Just say NO to personal cell phones on Ambulances

     If the title of this piece suggests to you a connection to a questionably successful anti-drug campaign from the 1980s, you are right, because what I am proposing may seem as difficult to do as separating junkies from their poison of choice. In many instances, cell phone use has gone beyond useful and into the realm of obsessive-compulsive. And, just like any other behavior that can spiral down into the unhealthy range, this one must be checked by management if an employee cannot do it for him/herself. The collateral damage is too significant to ignore.

     By taking such a negative stance on a communication tool that's impacted our society on virtually every level, I expect an equal reaction will be heaped upon me personally, but please hear me out. In EMS, beyond using official agency-provided cellular equipment, there is no role for the attention-diverting, privacy-invading, HIPAA-violating pieces of personal technology that seemingly no one can leave home without.

     In a recent survey conducted by EMS Magazine, 60% of the respondents said their agency had some sort of cell phone use policy, but less than half of those prohibited use on a call. When an employee is at work, a reasonable employer should be able to expect that that employee's attention be given to the important tasks at hand. Why must a patient and/or family be treated to the jarring notes of the latest ring download? How can providers be focused on their patient if they are constantly being hit up on direct-connect? Whether the job is a 9-1-1 call or an interfacility transport, our professional ethics should dictate that the patient in front of us is what is important. For the most part, anything else can and should wait. While there is the exception of family emergencies, how often are these personal cell calls truly a result of a loved one with an acutely urgent problem? What seems more likely are calls that fall into the very definitely nonurgent category of "What's up?".

     Considering the multitude of features now available on any commercially sold cell phone, a social, nonurgent call from a buddy or significant other is almost the least of management's concerns. Digital photography and audio recording options are more likely than not included in the most recent enticements from the phone companies, but these seemingly harmless add-ons bring with them another quagmire of ethical and legal dilemmas for the modern healthcare organization to wade through. Just go to www.myspace.com or www.youtube.com and you can begin to understand why the thinking person's EMS manager should do whatever he can to control, if not prohibit, cell phones on ambulances. What may be innocently captured for the purposes of "training" can quickly become a case for invasion of privacy, if not flagrant disregard for state and local laws regarding patient confidentialit--and all in a matter of minutes. Municipalities across the country have already banned these stealth photo-taking devices from gyms and dressing rooms to protect people in vulnerable situations. And who is more vulnerable than a patient in an ambulance?

     I do think there is a role for cellular technology in EMS. Agency-supplied cell phones should be made available for contacting medical control or for other operational issues when standard communication pathways are not working. Cell phones with photography capability could be used for scene documentation, such as a supervisor taking a picture of an ambulance involved in an accident. EMS can and should be able to utilize technology that is rapidly emerging. But implementation should be with official equipment used in conjunction with departmental policy. Even with significant structured policies in place, the proliferation of personal cell phones with all the distracting bells and whistles brings with it the great potential for misuse. The resultant untoward effects are just too great.

Raphael M. Barishansky, MPH, EMT-B, is executive director of the Hudson Valley Regional EMS Council in Newburgh, NY, and a member of EMS Magazine's editorial advisory board. He can be reached at rbarishansky@gmail.com