Post-9/11 hospital system utilized

TAMMIE SMITH / WSLS NewsChannel 10
Published: April 22, 2007

Shortly after 10 a.m. Monday, Morris Reece sent alerts to five hospitals in and around Blacksburg that there was an event unfolding with the potential of multiple victims.

"We knew that there would be various degrees and types of injuries," said Reece, regional hospital preparedness coordinator for an area of western Virginia that includes Roanoke and Blacksburg.

The five hospitals - Lewis-Gale in Salem, Roanoke Memorial, New River Valley, Mongtomery Regional, Pulaski Community - were told to be prepared to activate their internal disaster plans and to log on to a secure Web site where they would be able to simultaneously receive updates and further directions and communicate with each other.

"We had a real-time sense of what the needs were and how they were being met," said Katharine M. Webb, a senior vice president at the Virginia Hospital and Healthcare Association.

As the victims of the Virginia Tech shootings were taken to area hospitals, Webb said, she and staff members in Richmond were able to see - online - the conversations going on between the hospitals and the emergency coordinators in the Blacksburg area.

Also signed on and monitoring the situation were William Berthrong, hospital planner at the Virginia Department of Health, who was in Richmond, and Steve M. Ennis, the hospital association's technical advisor for preparedness, who monitored events from Fredericksburg.

The Web-based emergency operations system, which is in place around the state, was created after the Sept. 11 attacks as a way to improve hospital response to disasters.

It is a key part of hospital emergency response and is funded, in part, with federal emergency-preparedness dollars devoted to making sure hospitals can quickly ramp up in emergencies and accommodate a surge of patients.

"What we saw in this past week was demonstration of our ability to coordinate the health-care response through the online hospital status and reporting system that we put in place," Berthrong said. "Hospitals can communicate with each other and anticipate needs before they become acute. This information is accessible by [emergency medical services] and dispatchers, and so it really came in very helpful."

Hospitals canceled elective surgeries and called in extra staff. The shootings turned out not to need all the resources that were available. Fourteen EMS agencies responded, more than what was needed, so ambulances were redirected, Reece said. A mobile hospital command center and a mobile field hospital put on alert were not called into service.

On the other hand, some resources that could have been used were not available. Windy conditions prevented use of two emergency helicopters that were available, Reece said.

At a debriefing later in the week, a few problems were identified. Reece was also using his cell phone to keep in touch with responders at the scene, and that became a problem when cell-phone lines became jammed by everybody trying to be on at once.

The communications systems used by the different responders were sometimes not able to talk to each other.

Also, because of federal privacy law, hospital staff members were not able to respond to an onslaught of callers seeking information about potential victims. Privacy laws prohibit even disclosing whether someone is a patient if the patient or the patient's designee has not given permission. Once a list of patients became available, there was discussion of whether to post it on the Web system.

"I called the governor's office and said, 'What can we do-' " Webb said. Even a state declaration of emergency did not offer a way to respond to callers' queries.

In the end, a toll-free phone line was set up, and callers were directed to it.

Tammie Smith is a staff writer at the Richmond Times-Dispatch.