Outdated hospital bed system hampers Katrina relief effort

National Disaster Medical System

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After the September 11, 2001 terrorist attacks on Washington and New York, Dr. Stephen Cantrill was contacted to find out how many injured people the Denver Health Medical Center could admit if needed.

“I faxed bed counts to Fort Carson,” said Cantrill, associate director of emergency medicine at Denver Health and an assistant professor at the University of Colorado. That’s when he decided an online system would be better, faster and more reliable.

As Hurricane Katrina took aim at the Gulf coast this week, he submitted to a Health and Human Services agency his final report on how to automate the system that locates available hospital beds in a disaster.

His prototype system, called HAvBED, is running, but it is no longer accepting live data feeds now that the project sponsored by the Agency for Healthcare Research and Quality has ended. What happens next?

Cantrill said he has no idea. “That’s out of our hands,” he said.

But he hopes his report doesn’t just disappear into an HHS file cabinet. “I want someone to build on what we were doing,” Cantrill said.

HAvBED linked a few existing state and regional bed reporting networks with other sites nationwide. Hospital staffers filled in the blanks on a Web screen to report which kinds of patients they could accept. A geographic information system displayed an on-screen map showing which hospitals could take emergency victims. Emergency managers could click on the map to find out more.

Katrina “is the prime example of how our system could have helped” in evacuating sick and wounded people from New Orleans, Biloxi and the surrounding areas, Cantrill said. “That’s exactly what the system was designed for.”

The hospital bed reports are part of the National Disaster Medical System, which located 2,600 hospital beds for hurricane victims in a 12-state area around the stricken area. NDMS is not an IT system but a set of procedures and agreements for mobilizing medical personnel and other resources in the event of a disaster.

Hospitals that are part of the system are asked to report how many patients they could admit in various units, such as intensive care and pediatric units. Because the system is not online, the hospitals send the information by fax or phone to a regional center, which then reports to Washington.

The two-decade-old system was part of Health and Human Services until the Homeland Security Department was created. Now the two agencies share responsibility for NDMS.

It links federal military and civilian agencies, local and state emergency managers, volunteer physicians and other medics, and hospitals to coordinate the medical response to emergencies when the situation overwhelms local resources.

Health and Human Services Secretary Mike Leavitt declared a public health emergency Wednesday, an act that reduces paperwork and authorizes deployment of federal medical aid.

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