Are most hospitals in the United States ready for a full scale bioterrorism or disaster event?
Not by a long shot.
"Overall, unfortunately, we've made only baby steps rather than big steps" toward being prepared for disasters, says Laura Segal, public affairs director for Trust for America's Health, Washington, D.C. "We need to start to be better prepared for healthcare catastrophes like Hurricane Katrina and others. We're a long way away from where we need to be."
On the information technology front, the organization found "interoperability is a big deal" but little coordination or regional efforts have taken place, says Segal, fingering Washington, D.C. as a potential example. An infectious disease found in the district and in the nearby Maryland suburbs at the same time might not be detected since disease monitoring systems may not exist or may not talk to one another, she says.
While the federal government has poured more than $1 billion into emergency preparedness, it may need to double the amount to "make the bureaucratic changes that have to be made," she says.
Some hospital systems have plunged forward and made investments in tracking disease outbreaks. More than 200 public hospitals have signed on to The RODS (Real Time Outbreak and Disease Surveillance) Project, a University of Pittsburgh open source initiative.
Other organizations are approaching detection by using emergency department information systems (EDIS) applications such as those available from Picis (Wakefield, Mass.), A4 Health Systems (Cary, N.C.) and Emergisoft (Arlington, Texas). And some are relying on laboratory systems reporting from companies such as Cerner Corp. (Kansas City, Mo.).
Dr. Mark Crockett, a practicing emergency room physician at MorrisHospital (Morris, Ill.) and head of Picis' Emergency Division, says the company's Ibex PulseCheck EDIS helped detect a flu outbreak in 2003 in Chicago.
Another approach to bioterrorism detection is offered by Cerner's HealthSentry, which connects healthcare organizations' pharmacy and laboratory systems with the local public health department. Public and private laboratories within a specific geographic area send their results electronically to Cerner, which in turn sends the data via daily reports and alerts to member hospitals as well as state, county and local heath agencies in a particular region, says Sue Tarkka, senior solutions manager.
So far, in the several urban areas where the system is used, "We've seen no bioterrorism, and that's an important thing, but we have seen alerts coming through for E. coli O157:H7 and other rare organisms," she says.
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