Another side of aftermath

Hurricane Katrina has left in its wake a heightened awareness of the many IT-related gaps in emergency response systems in the Gulf Coast regions, and most likely in other communities throughout the nation.Shortcomings were rampant among the systems handling emergency communications, disaster resource management, situational awareness, patient tracking, disease surveillance and post-disaster family reunification, experts said.Katrina's devastation was exacerbated by failures in basic electrical power and telephone and Internet services, which have spurred interest in creating backup systems to restore such services quickly after a catastrophe."Until now, there has not been much investment related to catastrophic failures in which the infrastructure is destroyed," said James Jay Carafano, senior fellow at the Heritage Foundation, a Washington think tank.Post-Katrina, however, there is greater motivation to plan for creating backup communications systems, possibly with wireless technology, he said.But Charles Werner, fire chief for Charlottesville, Va., and an adviser to the Homeland Security Department on linking radio systems among first responders, cautioned against placing too much emphasis on redundancy and secondary systems."It seems critical to re-examine the thought of putting money into any secondary [system] when the focus must be placed on bringing primary radio systems to an acceptable performance level," Werner said.ONE AND THE SAME TECHExperts said the incompatibility of police, fire and EMS radios made it difficult to talk with each other and with first responders in nearby towns. This slowed the Katrina response, and is a widespread problem in communities nationwide.With or without such backup systems, Katrina also has heightened awareness of the need for more advanced IT tools to coordinate disaster response. For example, IT systems to reroute telephone calls might have benefited people trying to reach 911 centers.After Katrina hit, people "were calling 911 and no one was answering," said David Aylward, director of ComCare, a non-profit emergency communications group helping DHS write open standards for data programs for first responders. "There was no system in place to roll the calls over to a 911 system that was still operating."Also needed are IT systems to track available disaster-related resources to be used or donated, such as hospital beds, water supplies, vehicles, skilled personnel, food, boats, cots, medical supplies and search and rescue equipment.Werner said he experienced some frustration in trying to volunteer personnel and equipment following Katrina, because there was no central online system coordinating the requests.The problem is that requests for help were going out to multiple states, Werner said. "By the time you can locate the materials, you find out the request already has been filled," he said.The Emergency Interoperability Consortium, a non-profit group of industry and public agencies, is working with DHS to develop data interoperability standards for a resource tracking system. According to Matt Walton, consortium chairman, the system will be used to provide inventories of disaster-related assets and resources, such as personnel, equipment and supplies. It should be ready for public use in six to nine months, he said."This resource will facilitate, for the first time, the exchange of information about assets -- fire trucks, bomb-sniffing dogs, helicopters -- across all the different systems out there. Clearly, in the context of a massive event, the information has to come together to be shared rapidly and efficiently," Walton said. "This would have had a tremendous impact [immediately] following Katrina."The consortium also helped develop the Common Alerting Protocol, an Extensible Markup Language standard for emergency warnings and alert messages, as well as the distribution element, another XML standard for use as common wrapper to send files and databases, such as maps, video files and photographs, across disparate systems and applications.The Organization for the Advancement of Structured Information Standards, a non-profit standards-making group, is reviewing the distribution element.In addition to tracking resources, regional IT systems also are needed for situational awareness of a disaster, with geographic maps showing affected areas, road and hospital closures, location of personnel and resources and the like, Aylward said.The ComCare alliance has been working on developing open IT standards for just such a medical facilities system, called Have-Bed, to provide real-time information on the availability of hospital beds, equipment, personnel and supplies. It can be used post-disaster but also for daily communications among hospitals, emergency managers and 911 centers, Aylward said.WHERE IS EVERY BODY?Ideally, communities ought to have IT systems in place to keep track of medical patients and people who are seriously ill ? both in and out of hospitals ? as they are evacuated to other locations across the country following the disaster, said Dr. Jeff Elting, emergency preparedness director for the District of Columbia Hospital Association in Washington.The systems would indicate where patients were taken, in what condition they arrived, what treatments they received and if their families had been notified, he said."Patient tracking is a challenge, especially for people who are not hospitalized," Elting said.Work recently began on standards for such a tracking system. ComCare, and the Virginia Hospital and Healthcare Association, with a membership of 62 hospitals, Sept. 30 launched a collaborative working group to develop a national set of common requirements for post-disaster patient tracking systems.The Red Cross and many academic and public health agencies are participating."The challenge for our group is to develop requirements for systems that are used to improve everyday emergency response, but can easily be scaled up to support mass casualty incidents," said Dr. Robert Bass, ComCare board member and president of the National Association of State EMS Directors.IT systems to facilitate family reunification following a major disaster also should be a high priority, Carafano said. While there are reunification services and Web sites, there is a need for further development and more widespread usage, he said."There is a need for victim registries. There is a shortfall of capacity to track and reunite families following a disaster," Carafano said.As IT gaps were revealed post-Katrina, some IT systems were created quickly to fill in the niches.For example, medical IT company EMSystem LLC of West Allis, Wis., donated software to federal health authorities to set up a medical resource inventory system and medical syndromic surveillance system in the disaster region after Katrina.A syndromic surveillance system lets health centers, hospitals and medical intake centers report patients' symptoms, such as high fevers, diarrhea and difficulty breathing, to a central monitoring agency to help generate an early warning of major disease outbreaks.Public health officials also created an online pharmacy coordinating system. "They were able to put together a database in 10 days," Aylward said.The system lets physicians treating evacuees in other states use a central repository of information, he said.Staff Writer Alice Lipowicz can be reached at alipowicz@postnewsweektech.com.