National Hospital Available Beds for Emergencies and Disasters (HAvBED) System

IV. Methods

This project required and involved collaboration and communication among multiple partners. This section describes the process by which this project was completed within the 14 month contract period and the degree to which communication and collaboration were key to its completion and success.

1. This project was conducted by a project team led by Dr. Stephen Cantrill, Associate Director of Emergency Medicine at Denver Health Medical Center. Dr. Cantrill has been involved in medical informatics for 40 years and bed availability reporting issues for 20 years. Co-investigators include Dr. Peter Pons, who has extensive experience in prehospital care and disaster management, and Dr. Sheri Eisert, who has extensive experience in health systems research. Project managers included Carrie Vinci and Jacob Dye.
2. An Advisory Group for the HAvBED Project was identified with representation from the following (Appendix A):
   • Department of Health & Human Services:
     • Agency for Healthcare Research and Quality (AHRQ).
     • Office of the Assistant Secretary for Public Health Emergency Preparedness.
     • Health Resources and Services Administration.
     • Centers for Disease Control and Prevention.
   • Department of Defense:
     • Office of the Assistant Secretary of Defense for Health Affairs.
     • USTRANSCOM.
     • USNORTHCOM.
   • Department of Homeland Security:
     • National Disaster Medical System.
     • Federal Emergency Management Agency.
   • Office of Veterans' Affairs.
   • New York City Office of Emergency Management.
   • Uniform Services University of the Health Sciences.
   • AHRQ Integrated Delivery System Research Network Partner: Weil Medical College.
   • Denver Health Medical Center.
3. A project Development and Implementation Working Group was identified and formed with representation and participation by:
   • Denver Health Emergency Medicine.
   • Denver Health Information Systems.
   • Denver Health Health Services Research.
   • HERDS.
   • EMSystem.
   • Hospital Capacity Web site.
4. Five Advisory Group meetings were held during the duration of the project. These meetings were instrumental in guiding the project and achieving consensus on issues such as institutional bed definitions and specification of those data elements to be collected by the system. The results of the project were presented at the final Advisory Group meeting on July 12, 2005. A live demonstration of the HAvBED computer system was presented during that meeting. The minutes of these meetings are presented in Appendix B.
5. Site visits were made to several existing bed/resource availability systems to better understand the capabilities of these systems and to enlist agreement by these systems to provide an up-linked data feed to the HAvBED system during the periods of system testing and operation. The systems visited included EMSystem® (Milwaukee, Wisconsin), the Hospital Capacity Web site (Seattle, Washington) and the New York State Department of Health Hospital Emergency Response Data System (New York City). A system questionnaire was developed prior to these visits to optimize data gathering (Appendix C). Each of these systems agreed to participate in the HAvBED demonstration. Other systems operational in this area were investigated via conference call and Web demonstration.
6. Site visits were conducted to two systems involved in patient tracking: the St. Louis Metropolitan Medical Response System (MMRS) and USTRANSCOM/TRAC²ES (Scott AFB, Ill) and one system involved with casualty identification (HERDS).
7. A software specification document was prepared to capture initial design elements of the desired HAvBED system (Appendix D).
8. A coalition of interested parties, including HAvBED staff, developed a communication protocol to be used in the communication between our partner systems and the HAvBED system. This protocol utilizes the Extensible Markup Language (XML) and is designed to allow easy expansion. (Go to Appendix E)
9. The HAvBED Project Working Group then designed and implemented the necessary software to make the HAvBED demonstration operational. This included data base design and implementation, Web services and Web interface design and implementation and geographic information system (GIS) interface design and implementation.
10. Hospitals that were not using any of our partner systems were solicited to enter their HAvBED data manually, thereby demonstrating the ability to incorporate data from all hospitals (and from potential alternative care sites), whether they are part of another system or not.
11. Three test periods for HAVBed data collection were specified. Test period #1 ran from June 20 through June 26, 2005 and involved a period of "Heightened Reporting," i.e., hospitals were requested to enter bed availability data a minimum of once per day. This test period allowed initial evaluation of the adequacy of the system-to-system and manual data entry interfaces and the utility of the display of the bed availability data. Test Period #2 ran from June 27 through July 6, 2005, and utilized the data available from our system partners during periods of normal operation. The final test period, #3, ran from July 7 through July 31 and allowed final evaluation of the demonstration system. It, too, was a period of "Heightened Reporting" with bed data being supplied on a daily basis. During this final test period, the usefulness the system in an EMS field environment was also evaluated.

Return to Contents
Proceed to Next Section