IMPRESS newsletter volume 4, regarding the project's exercises that will be implemented to validate the DSS

1. FURTHER INFO
Dr. Sofia Tsekeridou
Project Coordinator
INTRASOFT INTERNATIONAL
sofia.tsekeridou@intrasoft-intl.com
Mr Ilias Gkotsis
Dissemination Leader
CENTER FOR SECURITY STUDIES
i.gkotsis@kemea-research.gr
Project website: www.fp7-impress.eu
E-mail: info@fp7-impress.eu
Twitter: @Impress_FP7
LinkedIn: “IMPRESS FP7 Project” group
Facebook: “Impress Project - FP7 ” page
Blog: fp7-impress.blogspot.com/
The Greek-Bulgarian exercise of IMPRESS includes an
earthquake scenario at E79 motorway near the Greek-
Bulgarian border, combined with very heavy rainfall,
which will have two significant impacts: first, a land-
slide leads to retreat of the roadside pavement and an
overflow of the Strimona river bed to the road. In addi-
tion rocks fall down the hill along the motor way block-
ing the road and crashing a number of cars.
All the above cause a large number of injured drivers
and passengers, having urgent need of medical care
and transportation to the nearby hospitals.
Due to the closure of the road to Sofia, the Bulgarian
authorities request international cooperation, activating
procedures for cross-border emergency support
through the European Emergency Response Centre
(EERC) in Brussels.
The IMPRESS system will be used to support field data
gathering from multiple incident scenes and strengthen
coordination between the response organizations and
the involved emergency medical services, including the
international support.
This project has received funding from the European Union’s Seventh Framework Programme for research,
technological development and demonstration under grant agreement no [608078]
During large and major incidents
health service providers have to
deal with disproportion between
the needs and the available hu-
man/material resources in the re-
sponse capacity and the inherent
time constraints of an emergency.
These critical factors play a seminal
role in the decision-making process during a crisis event, which
affects all levels of command & control (strategic, operational, tacti-
cal). The weakness of the current health emergency management
systems lies in the limited capability of command & control opera-
tions to coordinate the actions of the separate services and turn
them into an effective, multi-faceted crisis response mechanism.
The IMPRESS solution aims to improve the efficiency of decision
making in emergency health operations, to provide a consolidated
concept of operations, to effectively manage medical resources, to
prepare and coordinate response activities using data from multi-
ple heterogeneous sources. IMPRESS facilitates communication
between Health Services (and Emergency Responders) during the
whole crisis cycle and at all levels of response, turning emergency
medical teams into one coherent response force.
The IMPRESS approach catalyzes a dramatic and durable impact
in the way that Health Services are provided in crisis situations in
EU, and helps improve the integration of health care and emergen-
cy actors with other Crisis Management stakeholders.

2. Τhe first IMPRESS real-life pilot was successfully
conducted in Palermo, Italy on 7 June 2016, in
the framework of a large-scale civil protection
multi-agency exercise, locally organized by the
National Research Council of Italy in cooperation
with the Civil Protection of Palermo.
The health emergency exercise scenario in-
volved a fire on-board a cargo ship moored in
front of the Palermo harbor, in the sea, right in
front of the Palermo promenade. The fire could
not be extinguished and the captain and crew
should abandon ship. Due to Northeasterly winds
the plume of toxic substances released in the fire
reached the densely populated area of Kalsa
District. Several victims were reported which
needed medical attention and transportation to
nearby hospitals; essentially triggering a mass
casualty emergency operation.
The exercise organization requested a commit-
ment of 21 public organizations, 624 people, 110
ground vehicles, 10 ambulances, 17 ships and
boats and 5 airborne means. Six (6) operational
centers, equipped with IMPRESS incident man-
agement and DSS tools, have been installed in
the facilities of the Italian Coast Guard, the Ad-
vance Medical Post created in Puntone dock at
the Port area of Palermo (AMP A), the Regional
Ambulance Dispatch Center (118), the Crisis Unit
of the Prefecture of Palermo, the Emergency
Department of the Hospital Buccheri La Ferla
and the Civil Protection Headquarter (SORIS), all
of them exchanging incident, patient, notification
and dispatch data in real time and coordinating
their response through the 1st integrated IM-
PRESS system. Handheld mobile devices, run-
ning the IMPRESS mobile application communi-
cating with the Incident Management and DSS
tools at the distributed operational centers, were
used to collect field and patient data and feed
decision support tools for prioritizing the patients’
triage list and select the proper hospital and route
to send the ambulances with the victims, as well
as optimize usage of available resources
(ambulances, beds).
All activity and assets along the whole emergen-
cy timeline from the burning ship till the hospitals
ED were continuously monitored and displayed
to the involved actors using the IMPRESS sys-
tem capabilities.
All operations in combination with the IMPRESS
system response were followed by an extended
list of international evaluators (4), ethics experts
(3) and observers (15), positioned at various key
places (on board a ship to follow the rescue at
sea and then the treatment and dispatch at the
Advanced Medical posts, or at Command and
Control centers of 118, Prefecture and the Hospi-
tal), who collected data and provided feedback
concerning the performance of the system to the
realistic requirements of the scenario.
The integrated IM-
PRESS system has
been tested in coop-
eration with the Crisis
Management and
Disaster Response
Centre of Excellence
of NATO in context of
the Consequence
Management Exer-
cise “CRNA GORA
2016”, which has been conducted by EADRCC
from 31 October to 4 November 2016 in Podgori-
ca (Montenegro). The exercise involved 680 par-
ticipants from 10 Partner and 7 Allied nations
(Albania, Armenia, Austria, Azerbaijan, Belgium,
Bosnia and Herzegovina, Croatia, Finland,
FYROM, Georgia, Israel, Romania Serbia, Slove-
nia, Spain, Sweden, Ukraine and USA). The par-
ticipation of the IMPRESS project in the exercise
was realized as a result of cooperation between
IICT-BAS, partner of IMPRESS project, and the
NATO Center of Excellence in Sofia. The field
exercise offered a great opportunity to deploy
and test IMPRESS components (INCIMOB and
INCIMAG) under realistic health emergency con-
ditions.
The scenario of the field exercise was based on a
large-scale flood and chemical incident and the
relative response and deployment of emergency
teams in eight main sites surrounding Podgorica,
the capital of Montenegro. According to the sce-
nario, approximately 14.000 people has been
affected by the floods. A large number of victims,
anticipated in the scenario, spread in the various
sites, has been rescued, triaged and transported
to the local hospital. IMPRESS has played the
role of the DSS system, improving preparedness
and response of the Health Services.
Mobile devices equipped with the INCIMOB ap-
plication for medical first responders were used
and field tested. They were connected with medi-
cal devices gathering vital signs of the victims
and interfaced with INCIMOB mobiles. Personnel
of CMDR COE has been trained by IMPRESS
partners for using the INCIMOB devices and ap-
plication during the exercise.
The CMDR CoE personnel used INCIMOBs to
gather field data and triage victims in diverse
sites, sending relevant information over Internet
to an interoperating Incident Management Post
with INCIMAG, set up in Athens, Greece at the
premises of EKEPY (National Health Emergency
Operations Centre) of the Ministry of Health.
In Danilovgrad bridge, the IMPRESS team in-
putted the victim’s information with the help of
CMDR-COE operator and transmitted all data
about the patients of a car crash, needing imme-
diate medical help
along with rescue
support, to the INCI-
MAG located in Ath-
ens.
INCIMAG, the IM-
PRESS data man-
agement and coor-
dination component,
was installed in EKEPY for this purpose. End
users from the MoH Services, EKAV
(Ambulance Service) and the General Secretariat
of Civil Protection were trained on the INCIMAG
DSS functionality and INCIMOB applications on
31st of October. During the CRNA GORA 2016
exercise, the INCIMAG component was receiving
and displaying situational reports and victims’
data from Montenegro and forwarded sugges-
tions by the IMPRESS Recommendation Engine.
Simulated hospital data provided by the
WARSYS module of IMPRESS were used to
demonstrate response options, according to the
field gathered information.
DARIUS project was represented in
the 16th European RPAS Conference
and Policy Forum held the 25/6/2014
in the Royal Military Academy, Brus-
sels (B). The project results and
achievements were presented within
the section entitled «RPAS for Re-
search & Rescue». DARIUS project
presentation focused to the interopera-
bility potential ensured by DARIUS
solution.
Journals:
-Efstathiou N., Psaroudakis C.,
Skitsas M. and Koutras N.
(2016) WARSYS: An efficient data
warehouse to support decision sup-
port components of health services
in major crises, Journal of Polish
Safety and Reliability Association,
Summer Safety and Reliability Semi-
nars, Volume 7, Number 1, Pages
53-60
Papers:
-Dobrinkova N., Seynaeve G.,
Slavev A. and Zlatkova A. (2016)
IMPRESS PROJECT DECISION
SUPPORT TOOL IN REAL TEST
CASE SCENARIO APPLICATION,
Presented in 6th INTERNATIONAL
CONFERENCE ON CARTOG-
RAPHY & GIS, Albena, Bulgaria
-Dobrinkova N., Galatas I., Seynae-
ve G. (2016) An Intelligent System
for Resource Allocation Optimization
of Medical Teams in Mass Casualty
Incidents, Presented in IEEE 8th
International Conference on Intelli-
gent Systems, Sofia, Bulgaria
-Alessandro Borri, Christos
Dimopoulos, Simona Panunzi,
Rachele Brancaleoni, Claudio Rob-
erto Gaz, Daniele Gui, Sabina
Magalini, Andrea De Gaetano
(2016) Modelling Trauma Physiology
for Large Crisis Management, Pre-
sented in 15th International Confer-
ence on Modeling and Applied Simu-
lation, Larnaca, Cyprus
Presentations:
Sofia Tsekeridou, IMPRESS -
Improving Preparedness and Re-
sponse of Health Services in Major
Crises, Final Workshop of MELOGIC
Project, Brussels, 14 November
2016.
IMPRESS training and LLT com-
ponent has been developed,
which is linked with INCIMAG
and WARSYS components, col-
lecting information in order to
provide offline processes for the
training of related end-users and
experts.
These components are available
through the following link.
http://impress.coders-lab.com/
 The NATO CMDR COE in
Sofia, Bulgaria, is organizing the
Lessons Learnt conference from
the Montenegro exercise – the
final dates have been confirmed
to be 25-27/01/2017 in Sofia.
The results of using the IM-
PRESS solution and its compo-
nents during the exercise will be
presented and discussed in the
context of this event.
 Each year, the EENA Confer-
ence brings together emergency
services, public authorities, re-
searchers and industry repre-
sentatives from all around the
world to foster the sharing of
best practices between all the
relevant stakeholders. In this
year’s event, the IMPRESS Pro-
ject Coordinator has been invited
to give a Talk at the Innovation
Theatre of EENA 2017, in Buda-
pest, Hungary, on 5-7 April
2017.
3) The 3rd and final IMPRESS
Stakeholders Advisory Group
Workshop will take place in April
2017, in Thessaloniki, Greece,
following the last pilot of IM-
PRESS.