Linkages of acute care and emergency medical services to state and local public health programs: the role of interactive information systems for responding to events resulting in mass injury.

"1.Increase the available radio spectrum for emergency communications.2.Create secure, redundant communication systems that allow for two-way cross-agency communication.3.Properly train staff to use the new systems and technology, and to prepare for current working conditions that may be more stressful and demanding, given the increased threat of a terrorist attack.4.Create a regional-based “threat forecast,” which would be updated as needed and reviewed annually by regional first-responder organizations. Funding and training levels could be guided by the threat forecast so that high-probability and high-impact threats are addressed.5.Mandate multiagency training opportunities. Training should focus on establishing and maintaining critical linkages between law enforcement, EMS, and medical, public health, and emergency management.6.Develop threat-warning systems for first responders to enable them to use protective equipment at the earliest possible moment.7.Obtain HIPPA exclusion for health issues related to national security, and cover reporters under “Good Samaritan” statutes.8.Redesign the EMT curriculum to reflect current issues.9.Assemble a consortium of first-responder agencies. Its tasks should include reviewing and suggesting revisions to federal legislation, as well as ensuring that future programs are designed to enable seamless response and maximum efficiency.10.Create partnerships in acute care/emergency response with the community, the government, and the military.11.Develop a national model for emergency response to help standardize response on a national scale.12.Establish and mandate the use of standard language/terms among emergency responders.13.Create national standards for training, equipment performance, and interoperability.14.Develop reliable, real-time, two-way communication systems between hospitals, field providers, and public health for use during day-to-day operations, as well as during a disaster response.15.Have communities determine hospital surge capacity as well as communitywide surge capacity. These plans should address each of the types of resources necessary for different types of disasters. Specifically, the plans should consider the types and amounts of equipment, supplies, beds, and personnel necessary to care for patients with trauma, burns, infectious diseases, chemical contamination, or inhalational injuries.16.Develop plans for how the system will “degrade gracefully” in times of disaster; that is, which rules must be followed and which can be bent, including federal regulations.17.Develop regional plans in addition to plans that are already in place for individual hospitals or agencies. Create a “big picture” plan that includes the entire region. ☆: Proceedings of the meeting “Linkages of Acute Care and EMS to State and Local Public Health Programs,” July 8–9, 2003, Washington, DC. The agencies represented at the meeting are listed in Appendix C.: Supported by the Department of Health and Human Services, Centers for Disease Control and Prevention, Program 02195, “Linkages of Acute Care and EMS to State and Local Health Programs: The Role of Interactive Information Systems for Responding to Events Resulting in Mass Injury.” Award No. U38/CCU322274-01."