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Recommendations for a National Mass Patient and Evacuee Movement, Regulating, and Tracking System

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These recommendations are offered to assist in development of a system that could be used during a mass casualty or evacuation event to locate, track, and regulate patients and evacuees. The recommendations can provide decision support to persons and organizations responsible for patient and evacuee movement, health care and transportation resource allocation, and incident management.

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Prepared by:
Abt Associates

Investigators:
Tom Rich, Project Director
Paul Biddinger, Co-Principal Investigator
Richard Zane, Co-Principal Investigator
Andrea Hassol
Lucy Savitz
Margarita Warren

Contents

Executive Summary
1. Project Origin and Background
2. The National System: Goals and Objectives
   2.1. Locating and Tracking
   2.2. Regulating
3. Recommendations for a Phase I National System
   3.1. Patient/Evacuee Data Elements
           Minimum Data Elements
           Secondary Data Elements
   3.2. Obtain Patient/Evacuee Data From Existing Systems
           Feeder Systems
           Illustrative Data Flow Between Feeder Systems and the National System
           Implications of Relying on Feeder Systems
   3.3. Link a Limited Number of Feeder Systems to the National System
           Federal Tracking Systems
           Information Systems At Hospital Systems
           Disaster Shelter Registration Systems
   3.4. Focus on a Limited Number of Health Care and Transportation Resources
   3.5. System Operation
   3.6. Implementation Plan and Estimated Costs
           Task 1: Project Start Up
           Task 2: System Specification
           Task 3: System Development and Testing
           Task 4: Pilot Test
           Task 5: Documentation
           Estimated Phase I Costs
4. Priorities for Subsequent Phases
   4.1. Linking Additional Feeder Systems to the National System
   4.2. Improving Health Care and Transportation Resource Availability Data

Appendixes
Appendix A: Project Team and Steering Committee Members
   Key Project Staff
   Steering Committee Members
Appendix B: Legal Issues
   Relevant Federal Legal and Regulatory Issues
           Patient Information and Privacy Standards
   Relevant State Legal and Regulatory Issues
           Patient Information and Privacy Standards
           Complaints and Incident Reports
           Patient Rights
           Discharge Planning; Advocacy Office
           Reportable Diseases, Isolation and Quarantine
Appendix C: Existing Systems: Tracking Systems
   Overview
   Systems Used at the Local or Regional Level
   Systems Used or in Development at the Federal Level
Appendix D: Institutional Records Systems
   Summary
           Hospitals
           Nursing Homes
           Home Health
           Shelters
           Prisons and Jails
           Other People Needing Evacuation Assistance
   Hospitals
           Typology and Definitions
           Hospital Intake and Discharge Processes
           Existing Hospital Information Technology Systems with Population-Level or Client-Level Data
           Hospital Perceptions: Benefits of Evacuation Tracking
           Hospital Privacy and Confidentiality Issues
   Nursing Homes
           Nursing Home Typology and Definitions
           Nursing Home Intake and Discharge Processes
           Existing Nursing-Home Information Technology Systems with Population-Level or Client-Level Data
           Nursing Home Evacuation Plans
           Nursing Home Perceptions: Benefits of Evacuation Tracking
           Nursing Home Privacy and Confidentiality Issues
   Home Health
           Home Health Typology, Population and Definitions
           Home Health Intake and Discharge Processes
           Existing Home Health Information Technology Systems with Population-Level or Client-Level Data
           Home Health Evacuation Plans
           Home Health Perceptions: Benefits of Evacuation Tracking
           Home Health Privacy and Confidentiality Issues
   Shelters
           Shelter Typologies and Definitions
           Homeless Shelter Intake and Discharge Processes
           Shelter Information Technology Systems
           Shelter Privacy and Confidentiality Issues
           Shelter Perceptions: Benefits of Evacuation Tracking
   Prisons and Jails
           Corrections Typology and Definitions
           Existing Corrections Information Systems
           Special Evacuation Issues in Jails and Prisons
           Privacy and Confidentiality in Corrections
           Correctional Staff Perceptions: Benefits of Evacuation Tracking
   Data for Other People Needing Evacuation Assistance
Appendix E: Resource Availability Systems
   Hospital Assets
           Hospital Baseline Resource Inventories
           Hospital Real-time Availability Systems
           National Hospital Availability Systems (HAvBED)
   Nursing Home Assets
           Baseline Resource Inventories
           Real-time Availability Systems
   Home Health
           Baseline Resource Inventories
           Real-time Availability Systems
   Shelter Assets
           Baseline Shelter Resource Inventories
           Real-time Shelter Availability Systems
   Transportation Assets
           Baseline Transportation Resource Inventories
           Real-time Transportation Availability Systems
   Corrections: Prisons & Jails
           Baseline Corrections Resource Inventories
           Real-time Corrections Availability Systems
   Other "Mixed" Asset Systems
   Local Crisis Management Resource Availability Systems
Appendix F: Resource Requirements Models
   AHRQ Hospital Surge Model
   Mass Evacuation Transportation Model

Copyright Information, Acknowledgements, and Disclaimer

Development of Recommendations for a National Mass Patient and Evacuee Movement, Regulating, and Tracking System was funded by the U.S. Department of Health and Human Services (HHS) Office of the Assistant Secretary for Preparedness and Response, the U.S. Department of Homeland Security's (DHS) Federal Emergency Management Agency and the U.S. Department of Health and Human Services Office of the Assistant Secretary for Preparedness and Response. The authors would like to acknowledge the efforts of the Department of Defense (DoD) and the contributions of DoD project lead Captain F. Christy Music, We also want to acknowledge the contributions of the members of the Project Steering Committee, who are identified in the appendix of this report.

This project was awarded to Abt Associates Inc. under Agency for Healthcare Research and Quality Contract No. 290-00-0003, Task Order #12. Opinions or points of view expressed in this document are those of the authors and do not necessarily reflect the official position of the Agency for Healthcare Research and Quality.

This document is in the public domain and may be used and reprinted without permission except those copyrighted materials noted for which further reproduction is prohibited without the specific permission of copyright holders.

AHRQ Publication No. AHRQ-09-0039-EF
Current as of February 2009

 

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