Task Force Sees Gaps in Emergency Communications

Time is short, said committee Chairman Jim Bugel of AT&T. Under the act, the report is due Feb. 4. Bugel asked three subcommittees to assess the landscape, identify major shortcomings and report by late November on critical work under way.

David Aylward, director of the COMCARE emergency response alliance, told the group the EMS responders and public health are “the poor sisters” among first responders. “I've been at this for about 10 years, and one of the things that is always the case is that there’s a big-boys’ club and then there are other clubs,” Aylward said. “The medical people tend not to be part of the big-boys’ club.” And enough spending on health information technology doesn’t trickle down to help emergency response, he said.

EMS and emergency medicine tend not be well organized and they haven’t done a good job of lobbying policymakers, Aylward said. “We tend to be excluded, whether it’s from the committees that are doing the planning or from the state plans themselves,” he said. “It’s time to get over that and get organized and have our own centralizing forces.” Several members of the committee said they agreed.

Committee member Karen Sexton, CEO for hospitals and clinics at the University of Texas Medical Branch, said she saw the poor state of emergency medical communications when she oversaw the evacuation of the hospital during Hurricane Rita. The hospital had to send 427 patients away. “In that evacuation we used 100-plus ambulances, 32 helicopters and six fixed wing [planes] and multiple busses,” Sexton said. “My frustration was once we put our patients on the road we no longer had any communications with those vehicles as they tried to navigate the traffic in Houston and get our patients to medical facilities.”

“One thing that we're doing the same way we did it 35 years ago is talking on the radio,” said Kevin McGinnis, representing the National Association of State EMS Officials on the committee. “We have such a great opportunity to do so much more for our patients.”

EMS communications apart from fire services’ has received little attention, said committee member Shawn Rogers, director of emergency medical services for the Oklahoma State Department of Health. “I think it’s very important that non-fire EMS be reflected,” he said. “Most EMS throughout the middle of the country is non-fire and those endeavors, mostly small towns and private operators and hospital-based operations, have been little touched by preparedness efforts thus far.”

Recent disasters have made the gaps in emergency medical communications clearer, said committee member Richard Liekweg, CEO of the University of California-San Diego Medical Center. The most recent challenge was the wild fires that swept across southern California last week, he said. “We learned a lot from the results of the Katrina disaster,” Liekweg said. “We certainly learned from the fires in San Diego we had four years ago and a lot of that showed as we came together as a community [last week]. The communications were extremely effective. There are certainly some lessons learned… things that worked well.”

Bugel said the discussions are timely in that health care has emerged as one of the major issues early in the 2008 campaign for president. “It’s amazing that currently only 5 percent of clinicians have computerized patient records and that only a small fraction of the billions of medical transactions that take place every year in the United States are conducted electronically,” Bugel said. “The ability to consult patients’ full medical history online would make it easier for doctors to deliver the most appropriate and comprehensive care. Public health officials could use the database to detect trends and determine the value of different treatments for specific kinds of patients.”