Automated Emergency Response Operations

Indigenous, rural, and remote communities are comparatively underserved when it comes to ambulance/EMT provision. The unequal treatment, experience, and outcomes in health and health care for people of color stemming from the overt and systemic racism in health care policy and practice has resulted in a system where members of Aboriginal Communities have shorter and less healthy lives than non-indigenous Australians.

Studies note the “potential years of life lost (PYLL) due to premature mortality (PYLL) of the two communities (between the ages of 45 and 49) with the gap between Indigenous and non-Indigenous populations being around 350 per 1,000 pop. PYLL is the number of additional years a person would have been expected to live had they not died before the age of 75.

There should be no difference.

In response to this, our proposal provides a people-centered drone delivery infrastructure that enables essential health services, equipment, and medicines to be more accessible and affordable for those left out of the system.

Chronic conditions like respiratory diseases (including asthma), heart and circulatory diseases, high blood pressure, diabetes, kidney diseases and some cancers are more common among Aboriginal and Torres Strait Islander people than among non-Indigenous people and tend to occur at younger ages for Aboriginal and Torres Strait Islander people than non-Indigenous people. Aboriginal and Torres Strait Islander people are also more likely to die from chronic conditions than non-Indigenous people.

We also seek to support midwife-centered maternity care through supporting midwifes and Traditional Birth Attendants with enabling the swift delivery of drugs such as oxytocin, blood products if required for emergency obstetrics. Our technology may combine with telemedicine initiatives to carry samples back to the secondary and tertiary hospitals for diagnosis (and then return with the appropriate drugs, micronutrients etc. as required.)

There are a couple of major factors that have a positive impact of health and quality of life. Availability of critical health resources (i.e. trained personnel properly equipped), and adherence to prescribed treatments.

In the first case, our Theory of Change centers around the lack of availability of AED, Trauma Kits. It is not that they don’t exist, it’s just that the distances are so far, and the roads are so poor that the patient is often beyond assistance by the time the equipment arrives, particularly if the patient is not right in the middle of the community area.

In the second case, patients are very reluctant to leave Country (the term often used by Aboriginal peoples to describe the lands, waterways and seas to which they are connected. The term contains complex ideas about law, place, custom, language, spiritual belief, cultural practice, material sustenance, family and identity.) to get diagnosis, and also refill prescriptions.

This is particularly solvable where there are nurses available that are trained and licensed to administer intravenous drugs. Some chemotherapy drugs have a very short efficacy after being formulated and so the patients often have to travel outside Country to have them be administered. The use of drones to carry such pharmaceuticals direct from the compounding pharmacy to the patient that is comfy in their local community increases the chance that the patients will follow the treatment regimen prescribed.

Sources

Australian Institute of Health and Welfare 2016. Australia’s health 2016. Australia’s health series no. 15. Cat. no. AUS 199. Canberra: AIHW)

David G, Harrington SE. Population density and racial differences in the performance of emergency medical services. J Health Econ. 2010 Jul;29(4):603-15. doi: 10.1016/j.jhealeco.2010.03.004. Epub 2010 Mar 16. PMID: 20398954.

Hocking, S. , Draper, G. , Somerford, P. , Xiao. J, , Weeramanthri, T. (2010). The Western Australian Chief Health Officer's report 2010. Perth, WA: Western Australian Department of Health.

Our Theory of Change and consultations indicate that strengthening of the Supply Systems through the provision of specialized equipment (vis drones) will overcome these barriers and address the historical inequities and lead to improved health outputs.

By eliminating the unequal treatment and experience in health care for people of color we mitigate the effects of the systemic racism in health care policy and investment. This program actively counters historical antiracism in health care delivery systems, promotes antiracism in health care provision (including the specific issue of Australian Aborigines’ attachment to Country), and demonstrating to health care leaders and professionals that the modern medicine is not the exclusive domain of white urban Australia.

Our vision is to reduce morbidity and mortality in rural communities by increasing the accessibility of health resources to those in need and reducing the time of response. We also seek to improve patient adherence to treatment protocols by enabling the patients to stay “in Country” and get their drugs brought to their door.

We believe the system we are proposing to develop is adaptable to a range of contexts, and can be scaled to cover island archipelagos such as the Torres Strait to the vastness of the Outback- as well as Sovereign Nations in the Florida area, the Dakotas, and in Canada. As the system adapts to each context and the benefits are felt, we will accelerate progress toward the underlying goal of health equity.

We plan to achieve this through the provision of an integrated drone and delivery box solution: Taking advantage of recent advances in drone technologies (specifically the ability to carry significant payloads significant distances) and conjoining this to Valqari’s Drone Delivery Station. The combination of the two technologies (with associated supporting software) will enable the automatic carriage of sensitive items such as pharmaceuticals and other items on the health supply chain

By using this system for the first case, the automatic dispatch of emergency health resources (AEDs, etc) , the process is like this.

We will create a tailored Medical Cabinet in a Box, that contains an optimised selection of medical resources (Including but not limited to, insulin, antivenins, anti jellyfish sting, Epi Pens, AED, trauma kits, first aid kits, hypothermia blankets, life jackets, spinal stability stretchers, flares, etc), with a drone standing ready to respond to an authorized launch code.

Upon request, the system will load the correct emergency response package to the drone, which will then be launched to the coordinates given.

By combining currently available technologies in an innovative system we are creating the potential for remote and Indigenous communities to have emergency and routine medical and other essential supplies delivered swiftly and efficiently. Our proposed solution will be well suited to regional or remote/Indigenous communities and address “Tyranny of Distance “and the inequalities of access to healthcare and other essential items to remote locations;

In addition to solving the technical issues of connecting the hardware and software, our researchers are creating an optimal location model that will determine the optimal locations for the placement of such resources. We will develop a location algorithm, using GIS and overlays of health data (hospital admissions, ambulance call out data), population, airspace and other restrictions. The result will be an optimized location map, based on the range and capacities of the idealized drone.

To address the Health Care Supply Chain Issue, we plan to establish a network of DDS that will enable the secure, HIPPAA equivalent compliant distribution of drugs from compounding pharmacies to rural community centres in Country. This will enable nurses to operate to the limits of their training and licence, (rather than the limit of the available drugs) and enable patients to stay with their families while they recover.

As this idea is accepted into the community we propose to offer the delivery process to commercial operators to defray the cost and enable Aboriginal and Torres Strait Islanders and other rural community members to have the same access to e-commerce and postal service as their urban populations. This will lead to economic benefits (as community members are able to access items with a reduce costs of transport. Farmers and machinery operators, for example, will be able to get spare parts almost immediately, and for cheaper, rather than take the day off to drive to the supplier in the nearest big town for a small but critical item. The economic benefit from the private sector participation will contribute to the sustainability of the entire system. 

The Target populations whose lives we are working to directly and meaningfully improve are the Indigenous, rural, and remote communities who are comparatively underserved when it comes to ambulance/EMT provision.

Specifically, we are looking to work in the Torres Strait Islands Communities:

The Torres Strait Islands are a group of at least 274 small islands in the Torres Strait, a waterway separating far northern continental Australia's Cape York Peninsula and the island of New Guinea. They span an area of 48,000 km2 (19,000 sq mi), but their total land area is 566 km2 (219 sq mi).

Only 16 of the islands are inhabited. The Torres Strait Islands' population was recorded at 4,514 in the 2016 Australian census, with 91.8% of these identifying as Indigenous Torres Strait Island peoples.

This is an excellent location for drone deliveries as it is very uncrowded Airspace with a lot of islands, which are reachable only be small boat. If there is a failure in the drone, then there is unlikely to be any damage on the ground. On the other hand, crossing water means carriage of anything to anywhere required a boat, boat operator, transhipment, and potentially additional risk (of being caught in a storm).

Another valuable element of locating the trials in the Torres Straits is that any lessons learned here may be transferred to mainland Australia and replicated in slightly more crowded airspace of Outback Australia, and thence to ever more dense populations.

The underlying goal of this initiative is to meet the needs of Aboriginal and remote communities across Australia, in a focused and sustainable way.

What this solution aims to do, in the short term, is prove the technology and refine the model such that members of the Aboriginal and Torres Strait Islander communities can advocate for such funding and regulatory support to establish and maintain a health Islander Life

I have deep personal ties with the community and a passion for using technology to making a difference to vulnerable communities across the world 

My career has been in delivering the wherewithal for health communities, whether supplying clean water and health education with Oxfam in Palestine, building maternal and Health Care Centers and a network of Blood Banks in post conflict Iraq, to working with refugees in Syria and Jordan 

As a result of my work with UNICEF, managing the Vanuatu Drone trial in the Pacific. I have become aware of the huge potential of drones to deliver life saving interventions at a fraction of their "normal" cost. I have also become aware of the barriers to the uptake of this innovative technology in traditional communities. 

Specifically, people do not like to be near drones with their sharp spinning blades; they don't like the inconvenience of having to wait for drones, and they don't want their goods to fall into puddles, or the wrong hands.

However there is a niche developing in the use of drones to deliver critical life-saving equipment in the golden minutes after an "incident". Heart attack victims have better survival rates, trauma victims get the bandages they need on the wounds quicker, so lose less blood, etc. 

I am confident that, in our conversations with the [female] Mayor we will be able to work with the community to determine what THEY most need (is it immunisations for infant care? Is it life jackets for kids that go just that little bit too far out from the island? is it vinegar for the awful blue bottle jellyfish that seem to come earlier and earlier every year? We don't know.. but we can respond to what ever the focus groups present through the Participatory Rural Appraisals (PRA) we will enable (for cultural reasons, I should not be present).

Armed with that knowledge, we can step into our Technical world, and develop a solution that future proofs the populations there. Through enabling (down the track) e commerce and inter island communications we will reduce the draw of the big cities and enable kids that grow up in the TI, to stay in the their culture and homes. 

This technological scoping will be a pilot for the wider (mainland) Aboriginal population and the lessons learned in the process can be spread peer to peer between peoples and tribes. Beyond Australia, and as the regulations allow, this model can be offered and amended to meet the needs of the Inuit in Nunuvut, the Chamorou of Guam, and everyone in between. 

In all cases, and beginning with the Torres Strait Islanders, we will be led by the outcomes of the PRA. 

We seek SOLVES assistance firstly in financial support. The pump of this initiative needs to be primed with more than a few “three cups of tea”- many of which will go one without our direct participation (behind the scenes community meetings). We need to support the local health works as they work within their communities to identify the best opportunities to make the biggest difference- and to identify what barriers there may be to implementation. If and when this comes to pass, there will be the opportunity to train the local community leaders (and kids) in first aid, and how to recognize and respond to the heart attacks and strokes which seem to be the prevalent cause of admittance in hospitals. We also may need to refresh their familiarity with administering IV drugs, as the opportunity to treat community members with cancer in the comfort of their home and community, rather than send them to the Mainland for their chemo.

Technically, we would appreciate the input of epidemiologists, and engineers to backstop the technical aspect of the solution, what ever it may be. In order to make this a community led and managed initiative, we would need to train the local technicians (who are currently wizards and making even the oldest outboard motor run well) on the care and maintenance of drones and drone stations. On the legal side, we will be navigating uncharted waters of Beyond Visual Line of Sight drone use – but we are encouraged by the recent changes in the governing laws that will make this possible.  

And on the market side: Without predicating the outcome, we would like to see this become self sustaining through commercial use, for example using drones to deliver the Post, reduce the dependence on fossil fuels for the short rides between islands.

Currently all carriage is at ground level, by foot or boat. People dont' get the care they need when they need it. If at all. 

We would like to change that by bringing a technology we are familiar with from other locations to this context.

From this test case, we want to take this model and use it to overcome historical inequalities in other locations, as described and enabled by the changing drone regulations. 

My experience in Vanuatu with UNICEF is that this has the potential to deliver incredible savings to impoverished post colonial nations- improving their health outcomes while enabling investment in other community priorities. What is possible there, is possible everywhere.

In the next year I want the population of Torres Strait to be "equipped, enabled and empowered" to reach equitable health outcomes.
I would like there to be a population that embraces this new technology, and uses it for solutions that I have not thought of.

In the longer run, I want the YPLL of the Torees Strait to be indistinguishable from the broader Australian population.. and for this trend to follow the implementation of the model as it spreads to other populations where physical access to health care is the issue

Meetings- especially those to which I am not invited, as white immigrant Australian

"Cups of tea"

Feedback

Consensus documents

Locally led design documents.

In the first case, our Theory of Change centers around the lack of availability of AED, Trauma Kits. It is not that they don’t exist, it’s just that the distances are so far, and the roads are so poor that the patient is often beyond assistance by the time the equipment arrives, particularly if the patient is not right in the middle of the community area.

In the second case, patients are very reluctant to leave Country (the term often used by Aboriginal peoples to describe the lands, waterways and seas to which they are connected. The term contains complex ideas about law, place, custom, language, spiritual belief, cultural practice, material sustenance, family and identity.) to get diagnosis, and also refill prescriptions. 

We make landing stations for drones, our partners make drones...

My thinking is that these landing stations could be pre-positioned with life saving equipment , form AED to Lifejackets, that people could get delivered to the patient, by drone, far faster than any alternative.

The slew of technology is awesome and .... largely solved. But it is solved for the pizza deliveries in the suburbs, not for the indigenous populations in remote communities.

I'd like to start in the Torres Strait, and thence expand from Alaska to Guam, as the regulations allow. and htence to underserved populations around the world.

We  are at TRL6/7 with commercial applications.

There are no significant technical issues to be solved in this.. it's "merely" a question of application and demonstration.

We work hard to recognise and overcome historical underestimation.