Reporting for Duty

In the aftermath of 9/11, New York City hospitals reported a massive influx of volunteers from health professions eager to contribute. However, hospitals could not use these volunteers because the government lacked an efficient and standardized verification method to confirm their identities, credentials or employment.

The inability to utilize qualified medical volunteers in the wake of the attack prompted Congress to pass the Public Health Security and Bioterrorism Preparedness and Response Act of 2002, which established the Emergency System for Advanced Registration of Volunteer Health Professionals (ESAR-VHP). The ESAR-VHP is helping states implement a national system to help emergency responders manage medical volunteers during disasters.

"One of the issues we've had is that when you have health-care professionals show up at a mass casualty site, there has been no way to identify or verify that individual is a nurse or physician," said Jennifer Hannah, acting team leader of the ESAR-VHP. "The reason for these systems is so you can verify people's identity and credentials."

The Health Resources and Service Administration (HRSA) provides national standards and guidelines for volunteer registration systems. HRSA guidelines mandate that states have a system that holds current, verifiable volunteer information -- such as identity, licensing, credentials, accreditation and privileging -- in hospitals. Yet electronic database systems are only part of the federal equation.

Registration systems must also include volunteer recruitment, statewide planning to coordinate all necessary constituencies, state capacity for managing credential information and procedures for linking these systems to state emergency management. The ESAR-VHP program provides technical assistance for states to develop effective volunteer registry systems, with higher priority given to states with larger populations.

A Better Way
During hurricanes Rita and Katrina in 2005, several states' ESAR-VHP programs deployed more than 8,300 health professionals to the Gulf Coast despite their programs' infancy.

However, after the 2005 hurricane season, federal officials concluded that high priority should be placed on a better coordinated response between federal and state agencies.

On Dec. 4, 2006, the ESAR-VHP program initiated a pilot involving four states to develop state and federal protocols for the deployment of state volunteers in a federal emergency response. Connecticut, Michigan, Minnesota and Oklahoma participated in the 48-hour exercise to test both federal and state protocols developed by the pilot group.

"We embarked on this project," Hannah said, "because after Katrina and Rita, what was found in the White House report on lessons learned was [that] there needed to be a better coordinated response between federal and state governments."

The exercise, which involved a hypothetical 7.2 magnitude earthquake, tested response times, communication processes, chains of commands, as well as how the system performed and how the staff managed it. It was the first volunteer exercise conducted that focused on hundreds of nationwide volunteers that could help in a large-scale disaster like Katrina. Hannah and executives at the ESAR-VHP division are still examining the after-action report to determine the exercise's success.

Registry Management Simplified
Michigan has been a pioneer of electronic volunteer registration, beginning in 2003 when it partook in a pilot for Global Secure Systems, a company that provides technology-based products and services to the homeland security industry.

Michigan helped mold and shape the Global Secure Volunteer Mobilizer platform, a secure, Web-based application for registering, credentialing, mobilizing and communicating with large groups of volunteers, said Virginia Ball, project coordinator at the Michigan Volunteer Registry.

"Before we had this program, we relied on spreadsheets," Ball said. "We had to figure out a way to document the people who wanted to volunteer, which is complex with that amount of information. Now in an emergency, we can pinpoint a volunteer we need instead of looking through spreadsheets."