Sunday, October 21, 2012

Tracking Patients in Emergencies

Two new technologies being tested by the National Library of Medicine (NLM) may help transform the way that hospitals keep track of patients during emergencies according to an article in the October issue of “NLM in Focus”. The article discusses several research projects such as the “People Locator ™” and the “Patient Tracking and Locating System”.

The People Locator is an online lost and found website of people that includes name, gender, age, health condition and photo when available that family members, emergency officials, and others can search during disasters.

The People Locator as part of the Lost Person Finder project includes several supporting applications such as ReUnite™, an app for smart phones, other mobile devices, and shares data with third party applications. These third party applications can include the Google Person Finder that is able to simultaneously search emergency sites by the International Federation of Red Cross, Red Crescent Societies, and others.

ReUnite first came into play during the January 2010 earthquake that devastated Haiti, and was NLM’s first downloadable iPhone app. Most recently, the NLM quickly set up the People Locator during the 2012 Philippine Floods to help track survivors of the torrential rains in the Philippines that inundated Manila and surrounding areas.

The Patient Tracking and Locating System produced by NLM’s Office of Computer and Communications Systems (OCCS) has a commercial digital pen that captures patient information via a tiny camera. The Real-Time Locating System is able to broadcast patient location and condition to care providers at a central location. With a software application devised by OCCS, patient records are transferred electronically from hospital to hospital.

Students of the Faculty of Medicine at Makerere University, in Kampala, Uganda used a scaled-down version of the OCCS to study the impact of bed nets in protecting 300 families from malarial mosquitoes in a distant rural city of Mifumi. They collected house-to-house data with the digital pen and special digital paper, then uploaded summary information and detailed records for the same day review back at the university.

The People Locator is finding success beyond its original disaster assignment. Recently St. Francis Hospital in Indianapolis Indiana closed its old hospital and with help from the Managed Emergency Surge for Healthcare, Inc., an emergency preparedness healthcare coalition supporting area hospitals in Indianapolis, created a private People Locator Website to monitor the transfer of patients to the new hospital.

The People Locator and the Patient Tracking and Location System are projects developed as part of the Bethesda Hospitals Emergency Preparedness Partnership (BHEPP). BHEPP partners include NLM and three nearby hospitals, NIH Clinical Center, Walter Reed National Military Medical Center, and Bethesda’s Suburban Hospital associated with Johns Hopkins Medicine. They are working together to develop a coordinated disaster response model for hospitals across the country.

Some of the BHEPP sponsored projects underway:

  • Roof top lasers and a dedicated optical fiber network are being installed at each partner hospital to transmit data between hospitals as a back-up dedicated disaster communications system
  • Technology is being evaluated that links voice communications systems used in disaster response such as hand-held devices, land-line phones, mobile phones, and radios
  • Digital pen recording for triage data is being evaluated to record disaster patient triage data and then uplink the data to a computer database
  • Tracking patients with RFID but so far this research projects has not yet begun due to funding issues
  • Devising a core set of patient data elements so that hospital partners can communicate common patient data in a disaster
  • Evaluating prescription data to access patient medication data available from commercial databases
  • Developing a reliable, interoperable, and redundant communication system to communicate with systems throughout the National Capital Region
 To manage the data, the NLM’s Disaster Information Management Research Center (DIMRC) coordinates NLM’s disaster research. Current projects include the Military Affiliate Radio System (MARS) a back-up communications system for hospital emergency operations centers, and the Hospital Incident Command Center, a responder training research project using virtual world technologies.