Just more than one year after Hurricane Sandy's waters flooded the northeast, cutting power and forcing more than 7,000 patients and residents at hospitals and nursing homes to evacuate, New York state demonstrated that it can now track those vulnerable citizens during the next big storm.
A demo in mid-November at a Manhattan hospital used the state's Evacuation of Facilities in Disasters System (e-FINDS), which the New York State Office of Information Technology Services (ITS) devised over the summer. Using pre-printed wristbands with bar codes and identifying numbers, handheld scanners, a mobile app and optional paper tracking, the system tracks patients and residents in real time across facilities.
The Web-based tracking system was spurred by a recommendation from Gov. Andrew Cuomo's NYS Ready and Respond Commissions and was a priority of the Department of Health, according to John Norton, Health Cluster CIO for ITS.
During an evacuation, health facilities will have enough pre-printed e-FINDS bracelets for all patients and residents. They will be fitted with the smudge-proof bands and scanned into the state's existing Health Commerce System using a computer and USB-connected scanner or mobile app. Users will then enter patients' basic information and where they are headed.
Norton said the easy-to-use application takes into account whether facilities have power, and also how much time they have during an evacuation.
For instance, patients at facilities with no power can be sent directly to their destination without being scanned, allowing the receiving facility to scan them in. Or, facilities can use the bar code-printed paper and write the patient's information for later entry into e-FINDS. The patient's evacuation history and intended destination is then accessible to all Health Commerce System users and can be communicated to loved ones.
Although ITS set up a database and 1-800 number during Sandy that tracked many of the state's moving patients and residents, this system left some people unaccounted for during the storm.
"We really had a hard time tracking them because we didn't have a system in place that was specifically meant for tracking patients or citizens during an evacuation," Norton said.
ITS developed the Web application in four weeks, printed the wristbands in another four weeks, and developed the mobile app, available on iPhone, iPad or Android devices, in a final four to six weeks for $1.1 million, not including staff time, Norton said. He said the biggest reason ITS developed the Java-based system in-house over using an existing federal system was that it could be quickly deployed in time for the 2013 hurricane season.
"We only needed to deploy an application basically on [an existing] platform so all the security was in place on all of the accounts," Norton said. "Otherwise, it would have taken much longer."
As a result of e-FINDS, more than 2,500 providers caring for more than 300,000 patients and residents statewide now have the ability in an evacuation to use tracking tools, said Sue Kelly, executive deputy commissioner of the New York State Department of Health. The state's hospitals, nursing homes and adult care facilities, as well as residential treatment programs, developmental centers and supportive housing facilities, will participate in e-FINDS during a future evacuation event.
Bellevue Hospital in Manhattan, which evacuated during Sandy, participated in the recent e-FINDS demo for the press. During the hurricane, the hospital manually tracked its patients, and also called to confirm their arrival at receiving locations before informing loved ones. Although this low-tech system successfully tracked all of Bellevue's patients, it was time- and resource-intensive, said Marcy Pressman, deputy executive director of Bellevue Hospital.
Contrasting that experience with the demo, Pressman said that e-FINDS would make future evacuations easier in terms of accessing Web-based tracking information remotely, which is especially valuable during power outages. "The beauty of it is that anybody who has access to that Web-based system has access to [the patients'] movements." This includes physicians who Pressman said had trouble following up with their patients during Sandy.
As for a real test, there hasn't been one yet, which is a good problem, according to Norton. In the meantime, Norton said the state will continue to develop e-FINDS to include more patient health information and to integrate other state systems, including one that offers bed and resource availability information, which will allow hospitals to both plan and track evacuations using the system.