office. The event was in concert with the nationwide Homeland Security “Stop the Bleed” campaign.
“I’ve been responding to major disaster events around the world for many years prior to coming down here five years ago,” said Subbarao, who provided field and technical support after the Haiti and Pakistan earthquakes, the Mumbai shootings, and Hurricanes Gustave, Ike and Katrina.
“Tornadoes, earthquakes and terror attacks, I studied all those things before I came to Mississippi in 2011. Five or six months later, this F4 tornado came to Hattiesburg causing tremendous damage. Students came to me and asked if I would help study this event. When studying the event, we recognized there were zero fatalities and fewer overall number of injured people and level of injury than what would expect compared to similar events.”
What came out was the critical role played by social media, Twitter in particular, in warning people to seek shelter. An article published on the findings was recognized by the United Nations and the Mississippi Emergency Management Agency decided to develop a plan to use social media purposefully. Hospitals were also interested in adopting a social media plan to respond to disasters.
“There was robust, two-way communication between the population that was impacted the response agencies in general,” Subbarao said. “People reporting power lines that were down, roads that were blocked, and other concerns. The appropriate response was: ‘We hear you, we are working as hard as we can and we will be there as soon as we can.’”
But in studying the disaster, they realized there was more than could have been done by combining the drone technology with telemedicine to create an ambulance drone that was small, cheap and mobile. But putting a mobile telemedicine package on a drone, the supplies could be sent to the address where there were injured people potentially providing critical, life-saving interventions.
“The idea was to provide a critical bridge providing emergency care before the first responders got there to take them to the hospital,” he said. “That is the seeding for the idea.”
Guy Paul Cooper, Jr., a fourth-year medical student, was co-developer of the HIRO.
“He and I scoped the field to see if this technology was out there,” Subbarao said. “I talked to a number of folks about unmanned aerial vehicles and while a lot was being done in terms of drones being used to survey a disaster area, no one was really doing what we suggested. On the commercial side, Amazon, FedEx and UPS are looking at transport drones. What we envisioned was more than a drone, but an integrated system with a medical kit that would be integrated with technology that was user friendly and would empower a person in a chaotic environment.”
It is even possible to use visual technology like Google Glass so when someone at the disaster puts on Google Glass, images of what that person is seeing are transmitted back.
“We can speak in their ear and give them reassurance,” Subbarao said. “It allows guiding that person. They can push a button on an application that will coincide with lighting a certain area of kit. We tell them, ‘Grab that.’ Then we can talk them thought it. We can even push video to show them how to do an intervention such as putting a tourniquet on that can literally save someone’s life and limb.”
The first working prototype they generated focused on rural emergencies. Perhaps someone at a farm has a cardiac emergency, and is a 40-minute drive from a hospital. A drone can get there in half the time and provide life-saving care.
“As we look at the things put in the kits, we are looking at common emergencies you might see in a disaster or rural setting,” Subbarao said. “One of the other utilizations for the kits is if you are in remote wilderness area hiking, and somebody gets bit by a snake or a bee, our kits can get out there and bring some life-saving interventions. Otherwise it might take first responders a great deal of time to get to you.”
Subbarao said they have received interest from throughout the U.S. and around the world about the use of this technology.
“We are very excited,” he said. “We are interested in refining it. Our next step is we are very focused on continuing to test the technology and working with state partners to be able to do some field testing. From our vantage point, I believe we have a solution. We feel we have a Mississippi solution, but also really a global solution based on the response we have received. We’re not building drones. We are not building medical kits. We are building a drone response system that can be plugged into an emergency response system.”
Subbarao said they believe there is a commercial potential down the road. Currently the biggest barrier to this are FAA regulations that don’t allow commercial drones to go beyond physical sight.
“The ambulance drone concept is best utilized in beyond visual line of sight,” he said. “If power lines and trees are down, the drone can get up over the barrier. We are working with the FAA on regulatory requirements. There are ways within the system to be able to do this. The important thing is the technology is here now. That is what is amazing.
Subbarao said their partners at Hinds Community College have been helpful.
“We believe there is a fellowship and kinship in Mississippi that will allow us to test and refine it here in the state,” he said. “This is a special place where we can develop ambulance drone technology in an amazing way.”
Hinds Community College was one of the first colleges in the country to develop a two-year associate degree program in unmanned aerial systems. Dennis Lott, who directs the program, is excited about the future potential.
“William Carey has done a superb job developing this telemedical unit,” Lott said. “I monitor worldwide data streams regarding unmanned aircraft systems and we are far ahead of the rest of the world in this area. It is astounding. I’m a homegrown Mississippi boy and it is exciting that here in Mississippi two schools have partnered together to bring this technology out that could really benefit humanity. We will continue to develop it and build it right here in Mississippi.”
Lott said there are clear indications that unmanned aircraft systems are an emerging industry that is going be the next golden era in aviation. There are estimates that 110,000 jobs will be created in the field in the next five to 10 years.
“It’s pretty big,” he said.
The HCC drones, which weigh under the FAA mandated 55 pound weight limit, were constructed specifically to deliver the William Carey College telemedicine package. The drone can also give a bird’s-eye view of the disaster allowing rescue personnel to know exactly what is going on.
“I think in the future most emergency response agencies will have an ambulance drone like this, and actual telemedical packages that will be delivered to remote locations to provide the help when it is needed and where it is needed,” Lott said. “After hurricanes, tornadoes, ice storms or mass casualties, as many as 100 people can be treated from one delivery with one of these drones.”