Submitted by Tori Buck, Director of Product Management
While at HIMSS, I had the opportunity to attend a session regarding the use of HIEs for Disaster Recovery efforts. Between wildfires and hurricanes, the United States saw many recovery efforts this past year. This session did a great job of explaining how the recovery efforts were helped along using HIE data, but also what really needs to be improved if we want to have a better outcome in the future.
What was most interesting about this presentation was not how great the HIEs were in being able to provide the data needed to care for the victims of these disasters, as much as what existing hurdles need to be overcome to improve the solution. A couple of steps were outlined specific to the improvement of disaster recovery.
Since recognized HIE models  differ from state to state, as well as the laws that govern the data authorization and consent to disclosure, there is little to no data exchange possible between state HIE solutions. While states recognize and understand that these differences need to be resolved for effective exchange, it may be a while before full interstate connectivity. This of course is the goal of the Carequality framework which is being developed and initiated through the Sequoia Project.
The current situation with HIEs as highlighted, has prompted the current solution to this hurdle of utilizing the Emergency Support Functions 8 (ESF 8) to gain temporary access to the data contained in a state’s HIE. Further, it was proposed that ESF 8 agencies take the lead as primary coordinators of disaster planning with the state HIE to ensure privacy and security measures are followed per state. In addition to this type of planning, there was a proposal to scale the current California initiative of PULSE  which stands for the Patient Unified Lookup System for Emergencies, to a nationwide level by connecting it to the Carequality framework.
Finally, one of the tools to aid in disaster preparedness that I found most interesting is the initiative run by the U.S. Department of Health and Human Services (HHS) called emPOWER. This program provides information on the number of Medicare beneficiaries that rely on electricity to run any medical or assistive equipment. This equipment includes ventilators, wheel chairs, and cardiac devices. The data is restricted to different levels of access based on the required usage, but at a high level, deidentified information can be viewed using the map provided.
What can we take away from all this information? The thing that stood out most to me, is the number of different systems that are in place, or in development which contain bits of important patient information. Ideally, there would be unity to the data such that all the related parts could be accessed from one single location. This access would need to be presented in a timely manner to allow treatment of patients when it matters most. It’s not clear how long it will take to get there, or if we are truly on the right path to achieve it. For now, there seems to be separate efforts that are trying to ensure collaboration and identify overlap of coverage. If all the different initiatives are signing on to work together, then it seems we are moving towards the emphasized moto during this presentation; “Planning and collaboration should begin way before a disaster.”