Disaster Data Challenges: Don't let data become part of the disaster

April 14, 2015Nick Nudell, MS, NRP

The Paramedic Foundation, Inc - Chief Data OfficerPrioriHealth Partners, LLP – Partner

National Association of State EMS Officials – EMS Compass Initiative Project Manager

DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official policy or position of HIMSS.

Conflict of Interest

Nick Nudell, MS, NRP

Has no real or apparent conflicts of interest to report.

© HIMSS 2015

Learning Objectives

Attendees will:

• Be able to describe key data needs during disasters

• Learn what issues and challenges were faced during previous disasters

• Learn considerations and solutions for common disaster day challenges

Biggest Killer Natural Disasters – 1915-2015

• 1920 a 8.2M earthquake killed 200,000 in Gansu Province

• 1927 an earthquake in Qinghai (Xining) Province killed 200,000

• 1931 Yellow River flooding killed 1M and flooded more than 40,000 sq/mi

• 1948 a 7.3M earthquake in Ashgabat, Turkmenistan killed 176,000

• 1970 the 150mph Cyclone Bhola hit Ganges Delta killing 300-500,000 in Bangladesh

• 1971 the Red River in Vietnam flooded killing 100,000

• 1976 Tangshan 8.2M earthquake killed 655,000 & injured 779,000

• 1991 Cyclone 2B killed 145,000 in Bangladesh and destroyed 1.5M homes

• 2004 a 9.4 Indian Ocean earthquake and Asian Tsunami killed 230,000 and displaced 1.79M across 15 countries

• 2005 a 7.5M Kashmir earthquake killed 76,400 and displaced 3M

• 2008 120mph Cyclone Nargis killed 138,000 and displaced 54,000 in Myanmar

• 2010 Haiti 7.0M earthquake killed 160,000 & displaced 895,000

• 2011 a 8.9M earthquake in Japan caused a Tsunami killing 28,700

• 2015???

Source: http://www.google.com/

Disasters – 2000-2014

• 2003 a 6.6M earthquake in Bam (Iran) killed 26,271 and 80% of the area’s buildings were damaged or destroyed

• 2005 Cat 5 Hurricane Katrina cost over $100B in damages and killed 1,836 people.

• 2007 California wildfires burned 1M acres in SoCal, 1,500 homes destroyed, killing 14 and injuring 160 of which 124 were firefighters.

• 2008 a 7.9M earthquake in Sichuan (China) killed 68,712 people were confirmed dead (with another 17,921 missing but presumed dead)

• 2011 1-mile wide EF5 tornado hit Joplin, MO killing 158, injuring 1,150, and causing $2.8B in damages

• 2012 Superstorm Sandy killed 233 and caused $68B in damages

• 2014 Ebola outbreak

• 2014 20 wildfires in San Diego County burned 30,000 acres killing one over 17 days

Source: http://www.google.com/

Disaster Data Needs

Public

• Am I in danger?

• What is going on?

• Where are my friends/family?

• What should I do?

• Where should I go?

• How long will it last?

• Do I need to evacuate?

• Are my pets safe?

• Can I volunteer?

• What if I need help?

Responders

• Am I in danger?

• Is my family safe?

• What hospitals are open?

• Is there traffic blocking access?

• How long will I be at work?

• What kind of supplies do I need?

• Where will my meals come from?

• Is the incident scaling up?

• Who is in charge?

• How do I use the volunteers?

• How do I communicate with others?

Hurricane Katrina

August 29, 2005

• Most destructive natural disaster in U.S. history

• Large and powerful hurricane as well as a catastrophic flood

• Impacted nearly 93,000 square miles across 138 parishes and counties

• Crippled thirty-eight 911 call centers

• Knocked out 3+ million customer phone lines in Louisiana, Mississippi, and Alabama

• 50 percent of area radio stations and 44 percent of area television stations went off the air

• 770,000 people were displaced

• 500+ ambulances plus thousands of paramedics provided mutual aid

Lessons Learned

• The inability to rapidly share data is the #1 problem

• Critical data lives in disparate systems on a day to day basis

• Damaged infrastructure complicates sharing across distance, languages, cultures, geographic barriers, & borders

• Automating manual records – a reality

• Communication systems may work

• Staff and their families need linkage

• Coordinating out of state resources

Source: http://www.ksdk.com/

Pre Disaster Data

• Build in situational awareness technologies to stay ahead of the disaster

• Real-time & redundant tools for communication, data management & sharing

• To be effective technologies must be used every day, not just disaster day

• Support mobile technologies and web based platforms

• Scalable from 1:N

• Information assurance = success

• Empower someone to rapidly adapt changes to policies & procedures as needed for effective response

http://google.org/publicalerts

Disaster Day Situational Awareness

“Disasters are sites of human innovation” – Leysia Palen

Situational Awareness = information and its interpretation – right type, at the right time, in the right amount

1) Incident data - Detailed scene information about patients (status, number, triage, etc)

2) Mission status - Units assigned, resources available, location of responders, hospital capability, police units assigned, distance to hospitals, etc

3) Area status – Available units (number, type, location), EMS doctor, status of missions in area, number of non-urgent missions, mutual aid availability, possibility to assemble ad hoc units, etc

4) Safety status – Risk factors, location of safe zone, permission to go to scene

5) Information Sources & Targets – EMS units, doctors, dispatch, fire/rescue, police, hospital, participants

6) Information Sharing – EMS radio, cell phone, ePCR, incident management software, face to face

Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2015, 23:4

Geospatial Alerting / Notification

http://google.org/

http://firstwatch.net/

Post Disaster

• Patient & Pet Location/Reunification

• Mortuary services

• Medical records

• Fleet tracking records

• Human resources data & follow-up for exposures

• Resupply for redeployment

• Resuming normal operations

• Communication systems returning to ‘normal’

• Reimbursement forms & reports

• Debrief & Lessons Learned

https://www.facebook.com/NWSKansasCity/photos/a.129569323764386.

26179.126747474046571/764153256972653/

Don’t Forget The Pets!

http://emergencypetmatcher.com

To Do: To Avoid:

• Plan for interoperability on a big scale

• Test for disaster scenarios while building for daily use

• Develop resiliency plans with contingencies for data system

• Establish regional data sharing councils & agreements

• Work out how you will:

– Manage thousands of ad hoc volunteers

– Integrate disaster assistance teams from across country

– Move data systems to the cloud

– Train (OJT) for new systems

– Coordinate with NGO & federal teams

• Don’t wait for FEMA – that is too late

• Hope PH or someone else has the answers

• Skip testing and drilling with partner agencies and/or competitors

• Buying off the shelf solutions without testing them

• Fail to engage “boots on the ground” users

• Purchasing solutions that tie your hands for:

– Support

– Data ownership

– Change management

– Upgrades

– Transitional periods

– Sandbox development

Discussion

Contact:

Nick Nudell, MS, NRP

nnudell@paramedicfoundation.org

(760) 405-6869

@runmedic #PIPSAA

http://www.emsnerd.com

http://www.paramedicfoundation.org

https://priorihealth.com