HIE Supports Disaster Preparedness and Emergency Services

Lee Stevens and Rachel Abbey | May 14, 2014

As we approach 2014 National Hurricane Preparedness Week (May 25-31), it seems like an appropriate time to pause and reflect on two hurricanes that have impacted the lives of many Americans, Sandy and Katrina, and the role of health information technology (health IT).  ONC has long supported the use of health IT and health information exchange services to support emergency preparedness and response efforts, and the lessons learned from both of these natural disasters have helped to inform future efforts and to protect patient information to make sure that it is available to patients and providers where and when it is needed.  

Over the past nine years since Hurricane Katrina, we have seen the landscape of health data shift dramatically, resulting in a national health system that has moved from paper and pen to an electronic environment with more than 50 percent of doctor offices using EHRs.  Almost every state has electronic secure messaging services available and 75 percent of states have implemented some type of a more robust HIE service, and we are far better prepared today than we were, even during Hurricane Sandy.

To build on the work already accomplished, ONC began to assess opportunities in California and the Gulf Coast to use health information exchange to support disaster preparedness and emergency medical service (EMS) response.  Along with stakeholders in California and the Gulf Coast (including Louisiana, Mississippi, and Texas), we completed a report that recommends two scenarios that could be implemented and eventually used to improve how states and communities respond to a disaster:

1)     EMS data exchange with hospitals: Using a health information organization (HIO) as an intermediary, emergency medical services (EMS) providers will be able to exchange data with hospitals in a standard format.  EMS personnel will be able to transmit data from their electronic patient care record (ePCR) to hospital emergency departments. Hospitals will be able to make patient data available to EMS personnel while in the field, and also send patient outcome data to EMS to support quality improvement objectives.

2)     Disaster response medical history portal (Patient Unified Lookup System for Emergencies or PULSE): Using pre-identified standards, a system will be developed to connect health systems and HIOs through a secure web portal.  During a disaster, this web portal would be activated and health care professionals and possibly first responders assisting in the response will be able to access the portal to view critical lifesaving patient health information.

As a next step, ONC and the HHS Office of the Assistant Secretary for Preparedness and Response (ASPR), through their ongoing collaboration, will continue to seek additional resources and create new partnerships to move both scenarios forward.  In fact both agencies recently received a joint HHS Ventures award, through its innovative IDEA Lab, to begin to lay the foundation for PULSE in California.  The award will provide an opportunity to increase momentum for PULSE and for California stakeholders to address key issues prior to launching the technical architecture. 

But this is just the beginning.  We will need to continue to pound the pavement to galvanize support to see this important work become a reality because in the end, PULSE could serve as a model for other states to access patient health information during an emergency or disaster.  And we are continuing to keep our eyes on the prize—patient data being available to patients and their providers where and when it is needed…including during disasters.