Customizing the Tool: The Tailoring of Crisis-Management and Mass-Casualty Software

Every emergency management service operates differently. Because there are no national standards for crisis-management or mass-casualty software, a variation in operation means that there are a variety of programs in use. However, emergency-services operators and disaster-management directors are seeking to merge the systems that monitor hospitals with those that monitor the scene on the ground to give them, in one place, all of the information they need. And, although some software companies are releasing products that present a wider picture, some users are not waiting for the upgrades but instead are writing their own programs.

The trend today is collaborative customization, and one product soon to be launched will help bring hospital compliancy and crisis management closer together. ESi, a Georgia-based crisis information-management software company, will be adding additional capability to its crisis-management systems this fall with the launch of WebEOC Health, which does for the Hospital Incident Command System (HICS) what WebEOC did for the situation room – it digitalizes it. “The system was designed to be a paper system, so what we did is take those basic same data elements and create a nice graphical user interface that greatly streamlines the collection and management of the same key pieces of information,” said William Glisson, ESi’s regional manager director of health services. “WebEOC Health is specifically built as a set of boards because, although 50 percent of hospitals in our country use the HICS suite, none of them use the suite completely as is.”

WebEOC Health’s 108 status boards are compliant with HICS guidelines and broken down into a number of categories designed for efficient use in a crisis. The first category, the Incident Action Plan, incorporates HICS forms that cover incident information, hospital branch assignments, and organizational assignments and objectives, and was designed to provide a quick and accurate report based on the information entered. WebEOC Health organized the 78 HICS job-action sheets so that users could check the status of an assigned task in the second category, Job Action Sheets. The third category covers the HICS forms related to patient tracking, resource accounting, and the registration of volunteer staff. And, should there be any issue not addressed by HICS, users can create their own status boards by using WebEOC’s innovative “Board Wizard.” WebEOC Health – which is currently being tested in hospitals in Sacramento, California – is expected to be released sometime later this year.

Flexible Connectivity and Easier Management

The creation of custom status boards is one way that WebEOC and ESi have made their products flexible enough to fit the needs of individual users. One user, Kathleen Criss, director of the Disaster Management Center at the University of Pittsburgh Medical Center, has taken that option and put it to use connecting the 19 hospitals in the University of Pittsburgh structure that she and her team are responsible for. “We are trying to take WebEOC the way it is currently built – for emergency management and emergency services – and allow it to support our healthcare needs and requirements,” said Criss.

Because not all 19 of the hospitals use the same operations tool for bed management, Criss developed what are called “Bed Boards.” “What we really needed was a dashboard kind of a system that would allow us to tap in and see what our availability was from a system standpoint,” she said. “So what we did was take WebEOC and build out a bed board, using the standards that are required through the American Hospital Association of HAvBED [Hospital Available Beds for Emergencies and Disasters] and also the National Disaster Medical System [NDMS] types of beds, [and] created two boards that allow us to pull information from our information systems that carry out the bed-management system.” To determine the number of beds needed in an emergency situation, the HAvBED standards are combined with the NDMS standards, and the total number of available beds is calculated.

Criss and her team are now focused on developing a new patient tracking system that communicates with EMS agency software no matter what type of system the crew uses. “What we are trying to do,” Criss said, “is take information from disparate patient tracking systems … so that if one EMS agency is using one system and another one is using something else, and it’s a mutual-aid [situation], or a mass-casualty that requires mutual aid, we still have the ability to capture that data in one dashboard so that … [the user] doesn’t have to go back and forth and back and forth between systems.” The ability of the different software systems to interface permits the different agencies involved to communicate with one another without doubling the overall workload.

Speed, Compatibility, and Specialty Care

One company committed to opening those lines of communication is EWAPhoenix, an emergency management software company headquartered in Herndon, Virginia. The company’s Patient Tracking module, released in March of this year, is designed to send the patient’s collected medical information directly to the hospital, and can be used daily as well as in emergencies. The Phoenix, a hand-held wireless device, is compatible with many crisis-management systems, including WebEOC. EWAPhoenix Product Manager Thomas Bock estimates that there are at least 50 different systems being used in the 143 hospitals the company works with in Indiana, so the company works not only with the hospital but also with the other software vendors to create compatible programs.

The Patient Tracking module has been designed for EMT use, with the federal- and state-required medical forms sent to a Windows Mobile device that possesses a barcode and magnetic-stripe reading capability. The pages are pulled up on the screen as the EMT needs them, “If an EMT doesn’t need to know your contamination level, then that page is never launched, saving time and scrolling and all that other stuff that putting an old form on a hand-held might do,” Bock said. He estimated that on a typical call the EMT would have the patient’s medical and biographical information in less than two minutes.

After treatment of the patient (which also is logged into the hand-held), the EMT can check hospital status on the module because the system incorporates not only the HAvBED counts for the hospitals in the area but also the specialty care available at each hospital, “so the EMTs know before they have even transported a victim where to take that victim,” Bock said. The information travels from the hand-held to a network established at the hospital, or at a triage center, so that, when the ambulance pulls into the hospital bay, the patient’s medical information is already in the system. “The Phoenix server is constantly in contact with either the hospital system or the system in use at the triage area,” Bock commented.

Collaboration between and among the agencies and organizations involved in an emergency situation is key to the successful management of a disaster and is rapidly becoming just as important for mass-casualty and crisis-management software. Officials at the Maryland Institute for Emergency Medical Service Systems (MIEMSS) in Baltimore are merging their Facility Resource Emergency Database (FRED) with the state’s County and Hospital Alert Tracking System (CHATS) into one application. “We’ll be using software to bring both of them together, and having them in one place [will allow] whoever is managing an incident to view it all together,” said Director of Emergency Operations and Regional Programs John Donahue.

The bottom line is that officials such as Donahue and Criss use emergency-management software not necessarily as is, but as needed. In short, the future of mass-casualty and crisis software may not be the one and only perfect program but, rather, a series of adaptable ones.