Accomplishments for Core Goal #9: Mass Casualty/Hospital Surge

Mass Casualty/Hospital Surge
The State’s Department of Health and Mental Hygiene (DHMH) and the Maryland Institute for Emergency Medical Services Systems (MIEMSS) have focused on initiatives to better plan for and coordinate during surge events, to automate and combine various situational awareness and surveillance tools into a single dashboard, and to provide additional human, medical, and transportation resources to public and private stakeholders.  Following are key projects and accomplishments:

• Maryland is in the process of deploying handheld patient tracking devices across the State.Patient trackers are handheld devices that can be used during Mass Casualty Incidents (MCIs) to produce pictures, video, and sound recordings to identify a patient and track each step of pre-hospital emergency care until they are admitted to a hospital or an acute care facility. By using a barcode bracelet and a camera, patient trackers instantly identify a patient, prioritize their needs by vital signs and other statistics, and report all of the information to a real-time dashboard (Health and Medical Dashboard) which can track and query patients. This means that every person in need can be accounted for and family members can be reunited more easily. Previously, patient tracking was done by manually written and faxed lists or other non-automated and unreliable means. Currently, the State has deployed 360 patient tracking devices to EMS providers across the State and plans are in place to deploy an additional 373 devices. The State has set a goal of having patient tracking devices available to arrive at the site of a mass casualty incident with 20 minutes. To prepare for the use of electronic patient trackers, the Health and Medical Dashboard has been uploaded with patient tracking software and is able to receive, store, and report patient tracking data.

• The Maryland Institute of Emergency Medical Services Systems (MIEMSS) is currently in the process of installing DEMSTEL phones in hospitals, health departments, 9-1-1 Centers, Police Barracks, State facilities, and local Emergency Operations Centers. The Digital Emergency Medical Services Telephone (DEMSTEL) is a Voice over internet protocol (VoIP) communications tool which maintains microwave connectivity between critical facilities such as hospitals, health departments, and 911 call centers even when primary telephone and radio networks become inoperable. To-date DEMSTEL has been installed at 74% (168 sites) of all identified sites.

• Launched the first statewide electronic patient care reporting system to provide limited acute care facilities with patient information in near real-time. With 96.67% of the state utilizing the interoperable eMEDS software, time-sensitive patient information can be transmitted instantly from one medical provider to another. Because of the ability to be integrated with multiple other software programs such as the Health and Medical Dashboard and each 911 dispatch center’s Computer Aided Dispatch (CAD) systems, eMEDS reduces the amount of time spent looking for patient information and ultimately leads to a more effective patient care system.

• Developed an electronic dashboard that integrates multiple hospital emergency room and health & medical resource systems into one single online interface. With just a few mouse clicks, the Health and Medical Dashboard provides real-time updates to first responders such as the status of emergency rooms, specific hospital resources, and notifications of health alerts from the Centers for Disease Control and Prevention (CDC). Prior to the State’s efforts to integrate and upgrade these medical resource systems, hospitals in Maryland relied on fax machines and call down lists to warn of a “code red” status (when an ER is overwhelmed and must divert patients to another hospital) or share information on critical medicines and supplies on-hand. The Health and Medical Dashboard automates this information and makes it available in real-time for all hospitals, 911 centers, State and local EOCs, local health departments, and EMS units in the State.

• Created a Disaster Medical Assistance Team for Maryland (DMAT Md1) under the direction of the National Disaster Medical System (NDMS) to be prepared to deploy mobile hospital services in the event of a catastrophic emergency. The DMAT commanders are recruiting physicians, nurses, paramedics and logistic personnel to fill the 105 positions in the team under the direction of NDMS. So far, over 85 members have been recruited and completed the necessary steps to joining the DMAT. Most recently, the DMAT was deployed by the NDMS to New Jersey for Hurricane Sandy.

• Established a medical and strategic national stockpile (SNS) warehouse and distribution center for protection and storage of medical surge and mass casualty supplies. The warehouse is a secure and temperature controlled facility which has received, inventoried, stored and distributed several tons of Personal Protective Equipment (PPE) including N-95 respirators, ventilators, antiviral medications, and other medical equipment and supplies needed to support hospital surge capacity. The Department of Health and Mental Hygiene (DHMH) warehouse was critical to the placement and protection of the SNS assets provided to Maryland during the spring 2009 outbreak of H1N1.

• The Department of Health and Mental Hygiene (DHMH) earned a top score in public health emergency preparedness from the Centers for Disease Control and Prevention (CDC) for the last 3 years.  DHMH improved from a score of just 67 percent in 2008.

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