Text Messages by Wireless Mesh Network Vs Voice by Two-way Radio in Disaster Simulations: A Crossover Randomized-controlled Trial

Background: Communication failures secondary to damaged infrastructure have caused difficulties in coordinating disaster responses. Two-way radios commonly serve as backup communication for hospitals. However, text messaging has become widely adopted in daily life and new technologies such as wireless mesh network (WMN) devices allow for text messaging independent of cellular towers, Wi-Fi networks, and electrical grids.

Objective: To examine the accuracy of communication using text-based messaging transmitted over WMN devices (TEXT-WMN) compared to voice transmitted over two-way radios (VOICE-TWR) in disaster simulations. Secondary outcomes were patient triage accuracy, perceived workload, and device preference.

Methods: 2 × 2 Latin square crossover design: 2 simulations (each involving 15 min of simulated hospital-wide disaster communication) by 2 modalities (TEXT-WMN and VOICE-TWR). Physicians were randomized to one of two sequences: VOICE-TWR first and TEXT-WMN second; or TEXT-WMN first and VOICE-TWR second. Analyses were conducted using linear mixed effects modeling.

Results: On average, communication accuracy significantly improved with TEXT-WMN compared to VOICE-TWR. Communication accuracy also significantly improved, on average, during the second simulation compared to the first. There was no significant change in triage accuracy with either TEXT-WMN or VOICE-TWR; however, triage accuracy significantly improved, on average, during the second simulation compared to the first. On average, perceived workload was significantly lower with TEXT-WMN compared to VOICE-TWR, and was also significantly lower during the second simulation compared to the first. Most participants preferred TEXT-WMN to VOICE-TWR.

Conclusion: TEXT-WMN technology may be more effective and less burdensome than VOICE-TWR in facilitating accurate communication during disasters.