Exploration of Overseas Remote Emergency Medical Systems: IPO Prospectus

In 2015, the mobile stroke unit topped Cleveland Clinic’s list of Top 10 Medical Innovations. This high-tech ambulance brings the emergency department directly to stroke patients. Equipped with mobile telemedicine devices, it enables the fastest and most effective treatment for emergency patients while en route to the hospital.

In the race against time during emergency resuscitation, the word “AMBULANCE” on ambulances abroad is even written in reverse as “ECNALUBMA.” The purpose is to allow drivers of vehicles ahead to read the word “AMBULANCE” correctly through their rearview mirrors, thereby promptly yielding the right of way. Thus, emergency medical personnel have the most profound and genuine understanding of the adage “time is life.”

In terms of emergency medical care, beyond the image of ambulances speeding desperately to accident scenes that comes to mind, driven by modern ICT (the integration of communications, information, and technology),Emergency centers abroad are also equipped with numerous telemedicine facilities, such as basic medical services including remote video consultations and data sharing.These measures enhance the rapid response capabilities of hospitals implementing emergency care, reduce unnecessary transport distances, and ensure that injured and sick patients reach medical facilities as quickly as possible for treatment.

Overview of Pre-hospital Tele-emergency Care

The modern pre-hospital emergency care system, empowered by telemedicine technologies, is a highly organized, multi-level coordinated emergency response involving participation from multiple institutions. During patient transport to the hospital, seamless communication and information exchange between out-of-hospital emergency medical personnel and in-hospital emergency department staff are essential.Information exchange plays a decisive role in the formulation of treatment plans by healthcare professionals; efficient, accurate, and complete communication leads to favorable medical outcomes., with specific details mainly reflected in the following aspects:

1. Access or view patients' existing electronic medical records to reduce information exchange time;
2. Leverage various tools to assist healthcare professionals in collecting valuable multimedia information, such as audio and video;
3. Make full use of fragmented and time-constrained periods for information communication and exchange;
4. Relies on synchronous bidirectional voice wireless communication technology;

In the past, the traditional model relied on manual recording of information from patients, family members, and even bystanders. In high-pressure situations, paramedics sometimes had to hastily jot down notes on whatever was at hand, such as scraps of paper, mobile phones, or latex gloves.It was not until the advent and widespread adoption of electronic health records (EHRs), smartphones, and mobile devices that new avenues were explored for collecting and transmitting audio, data, images, and video information to improve the efficiency of medical care.

Electronic tools that collect patient data are known as electronic medical records (EMRs). Their emergence has significantly enhanced the feasibility and efficiency of pre-hospital emergency care. Furthermore, EMRs are often integrated with 911 call centers, aggregating standardized data that includes medical health status, patient assessments, medication history, precautions, geographic information, demographic distribution, and environmental and scene-specific factors for each incident. This integration provides substantial support in facilitating patient handovers and aiding physicians in clinical decision-making.

Two-way wireless calling or communication phones can now directly connect with emergency personnel to report the patient's geographic location and estimated time of arrival. Moreover,Basic Mobile Health Model System (Including Smartphones, Multimedia, Web Servers, GPS Technology, etc.)Enables more timely and comprehensive communication between on-site personnel and emergency responders.

Therefore, on-site personnel use the latest handheld devices to obtain comprehensive patient information, including age, date of birth, gender, name, and geographic location, as well as emergency measures taken (such as immobilization, cardiac pacemaker insertion, continuous positive airway pressure [CPAP] ventilation, airway management, and psychological counseling). This data is immediately transmitted to emergency department physicians, enabling remote experts to conduct video consultations, view real-time photos, and interact with on-site staff as if they were present. Meanwhile, a software system determines the optimal emergency route and guides the ambulance to the scene at high speed.

The advantages of adopting mobile health technology can be briefly summarized as follows:
Timeliness—Mobile app interfaces are user-friendly and often faster than pre-hospital wireless communication and telephone conversations;
Security—The system bundles all files onto a specific device, enabling encrypted transmission and storage on secure data infrastructure. Once the information is transmitted, the files are automatically deleted from the mobile device, leaving no trace.
Convenience—enables users to input and transmit information on demand at any time;
Complete—Patient data, images, and audio recordings can be stored in a database and viewed via a web browser;
Accuracy—This system reduces healthcare professionals' reliance on unreliable memory.

Pre-hospital Remote Emergency Care Model

A specific application example is the Emergency Telehealth and Navigation (ETHAN) program launched in Houston, USA, in November 2015. The project involved regional partners such as local communities and pharmacists, who jointly provided telehealth services to patients. Critical patient data could be transmitted to Houston Methodist Hospital, which provided navigation services, while social volunteers or healthcare personnel tracked patient conditions and assisted with subsequent identification and support. During this process, 911 call centers could communicate in real time with on-site emergency specialists via tablets and apps to exchange patient information, discuss transport routes, and coordinate dispatch arrangements.

This technology-driven emergency navigation system enables patients to reach the most appropriate medical facility for critical care in the shortest possible time, while fully leveraging partnerships with community and collaborating institutions. Researchers state that this trend is expected to continue in the coming years.

In fact, home-based remote monitoring devices have been available abroad for quite some time, serving also as emergency alert systems. For instance, in 2009, a compact and lightweight ECG monitoring device was introduced, featuring a high-resolution backlit display, a one-touch button for ECG acquisition and transmission, automatic ECG interpretation, and built-in GSM/GPRS connectivity to transmit emergency medical service (EMS) information to healthcare institutions. When used in conjunction with a smartphone application, the app records patients’ physiological data, geographic location, disease diagnoses, medication regimens, and medical history. In critical situations, patients can transmit digital images and audio information to emergency physicians via their smartphones. Moreover, such smartphones are typically equipped with emergency response applications, GPS functionality, and a dedicated 911 shortcut key, enabling emergency calls that allow rescue personnel to arrive at the scene within a very short time.

Thus, this represents a typical overseas pre-hospital emergency care model, which is patient-centered and constitutes a complete, closed-loop system comprising multiple elements: the emergency alert system, wireless devices for measuring and transmitting data, smartphones equipped with emergency response apps, online electronic health records (EHRs), the HealthVault health management platform, Google Health personal EHRs, and the medical personnel involved in resuscitation.

Remote First Aid and Emergency Assistance

Not only is pre-hospital emergency care a matter of life and death, but for common emergency room treatments or urgent medical care, many healthcare institutions abroad have also adopted mobile devices such as the iPad to conduct remote video diagnoses for conditions like pediatric respiratory diseases. This allows patients to access emergency services from home, thereby reducing emergency department visits and hospitalization rates. Furthermore, remote triage helps conserve limited medical resources. This approach falls under a broader concept of emergency care—providing patients with the most critical assistance they need, precisely when they need it.

According to statistics, there are currently over 9,300 walk-in clinics and independent emergency rooms in the United States, with 50 to 100 new clinics opening each year. The annual number of emergency room visits is 110 million, and this figure continues to rise. There is a distinction between Emergency Rooms (ER) and Urgent Care centers in the U.S. If a medical condition is life-threatening or requires surgery, such as severe wounds or amputations, patients should go to an Emergency Room. For non-life-threatening conditions, patients may choose to visit an Urgent Care center.

The distinction between emergency rooms and urgent care centers in the United States is a relatively recent development. In the early days, the concept of urgent care centers had not yet emerged; only emergency rooms existed. Consequently, patients turned to emergency rooms as their sole option when they could not secure an appointment with a primary care physician. Starting in the 1980s, however, the trend gradually reversed: two-thirds of emergency rooms closed, while the urgent care center market experienced significant growth.

Subsequently, users have gained new options, as the impact of telemedicine on the urgent care industry is equally significant. The proliferation of online consultations has facilitated communication between doctors and patients, enabling individuals to receive care from urgent care or emergency physicians at home, in the office, or while staying at hotels. Surveys in the United States have found that 75% of primary care visits and 50% of emergency department visits can be managed through telemedicine.



Telemedicine technologies adopted in emergency rooms or urgent care settings should meet at least the following hardware and software requirements, primarily encompassing three core elements: data transmission speed, system stability,while meeting patient care needs,Ensure system security.

Data transmission speed is primarily determined by bandwidth. Generally, electrocardiogram (ECG) transmission requires 1–2 Kbps. High-definition video teleconsultation demands higher quality and enhanced security; most video-based telemedicine devices operate at a bandwidth of 384 Kbps. In terms of reliability, wired transmission offers superior signal integrity and fewer disconnections, making it better suited for transmitting audio, documents, images, and other data.

As for network security, 3G or 4G networks, such as LTE, can ensure security without compromising quality. All patients' health information, PHI, encryption of remote products, and HIPAA protocols are primary considerations.

Hardware devices must be compatible with remote video conferencing consultation systems. This requires the acquisition of desktop hardware or the installation of proprietary systems with remote control capabilities, such as remote cameras, computers, TV monitors, encoding/decoding hardware and software (for converting analog signals into digital formats), and microphones.

Commonly used applications for remote physician-patient consultations include VSee and Vydio. Similar to Skype, these platforms offer additional HIPAA-compliant privacy safeguards and encryption features while consuming less bandwidth. The teleconferencing systems can be downloaded free of charge for use on personal computers, 3G/4G-enabled mobile phones, or iPads. Remote consultations can also synchronize signals with medical devices such as otoscopes, stethoscopes, and ultrasound instruments.

International Applications of Remote Emergency Care

Overall,The most common applications of international emergency telemedicine systems include emergency care, stroke diagnosis and treatment, acute cardiac conditions, trauma injuries, and remote ultrasound examination.

In the field of emergency care, taking the foreign company SNC as an example, it is a system integrator and electronic systems provider that has developed the T2 telemedicine delivery system, capable of acquiring and transmitting information on critically ill patients. The T2 system consists of intelligent access points (APs), radio and network interfaces, medical device interfaces connected to patients, portal applications, intelligent machine algorithms, and web-based electronic health records.

The two primary components are the MEDICS software (Medical and Emergency Data Input and Communication Software) and the T2 access point. The MEDICS software is compatible with a range of devices, including tablets and laptops, and its design caters to the diverse needs of healthcare professionals by enabling clear transmission of data from various mobile medical devices, patient vital signs, and voice inputs. Additionally, the MEDICS software supports headset speakers and microphones, ensuring functionality in noisy environments.

On the ambulance, the T2 can be loaded onto a dedicated wireless network, with all patient information encrypted using 256-bit AES encryption, ensuring that only the receiving hospital can access the data. Another major feature of the T2 is data "throttling," which automatically adjusts the data transmission speed based on bandwidth availability, guaranteeing normal operation even in low-bandwidth areas.

Currently, the T2 system is designed for dual-use in both prehospital emergency medical services (EMS) and military settings, and can be deployed in prehospital care facilities, ground ambulances, helicopters, and fixed-wing transport aircraft.

Similarly, Lifeboat Telemedicine Solutions has also repurposed military equipment for medical use, developing two system versions. The first is a hardware system connected to ambulances, utilizing appropriate software packages, with DREAMS focusing primarily on disaster relief and emergency medical services. In addition, the company has developed a portable device called Lifebot 5, which integrates all emergency rescue equipment into a compact package weighing just 15 pounds, at a total cost of under $20,000.

In the field of remote stroke diagnosisFor patients with acute stroke, tissue plasminogen activator (t-PA) is the current standard of care for thrombolytic treatment of ischemic stroke. Given that the therapeutic window extends only 4.5 hours from symptom onset and t-PA administration involves a series of complex decision-making processes, it is best managed by experienced physicians. A preferred approach is to establish Primary Stroke Centers (PSCs) capable of providing uninterrupted diagnostic and therapeutic services 24 hours a day, 7 days a week. This model has already been implemented in the United States.

The hub-and-spoke model of Primary Stroke Centers (PSCs) centers on vascular neurology specialists who provide consultative advice, supported by peripheral primary emergency physicians and auxiliary equipment. It also incorporates a remote acute ischemic stroke evaluation system, which is a low-cost, web-based platform. Vascular neurology specialists can log into the website to access patients’ vital signs data, review CT images using DICOM software, and conduct video consultations with patients via high-bandwidth networks to determine NIHSS scores and provide corresponding t-PA recommendations. This rapid diagnostic approach improves stroke treatment outcomes. Other equipped facilities include CT scanners capable of transmitting DICOM images, high-bandwidth internet devices, and other equipment costing less than $10,000.

Furthermore, in February 2015, it was reported that Google Glass held promise for application in the remote diagnosis and treatment of stroke. In medical practice, time is critical for saving stroke patients, as pharmacological intervention must be administered before irreversible brain necrosis occurs. Google Glass enables preliminary assessment of a patient’s condition and data transmission prior to hospital arrival, thereby facilitating early and accurate decision-making by physicians and emergency personnel. During emergency resuscitation, off-site physicians can also maintain remote video or audio contact with neurologists at the patient’s bedside. Thus, the primary advantage of Google Glass lies in providing accurate patient information to subsequent treating physicians.

In Remote Emergency Diagnosis of Sudden Cardiac Diseases, using New Zealand’s pre-hospital emergency care as a reference. Its system comprises key components such as emergency call centers, 12-lead electrocardiogram (ECG) devices, medical alert systems, electronic health records (EHRs), cardiopulmonary resuscitation (CPR) applications, and remote monitoring. Data from 12-lead ECGs are transmitted by paramedics to hospital-based cardiologists to determine the appropriateness of thrombolytic therapy.

Mobile devices such as smartphones are equipped with CPR apps that can guide bystanders to perform immediate, on-the-spot resuscitation while an ambulance is being dispatched. Furthermore, this remote monitoring capability is well-suited for elderly individuals living alone; pressing the one-touch emergency button triggers an urgent call for help in the shortest possible time.

In Trauma Care, the first hour after injury is the golden critical period; timely and effective care can improve patient treatment outcomes by 25%. Unfortunately, only about 30% of Americans can reach a designated trauma center within 60 minutes. There are three regional trauma centers in the United States, with the Eastern Maine Medical Center (EMMC) being the largest, providing telemedicine services to 20 community-level hospitals. The initial construction cost of this center totaled $70,000, and its facilities include internet connectivity and large screens that enable physicians to perform remote diagnoses.

This facility enables experienced surgeons to bypass outdated practices, such as the emergency reversal of anticoagulation therapy in adults—an approach that less experienced physicians might overlook. Furthermore, EMMC facilitates remote trauma care through team-based participation in rescue efforts and interactive collaboration.

To address the issue that surgeons cannot guarantee 24/7 availability at their computers, iPhone introduced the FaceTime technical solution, enabling video interactions through simple Wi-Fi connections. Initially, EMMC launched the iPod consultation method, which provides high-definition video and audio capabilities, such as zooming in on a patient’s pupils for neurological examination in cases of craniomaxillofacial trauma.

Remote Radiology Examination, specifically, the surge occurred in the early 2000s or between 2003 and 2007. During this period, the adoption rate of teleradiology applications skyrocketed from 15% to 50%. This growth was closely tied to the widespread use of CT scanners in emergency departments. In response to this market trend, many hospitals adopted service models that promised preliminary reports within 30 minutes and final reports within 24 hours.

A well-known U.S. teleradiology provider is vRad, which partnered with NightHawk in 2010 and has since expanded its network to cover more than 2,700 healthcare facilities nationwide. Over the past few years, vRad has invested $50 million in building its IT infrastructure and was an early adopter of cloud technology.

In addition, mobile apps are also on the rise in teleradiology applications. A notable example is Mobile MIM, which received FDA approval in 2011 and provides secure and effective image diagnosis and viewing capabilities. It supports a wide range of imaging formats, including SPECT, PET, CT, MRI, X-ray, and ultrasound.

Featured Remote Emergency Care App

In fact, beyond radiology apps, there is a range of practical and convenient apps worth exploring in the context of remote emergency care.

An app called Fire Department can guide bystanders in performing cardiopulmonary resuscitation (CPR) on patients. What makes it unique is that its users are either individuals trained in CPR or compassionate volunteers willing to assist patients in urgent need of resuscitation. The workflow is as follows: when the 911 emergency center receives an emergency call, it sends alerts to nearby app users, providing the location of the incident and the location of the nearest automated external defibrillator (AED), thereby facilitating use by lay rescuers via the CPR app.


Johns Hopkins National Center has developed two mobile apps, Flucast and Surge, to help hospital medical staff respond to emergencies promptly.

Flucast is designed based on Google Flu Trends data and historical records. Research indicates that Google Flu Trends are closely correlated with influenza outbreaks and emergency department visits in inland cities, making Flucast a practical monitoring tool for emergency departments. Surge helps healthcare administrators and public health officials calculate the number of beds required in the event of a major mass-casualty incident. The app provides simulations of patient arrivals and triage scenarios, modeling different strategies under varying conditions, such as determining the appropriate number of beds and adjusting patient placement within the hospital. Measures available to administrators include increasing hospital bed capacity or prioritizing admissions based on disease severity. The app received $65 million in funding from the Department of Homeland Security (DHS) in 2010.

The CodeHeart platform, launched by AT&T and Washington Medical Center, enables cardiologists to view ECG images, videos, and test results in emergency situations. Developed by physicians at Washington Medical Center, this app is compatible with desktop computers, tablets, and smartphones. Via remote video, cardiologists can assess patients’ conditions, communicate with first responders, review test results, and help hospitals deploy medical teams and resources in advance, ensuring adequate preparation before patients arrive at the emergency department. The app has been in use at six Washington hospitals since 2011.

Ping4 Inc. invested $3.8 million in developing the next-generation emergency alert system, Ping4alerts!, based on smartphones, and markets it to emergency service centers worldwide. Compared with traditional emergency alarm systems, Ping4alerts! can target specific geographic areas, serving both local residents and tourists. Furthermore, the system is capable of transmitting rich data, including images and videos. It can even be used to issue distress signals in cases of missing children. Another advantage of the app is its bidirectional anonymous communication: users are not required to disclose any personal information other than their geographic location, and alert responses are also delivered anonymously.

GreatCall has been deeply engaged in the field of remote emergency care, launching three generations of innovative products from 2011 to 2016. In 2011, it released the mobile Personal Emergency Response System (mPERS), with the device named 5Star Responder, designed to be used in conjunction with a mobile app. The device features one-touch connectivity to a nationally certified, professional call center, as well as the ability to dial 911. The emergency response center ensures 24/7 availability.



In 2014, the company launched Splash, an advanced version of its waterproof emergency response device. While the system remained unchanged, the device was compact enough to fit on a keychain or in a wallet. It featured water resistance for up to 30 minutes, allowing users to wear it while showering and facilitating seamless connection with specialists at healthcare centers.



On January 5, 2016, GreatCall announced the launch of Lively, a wearable device designed to be worn on the wrist or neck. It features mobile activity tracking and a one-touch emergency call function. Medical center staff use a companion app called Link. The device is suitable for both elderly users and their caregivers, priced at $99.99, with each emergency response service costing $14.99.

Other overseas hospitals also use emergency care apps; specific app names and descriptions are provided in the table below: