Representative deployment — an illustrative composite of county EMS fleet deployments; numbers reflect typical field results, not a single named agency.
Situation
A county EMS system running 40 ambulances across ~1,100 square miles — suburban core, long rural routes. Each rig carried a single-SIM LTE router feeding the MDT, ePCR tablet, 12-lead ECG transmission to two receiving EDs, and a growing med-control video program. Crews maintained an informal map of dead zones: two river valleys, a state-forest corridor, and the last stretch to the county line. QA flagged repeated ECG transmission failures in exactly those zones — including on STEMI calls, where field-transmitted ECGs drive early cath-lab activation against the 90-minute door-to-balloon target.
Old-way cost
- Clinical: 3–5 failed or delayed ECG transmissions per month in known dead zones; each one pushed cath-lab activation to ED arrival instead of en route.
- Operational: ePCR sync failures meant crews finishing charts at the station after shift — an estimated 25–30 labor hours/month across the fleet.
- Program risk: the med-control video pilot stalled because physicians stopped trusting the link after drops mid-consult.
- Already spent: ~$40/month/rig on single-carrier SIMs delivering exactly one carrier’s coverage map.
Solution
- Peplink MAX Transit 5G in each of the 40 rigs — roof-mount combo antenna (cellular/GPS/Wi-Fi), 12V vehicle power.
- Two carriers per rig (the incumbent SIM kept, a second carrier added), bonded through SpeedFusion into one 256-bit AES encrypted tunnel to the hospital hub — hot failover plus WAN smoothing on the med-control video profile.
- SIM Injector at the depot: all SIMs stay in the equipment room and are served to rigs over the network — carrier changes never require touching a vehicle.
- Fleet managed in InControl: one dashboard for config, firmware, usage, and live GPS/AVL.
- Deployment: 2 rigs per day during shift change; full fleet live in under a month. No construction, no downtime.
Results (first 6 months)
| Metric | Before | After |
|---|---|---|
| Session-level uptime (tunnel) | est. 96–97% on routes | 99.9%+ |
| Failed ECG transmissions | 3–5/month | 0 |
| ePCR sync failures needing station rework | ~25–30 hrs/month | <2 hrs/month |
| Med-control video program | Stalled | Live on all 40 rigs |
| Added recurring cost | — | ~$75/rig/month = $36,000/yr |
| Cost per response (40,000+ responses/yr) | — | under $1 |
The line the fleet director uses: “We spent years mapping dead zones. Now the map is irrelevant — one carrier fades, the other one’s already carrying the call.”