How Quickly Can We Respond?

Emergency notification technology answers this primary question.

IN three years' time, the United States' perspective of public safety has dramatically shifted. Decades of relative stability within our country's borders have been usurped by the threat of violence, illness, and economic uncertainty. Consequently, the nation has adopted a heightened sensitivity for worst-case scenarios and a newfound respect for contingency planning.

U.S. health care professionals, including thousands of first responders from coast to coast, have been ushered onto a national stage and have become the focus of a harsh spotlight. With millions of Americans looking in their direction, there is but one question asked of them: How quickly can we respond?

Terror drills are being waged in communities across the United States almost as frequently as fire drills in elementary schools. On the heels of TOPOFF2 in Seattle and Chicago, which tested emergency preparedness for terrorist attacks, California conducted a statewide drill involving more than 500 hospitals, health care facilities, and ambulance providers. California's scenario staged an outbreak of biological contaminates and was only one of countless drills and exercises of its kind in the last year. For each mock disaster, the key measurement was response time.

Inadequate Response Tactics
Following the September 11, 2001, terrorist attacks, federal, state, and local governments quickly came to realize many of their emergency response methods were outdated and poorly organized. Money was then allocated by the Homeland Security Department to invest in technologies that enhanced emergency communication efforts. Governments at the local level investigated ways of improving communication between first responders and the community at large, with a concerted focus on the coordination and delivery of critical information before, during, and after large-scale events.

Despite vocal support for revamped emergency response measures, a recent report from the Council on Foreign Relations stated first responders still will need about $98 billion more to be adequately prepared for future catastrophic events. This shortfall has forced public safety operations to prioritize purchases such as bioterrorism suits and biohazard portable showers.

No matter the monetary restrictions placed on first responder programs, one area that should never be compromised is communication. That being said, economic realities have urged emergency professionals to look for cost-effective, technology-driven solutions that adequately address current and future critical communication demands.

Unfortunately, the health care sector (including many first responders) is one of the last groups in America to gain knowledge about a proven emergency communication technology that has benefited several industry segments, government agencies, and corporate entities for years. Developed some two decades ago, emergency notification technology first brought immediate communication capabilities to the nation's nuclear power industry. Today, use of the technology has expanded across a variety of operations that, like health care and first response, measure job success in seconds and the saving of human life.

The tragic events at Chernobyl and Three Mile Island in the late 1970s spurred the development of emergency notification technology for rapid, computer-driven communication in times of crisis. Software automated the dialing process so more calls could be made to emergency crews and managers, thereby expediting response times during critical events. This technology has evolved, improved, sharpened, and been applied to a growing list of industries to strengthen their emergency communications capabilities without severely burdening their budgets.

Single Points of Failure
Traditional means for communication with first responders and communities at risk have become outdated. In fact, manual phone trees historically have been the linchpin for quickly distributing information during a crisis and for building response teams to manage emergency situations. The problem is that phone trees can be derailed easily, with individuals either receiving incorrect information or not learning of the situation at all. The same holds true for widespread notification of local residents through sirens, television broadcasts, and door-to-door communication.

Automated emergency notification technology circumvents this issue by eliminating the potential for a single point of failure. It is stealthily replacing laborious and time-consuming manual call-outs. In addition to delivering messages to pagers, the technology can ring cell phones and work and/or home numbers. It can transmit information through e-mail, PDAs, and Blackberry devices. Most importantly, the entire process--information delivery and response--is automated so the message is communicated rapidly and consistently to a predetermined population with the feedback necessary for immediate and appropriate response by first responders and local residents alike.

This technology enables a single dispatcher to initiate a response team assembly or community notification with the push of a few phone or computer buttons, dramatically reducing the expense of man-hours or the time associated with manual message delivery. It also frees trained professionals from routine, non-skilled activities, allowing them to execute more important and specialized tasks related to the situation at hand.

Moreover, the technology allows a dispatcher to customize a message and then selectively choose its recipients based on specific calling lists or geographic location, quickly notifying response teams or the general public in a matter of minutes. In a health-related crisis, emergency notification technology provides the essential balance between human resources and automation, allowing professionals to perform their jobs while equipment manages the delivery of logistical information.

How Emergency Notification Technology Works
Essentially, automated emergency notification technology functions like an immediate phone tree, without requiring the time and energy of valuable human resources.

The software is designed to retain an unlimited contact list that is updated consistently to ensure information accuracy. The list can be manipulated from a single personal computer. Dispatchers pre-record or record in real time an incident-specific message that can be distributed to a contact list with a click of the mouse or a phone call, thus removing emotion from the equation. In addition, a system operator can access and modify the system's messages remotely, allowing greater functionality and usage. With this technology, accurate and consistent information is immediately distributed to everyone involved via his or her preferred form of communication (land/cell phone, pager, fax, e-mail, etc.).

In an emergency, the disaster leader first determines which messages to send out and which key people are needed for the response effort. In most cases, the majority of messages can be selected from the pre-recorded inventory. Then the system is set in motion.

Just as messages are distributed to the call list, so the system also receives inbound calls from those who have been contacted, automatically providing them with the same important information. As responders receive word, the technology takes them through a series of gating questions to qualify them as part of the emergency response team. If they are too far away, for example, the system will let them know they are not eligible for response. Those who pass the gates are instructed about what has happened and where they should report.

The disaster leader would monitor all of this activity on his computer screen as it unfolds or would receive status reports that can be sent to virtually any desired modality or area. Say only 10 of the 30 key people respond fast enough to the initial call-out; in that case, the system would notify the next 30 key people, and so on, until all necessary positions are filled. As a last resort, a disaster leader can manually determine who can fill a key spot that remains empty despite the call-outs.

Unlike its manual predecessors, this technology-enhanced phone tree can be stopped and restarted at an instant should changes in the scenario occur. Additionally, it provides valuable information by tracking employee codes, giving the disaster leader a detailed report on who was successfully reached.

Adding to its versatility, emergency notification software often can be used in conjunction with GIS (desktop mapping) technology to contact any designated audience or targeted geographic area, in addition to first responders or employees. Operators can route a message to reach a specific city street, a block of a downtown business district, an entire tri-county area, etc.

GIS integration can be extremely beneficial when an incident affects one specific area or when different messages are required for varied audiences in multiple locations. The power of this technology can be seen in its range of use. When a malaria outbreak recently hit South Florida, more than 600,000 residents were notified via this technology with health tips for avoiding exposure. In the same region, a flood forced the local emergency management department to alert fewer than 200 residents in a specific section of the community.

Overall, the technology is being used by health care organizations and emergency operations for a variety of situations, including team assembly for a massive emergency room event, notifications regarding contamination or contagious illnesses, and public safety warnings related to weather or man-made disasters. For example, during last year's Northeast blackouts, a community of 50,000 people outside Detroit was instructed to boil drinking water after the purification plant's power failed.

Facing the Future's Challenges
Today, many state health departments are deploying emergency notification technology, as are federal organizations. The anthrax scares of late 2001 and the global outbreak of SARS in early 2003 sparked a transformation of the way the Centers for Disease Control and Prevention communicates with the public and its first responders. Part of that process includes implementing technologies that speed the notification of responders and citizens at risk.

Last year, the United States faced the West Nile Virus, SARS, California wildfires, and Hurricane Isabel. In 2004, first responders can expect a new wave of challenges, some of them anticipated and others possibly beyond the public's imagination. As the country continues to focus on homeland security and better equipping first responders for whatever crisis they are summoned to manage, automated emergency notification technology will continue to play an important role, markedly improving reaction times and increasing the effectiveness of responses.

To maximize its potential, continued acceptance and adoption of this solution among health care organizations and emergency response units is critical. Without embracing this technology, America's response to critical events simply won't be quick enough.

This article originally appeared in the April 2004 issue of Occupational Health & Safety.

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