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Big Plans for Broadband
Policy: Dedicated universal broadband capabilities could allow advances in the emergency care of certain patients.
Strategy: A new network will enable it, but must be planned, constructed, operated and maintained.
Vision: Vitals and video stream to hospitals, docs consult remotely, patients are treated fast and appropriately.
So public safety got the D Block of the broadcast spectrum it coveted and the broadband network it wanted established in law. Now all we and our fire and law colleagues have to do is make the network a reality and fulfill its abundant promise.
In other words, now the hard part really begins.
The network is coming, at least on paper, where it was finally established by the Middle Class Tax Relief and Job Creation Act of 2012. Bringing it to real life is the mission of the First Responder Network Authority, or FirstNet. FirstNet is an independent body created within the Commerce Department’s National Telecommunications & Information Administration (NTIA) to develop and implement the dedicated interoperable nationwide public-safety broadband network that is expected to let EMS, fire, police, hospitals and others share large amounts of data seamlessly in emergencies and every day. It’s directed by a 15-member board whose roster ranges from Cabinet members to prominent EMS and fire leaders. They are informed by a Public Safety Advisory Committee that has representatives from major EMS organizations like NAEMT, NASEMSO and NEMSMA.
FirstNet will develop and operate the network, which tantalizes with capabilities like accessing victims’ complete medical records from the backs of moving ambulances and streaming live vitals and video to docs at hospitals. It could dramatically advance how we perform EMS and our new mobile integrated healthcare efforts.
But achieving what FirstNet board chair Samuel Ginn called “the largest telecom project in [American] history” remains an enormous undertaking, and we still have some hurdles to overcome.
Getting Started
The FirstNet board’s early activities have focused on setting out long-terms goals for the network and starting to look at options and technologies that can provide the kinds of hardy capabilities it wants for responders. In May it launched a series of six regional meetings with state and local representatives to start getting them up to speed on the network and what will be required of them. Next come one-on-one meetings with states to begin examining their individual needs and circumstances.
“The states are very unique,” says FirstNet board member Jeffrey Johnson, CEO of the Western Fire Chiefs Association and chief for 15 years of Oregon’s Tualatin Valley Fire & Rescue. “If you look at Guam, for example, what they have in common with Vermont is not a lot. What Alaska has in common with Manhattan is not a lot. The reality is, each of these states has unique needs, and we need to make sure, in our considerations, that we address those. Communicating among the skyscrapers and eight stories of sub-basements in Manhattan is a whole lot different than communicating just north of Fairbanks.”
Conceptually, this is a scenario EMS leaders can fathom: Finding solutions that meet the wide-ranging requirements of very different entities—in this case the full mélange of states and territories, with areas both super-rural and hyperurban—can be a bear. The public safety broadband network has to serve more than 60,000 federal, state, local and tribal agencies.
And the states get some say in how their parts take shape. They can even opt out of the FirstNet project and pursue their own broadband plans, as long as their networks meet federal standards and can ultimately connect up. (No state has yet decided to do that.) Alternatively, if a state gets stalled or doesn’t proceed one way or another, FirstNet can step in for them and build the network itself. That “should prevent these buildouts from becoming mired in state politics,” Johnson told EMS World last year.1
Still, states have to get the bodies and people in place to move forward, assess their conditions and needs, devise their plans and actually proceed, so there are plenty of political and organizational to-do’s. Some states may not yet have much handle on exactly what infrastructure they have in place;2 the Assocation of Public-Safety Communications Officials International (APCO) has a Broadband Committee that’s working on a template for collecting it.
Full Coverage
While the putative goal of the public safety broadband network is full coverage across the U.S. and its territories, reality may dictate that we settle for coming close.
“I think the aspirational goal of 100% coverage is, from a physics perspective, probably not very achievable,” says Johnson. “But can we get 99.6% or 99%? Probably. We haven’t completed any of the engineering associated with that yet, though we have some estimates that make it look realistic. The reality is, we won’t know until we’ve listened to the states and poured that information into the network. That leads to network design, and then we’ll have some coverage estimates.”
Constructing a whole new, all-encompassing system to public safety standards will also take significant time and money. Can that burden be shared? “There are many areas,” notes wireless consultant Andrew Seybold, “where the addition of partners will make it more practical to build out the LTE network.”3
Engaging with partners was Congress’ desire too: “They want to see us leverage partnerships,” says Johnson. “They want to see us harvesting whatever partnerships, public or private, that will lower the cost of building and operating this network and deliver the kind of service Congress wants at the ground level.”
That means working in some capacity with private wireless carriers isn’t off the table. In fact, the four largest—Verizon, AT&T, Sprint and T-Mobile—are all building out LTE (long-term evolution, the global high-speed 4G wireless standard to which the public safety network will be built) networks using existing systems and sites. Working with those top four commercial carriers to deploy the network using their vendors and sites could keep public-safety costs down2 but open the door to some type of capacity sharing with public-safety priority.
Equipment Ecosystems
While it may bring more data and video to the mix, EMS providers should understand the broadband network isn’t going to replace our other methods of communication. It will supplement those, and our trusty land mobile radios will remain the immediate backbone of voice communications.
In fact, voice initially won’t be included in the broadband network. In a statement of network launch requirements it published for FirstNet last December, the National Public Safety Telecommunications Council’s Broadband Working Group included direct-mode mission-critical push-to-talk voice among the features to be deferred from launch-day requirements.4 It will be added later, but for now voice isn’t much compatible with LTE.
We also have to determine exactly what kinds of devices we’ll be using on this new network. As the NPSTC notes, “there is currently no user equipment ecosystem for band class 14 devices, the spectrum allocated to the [public safety broadband network]. Users who are accustomed to a wide variety of handsets, tablets and portable Wi-Fi devices will have to wait for the time that these types of devices become available.”4 Melding data, video and voice into a single proven, reliable device could take a few years, suggests William Jackson of public-sector technology consultant GCN.5 In the interim, we could look at VoIP or mixed broadband/voice bandwidth devices.
“We encourage everyone to not make purchases right now with what they have to be able to take care of patients,” says Paul Patrick, head of Utah’s Bureau of EMS and vice chair of FirstNet’s Public Safety Advisory Committee. “As we move into the future, these kinds of new devices will be become available and accessible, and technology a lot of times gets cheaper as more is developed.”
Unlike police and fire, Patrick adds, EMS has a billable component that can produce some cash flow to direct toward new-age comms tools. It will be up to providers and their systems to pressure manufacturers and keep their devices open and interoperable, rather than propietary, to achieve the network’s full potential.
Costs
On that subject of cost: FirstNet has $7 billion to work with. That includes $5 billion promised from the proceeds of future spectrum auctions. It’s not an enormous amount to get started (new towers run $100,000–$300,000 each, and the Congressional Research Service estimates the network will need 40,000 new 4G node installations), and operation, maintenance and upgrades will be required once the network exists (the CRS cites a study pegging operating costs at another $8 billion over 10 years).6 A lot of people fear the money isn’t enough.5–7 It’s certainly going to put a premium on partnerships and collaboration.
“The $7 billion is what we have, and it’s FirstNet’s responsibility to figure out a way to make that work—that’s what it boils down to,” says Johnson. “Our efforts will be focused on spending the money Congress has allocated us in a way that gets the job done. We probably won’t know the specifics until we get farther into the project, but I think initial indications are that it is doable, given a handful of assumptions.”
Congress also provided $135 million under a new State and Local Implementation Grant Program (SLIGP) administered by NTIA. These funds will help states, localities, regions and tribes work with FirstNet and plan and implement their integration into the network.
Conclusion
So there’s a lot to do and many specifics yet to be worked out. That shouldn’t dampen EMS’ enthusiasm for an advance that could be truly groundbreaking for prehospital care and emergency response in the United States. Instead it should galvanize activity and participation toward overcoming remaining obstacles.
Just know that the wheels move slowly. As the network stands up, some areas will be operational before others. Some capabilities come first, others later. And EMS has to figure out how best to utilize its new broadband powers in ways that benefit patients.
Star Trek may be coming (see sidebar), but as the NPSTC’s document suggests, keep those expectations modest at first.
“I think managing our expectations early on is important, because this really is an unprecedented undertaking,” says Johnson. “This is the first nationwide public safety network built in the world that we’re aware of. It’s going to be an enormous project. So while we’re rightfully excited, it will take some time to get up, to get devices built, to get deployed, to get people trained, to get all the human components of operating on a single network nailed down.
“In the meantime, it’s a great time to use our energy to think about what we want this to be and what innovations can improve our street-level service. That’s a good way to be productive right now, while we still have lead time.”
“There are unknowns just because it’s so new, but we believe those will sort themselves out,” adds Patrick. “We’re moving forward and making progress, and that’s the exciting part about this: It’s bringing the future right to your hands—to your hand-held device, to your ambulance, to your rescue vehicle—and expanding it everywhere. It’s an amazingly positive thing for emergency medical services.”