HHS Seeks FCC Help Improving Emergency Medical Communications

“We have had a lot of changes in our office over the past year,” Yeskey said, “One of the things we really look forward to is a partnership with the FCC to take advantage of their communications capabilities and their experience and expertise to leverage what we have in our preparedness programs.”

For a year HHS has been emphasizing better communications at hospitals -- facility to facility and with emergency responders, Yeskey said: “We really started to emphasize coalitions and networking of facilities. We wanted our health care facilities, number one, to be integrated into the response community… We wanted them to have a seat that the table not only in the drills and the response, but in the planning and the preparation. That’s 80 percent of it is being at the table.”

An HHS program, Have Bed, aims to improve communications among hospitals with open beds during disasters. “We can do that on a statewide basis, community basis or a federal basis,” he said. “The old model of, ‘you load a plane, you load an ambulance, and you take them to a community and say here’s your patients, sort them out, put them in hospitals,’ is not the way we want to do business.”

Lessons of Hurricane Katrina have HHS looking at ways to decide which hospitals near impending disaster zones should evacuate and which should accept patients, Yeskey said. “If you look at the hurricane path… there’s that zone of uncertainty,” he said. “You have to make the decision early and if you're wrong it’s expensive and you're putting patients in harm’s way… Communications plays an important role in that.”

The summit included state officials’ testimony on progress expanding emergency communications. Dennis Tomczyk, director of hospital emergency preparedness for the Wisconsin Division of Public Health, said his state holds that all hospitals, even in rural areas, must be able to communicate. Last week in northern Wisconsin, he noted, a tanker truck overturned carrying 20,000 pounds of ammonium nitrate, four times the amount used in 1995 to blow up the Oklahoma City federal building.

“Any hospital can be the epicenter of an incident,” said Tomczyk. “Almost anything can happen anyplace. It’s important not just to have your big hospitals prepared, but your small five-bed hospital could be the epicenter. For the first 24 hours that may be the only medical resource available.”

Communications redundancy is critical not just in disasters but because anything from a blizzard to a construction accident can disrupt communications, he said. “We wanted every hospital in the state to have four levels of communications redundancy,” Tomczyk said. “We have landline and cellular technology available at all hospitals, two-way radio, UHF, VHF, 800 MHz… All hospitals have satellite telephones that are capable of transmitting voice, e-mail and data and, fourthly, hospitals have the ability to communicate by amateur radio.”

The “800-pound gorilla” of problems is that emergency medical responders often lack communications interoperable with those of other states’ responders, Tomczyk said. He cited the 2006 collapse of a highway bridge in Minneapolis. “If Wisconsin had to be involved, it would have been a disaster,” he said. State officials “have a very, very difficult time talking to one another… If something happens in Chicago, we just cannot talk.”

Communications redundancy is difficult to obtain in Utah and similar states, which have many remote areas, said Scott Westbroek, chief of operations and preparedness for the Utah Bureau of Emergency Medical Services. “We, too, have been trying to develop a level of redundancy,” he said. “What we encounter is that cellphonewise there are portions of our state that do not have cellphone coverage at all. It’s probably many years before we see that happen… Even with satellite phones we are having difficulty with coverage in some parts of the state.”

Dean Brenner, vice president of government affairs at Qualcomm, said the FCC is pushing development of a national public safety network through the coming 700 MHz auction. “Until we get there, we have these commercial networks with off the shelf commercial technology, with software that can be developed by 18 year olds,” Brenner said. “The question that we're working on is, how do you leverage all of that to apply it in the healthcare realm… We see it as a critical area for the wireless industry.”