BY SHARON H. FITZGERALD

By the time 2007 rolled around, the Tennessee Department of Health was on schedule to have a resource tracking system up and running in 80 to 90 percent of the hospitals in the state. Funded with federal bioterrorism dollars, the tracking system will help direct injured people to appropriate hospitals and medical centers in the event of an emergency or disaster, natural or otherwise, and will also aid emergency medical services personnel on a day-to-day basis.

"It's for emergency preparedness. We actually took a program that North Carolina and Mississippi had developed and implemented, and we brought it to Tennessee and modified it for Tennessee hospitals and emergency medical services," explained Judy Eads, assistant commissioner of the department's Bureau of Health Licensure and Regulation, where the new program is housed. The tracking system, which is updated at least daily by a trained professional in each hospital, monitors census information, the number of beds and services available, and whether a hospital needs to divert incoming patients to another facility.

Eads said several hospital professionals are trained as designated users of the system, and they log onto a secure Web site, where they can only see the information regarding their facility. E-mail reminders are sent to hospitals tardy with updating their data, and a phone call eventually results from a Department of Health consultant if a hospital's information isn't received by a certain time each day. The federal funding covers training and maintenance costs, plus the purchase of computers, servers and radio equipment. "We make it easy and accessible for them to enter this information," Eads said. "Every region has a designated person from the Health Department who works with these facilities, and they go out and do training."

Eads said the daily updating of hospital data is "very minimal and takes no more than five minutes. Every day, they log into the system and acknowledge whether or not services are still available or if they have diverted and can't take those services anymore." Hospitals initially register as having specific services available, such as a burn unit or a neonatal intensive care unit. Should all the beds in one of those units be full or another problem arises, then the hospital diverts potential patients using the tracking system. The system may ask the reason for diverting patients and an estimate of when the service will again be available, she added.

This information is certainly useful on a daily basis, but it's particularly critical in times of emergency. "When a disaster is declared, the facilities are required to go in and to update their information so that state Emergency Management will know exactly where our beds are across the state. They would also know if there was a back-up of any particular service," Eads explained. "If you have 500 burns to deal with and you know you don't have burn beds available in Tennessee, then [emergency and hospital personnel] will evaluate those areas, perhaps discharge people or move them to lower-level care or go to surrounding states for burn care." Eads added that only the governor can declare a disaster and, once that's done, state emergency officials enter information into the tracking system for immediate statewide release – information such as the place and time of the emergency or disaster and the approximate number of people affected.

Tennessee is divided into eight EMS regions, each with its own medical communication center. These centers are the pulse of the tracking system and capable of communicating with a myriad of emergency responders. Eads said 911 centers will operate locally as they always have, but those responders will turn to the regional communication center if responding to a disaster outside their county. "If there were a 100-vehicle pileup on the interstate and more than 100 patients needed to be transferred to hospitals, by talking with the regional medical communication center, then EMS traffic is directed" to and from the disaster site and on to appropriate healthcare facilities, she said.

After beta testing in eight hospitals in March 2006, the Department of Health launched a pilot involving 52 hospitals in the Chattanooga, Cookeville and Jackson areas. On Nov. 6, the department began rolling out the program to the state's nearly 150 hospitals. Eads said three servers — in Knoxville, Nashville and Jackson — house the systems database, "and then we have servers that are also replicated in each of the eight regional medical communication centers. If one part of the state's servers are taken out, we keep operating. Our system refreshes every 26 seconds, so everybody is seeing the same information."




January 2007