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From a Cellular Level

September 1, 2006
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With good reason, James Cramer developed a passion for making healthcare information transferable.

James Cramer, vice president and CIO at Scottsdale Healthcare, Scottsdale, Ariz., since 1991, understands how important it is for clinicians to receive the best information about their patients, even before those patients step inside an emergency room.

He doesn't need to imagine a situation where after a serious automobile accident someone may be airlifted to a hospital where no one knows his or her medical history.

After all, he lived it.

About a dozen years ago, as Cramer rode in an air-vac after being cut out from inside a car, he told the paramedics he was a vice president of Scottsdale Healthcare, and asked to be brought to their level one trauma center. "They kind of chuckled and said, 'We'll see,’” he says.

Years later, Cramer suffered from a serious fall in Sholo, Ariz., cracking some ribs. Again, he was rushed to the nearest hospital, this time by ambulance. "They knew nothing about me," he says. As it turns out Cramer received very good care at both hospitals, but what the clinicians didn't know could have hurt him, as he later found out he is allergic to Demerol.

Considering the accidents, Cramer's commitment to emergency preparedness, disaster preparation and information exchange makes perfect sense.

In August 2005, prior to Hurricanes Katrina and Rita, Scottsdale Healthcare began to look at collaborative disaster planning and communication flow as its emergency department prepared to build a new trauma center.

Scottsdale had announced its plan and begun construction when neighborhood company, General Dynamics C4 Systems, stepped in. "They came forth and said they'd like to work with us and help the whole communication flow," Cramer says, which led to a much larger regional crisis response program.

Dubbed the Coyote Crisis Campaign (CCC), the network is designed to test community emergency and disaster preparedness, and is a collaboration of various entities, among them, Scottsdale Healthcare, General Dynamics, the City of Scottsdale and the Arizona Air National Guard.

Cramer, who was on the overall executive committee for planning, chaired the program's General Dynamics ASP Web "cell" communication portion.

Originally portrayed as a type of instant messaging system, the system transformed into a chat room between the decontamination and emergency operations centers to allow for information exchange and resource deployment.

Flexible role-based unique user sign-ons as well as generic sign-ons were designed for the Internet-based chat rooms to have cross agency and interagency communication.

The CCC drill was created to test hospitals and stress systems. "As far as disaster planning," Cramer says, "you want to really try to stress your systems. If you just have 10 patients, that's probably not stressing the system."

At Scottsdale Healthcare, what this meant was not only a number of General Dynamics tabletop exercises, but also full-scale decontamination and mass-casualty drills with a C-17 military plane, Blackhawk helicopters, and over 100 community college students feigning all sorts of injuries — deep cuts, bruises, crushing injuries and gaping wounds.

Though the drill was overwhelmingly successful, there were challenges along the way and lessons learned — a library basement which did not allow for a cellular signal, and a daylight area where laptop screen viewing was difficult — more evidence of the importance of the simulation. "It's one thing to see it working from someone else," Cramer says, "but it's another thing when you're signing on and using it."

Author Information:

Stacey Kramer

Kathryn Foxhall is a contributing writer based in Hyattsville, Md.

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