In future, drones may be able to deliver donor organs, blood products or an AED to the correct location more quickly than traditional means of transport. However, it is not the technology but the regulatory framework that currently poses the greatest challenge. This is the focus of the Interreg project BeNeDrone (Belgium-Netherlands Drone), in which Belgian and Dutch partners are investigating how drones can be deployed safely across borders for emergency care.
Dr Bachtiar Burhani, a neurosurgeon at the Elisabeth-TweeSteden Hospital (ETZ) and medical coordinator for neurosurgery at the Brabant Acute Care Network (NAZB), is providing the medical expertise for the project. The aim is not to deploy medical drones on a large scale in the short term, but to create the conditions that will make this form of patient transport possible in the future.
Regulatory barriers
According to Burhani, a large proportion of acute care takes place within the so-called ‘golden hour’: the first sixty minutes following a serious accident or acute condition. During this period, rapid medical assistance can make a significant difference to the outcome of treatment. The researchers expect that, in certain situations, drones can reach their destination more quickly than, for example, an ambulance or other road transport. This applies not only to transport to incident locations, but also to transport between hospitals. According to Burhani, it should make no difference whether a flight takes place over an urban area or across the border between the Netherlands and Belgium.
It is precisely here that the greatest obstacles currently lie. Existing regulations only permit cross-border drone flights and flights over densely populated areas to a limited extent. BeNeDrone is therefore focusing primarily on determining which legal and operational conditions are necessary to enable safe medical drone flights and to better harmonise regulations between different countries.
Virtual test environment as a testing ground
An important part of the project consists of extensive simulations. At Tilburg University, researchers are working with drone pilots to test a variety of scenarios in an advanced virtual reality environment. This allows them to simulate situations that are not yet permitted in practice.
These simulations examine, amongst other things, flights over cities, motorways and national borders. Factors such as weather conditions, accessibility and air traffic density also play a role. The results form the basis for recommendations on future regulations and operational procedures. Differences between national regulations are also being examined. By comparing the regulations in the Netherlands with those in Belgium and Germany, the researchers hope to gain a better understanding of the conditions required for safe international drone flights.
In addition to the virtual simulations, a number of practical tests are also planned. For example, the researchers want to investigate how quickly a drone reaches a destination compared to a police vehicle with flashing lights, and what obstacles both encounter along the way. According to Burhani, every outcome is valuable in this regard. If the studies show that drones offer no advantage over existing modes of transport in certain situations, that too is an important scientific conclusion.
For the future of emergency care
Although the results of BeNeDrone are not yet directly visible to patients, Burhani sees the project as an important investment in the future of emergency care. He points to other initiatives, such as the trial in which a drone flies a fixed route between Isala sites for a year. In his view, such practical projects and the research within BeNeDrone complement one another.
According to the researchers, the rapid development of drone technology calls for continuous evaluation of both technical and legal possibilities. By building up knowledge now about safe deployment, interoperability and regulation, a foundation is being laid for future applications in emergency care. Ultimately, according to Burhani, there is one central goal: to help patients as quickly and effectively as possible. He emphasises that collaboration is essential in this regard. The BeNeDrone project demonstrates that innovation in acute care is not just about new technology, but also about jointly developing the framework conditions necessary to apply that technology responsibly in practice.
AED drone delivery
Last year, researchers in the United States launched the first real-world clinical trial using drones to deliver automated external defibrillators (AEDs) during emergency 911 calls for out-of-hospital cardiac arrest. Led by Duke Health, the study aims to reduce the time needed to deliver a lifesaving defibrillator by dispatching an autonomous drone alongside conventional emergency medical services.
The drone flies directly to the patient, lowers the AED, and dispatchers guide bystanders through its use while EMS crews are still en route. The goal is to deliver an AED within five minutes to at least half of the local population, significantly improving survival chances. The AI-enabled system combines autonomous navigation with real-time emergency coordination and could be particularly valuable in rural and underserved areas where ambulance response times are longer. If successful, the trial could pave the way for wider adoption of drone-assisted emergency care across the United States.
