This document discusses challenges with data during disasters and provides recommendations. It summarizes key data needs during disasters for the public and responders. It describes data issues during past disasters like Hurricane Katrina where 911 call centers were crippled. Lessons learned include the inability to rapidly share data across different systems and barriers. The document recommends pre-disaster solutions like real-time communication tools and situational awareness technologies. It also provides examples of post-disaster data needs like patient tracking and medical records. Recommendations are provided to plan for interoperability, test disaster scenarios, and establish data sharing agreements.

1. Disaster Data Challenges: Don't let data
become part of the disaster
April 14, 2015
Nick Nudell, MS, NRP
The Paramedic Foundation, Inc - Chief Data Officer
PrioriHealth Partners, LLP – Partner
National Association of State EMS Officials – EMS Compass Initiative Project Manager
DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official policy or position of HIMSS.

2. Conflict of Interest
Nick Nudell, MS, NRP
Has no real or apparent conflicts of interest to report.
© HIMSS 2015

3. Learning Objectives
Attendees will:
• Be able to describe key data needs during disasters
• Learn what issues and challenges were faced during previous disasters
• Learn considerations and solutions for common disaster day challenges

4. Biggest Killer Natural
Disasters – 1915-2015
• 1920 a 8.2M earthquake killed 200,000
in Gansu Province
• 1927 an earthquake in Qinghai (Xining)
Province killed 200,000
• 1931 Yellow River flooding killed 1M and
flooded more than 40,000 sq/mi
• 1948 a 7.3M earthquake in Ashgabat,
Turkmenistan killed 176,000
• 1970 the 150mph Cyclone Bhola hit
Ganges Delta killing 300-500,000 in
Bangladesh
• 1971 the Red River in Vietnam flooded
killing 100,000
• 1976 Tangshan 8.2M earthquake killed
655,000 & injured 779,000
• 1991 Cyclone 2B killed 145,000 in
Bangladesh and destroyed 1.5M homes
• 2004 a 9.4 Indian Ocean earthquake and
Asian Tsunami killed 230,000 and
displaced 1.79M across 15 countries
• 2005 a 7.5M Kashmir earthquake killed
76,400 and displaced 3M
• 2008 120mph Cyclone Nargis killed
138,000 and displaced 54,000 in
Myanmar
• 2010 Haiti 7.0M earthquake killed
160,000 & displaced 895,000
• 2011 a 8.9M earthquake in Japan caused
a Tsunami killing 28,700
• 2015???
Source: http://www.google.com/

5. Disasters – 2000-2014
• 2003 a 6.6M earthquake in Bam (Iran)
killed 26,271 and 80% of the area’s
buildings were damaged or destroyed
• 2005 Cat 5 Hurricane Katrina cost
over $100B in damages and killed
1,836 people.
• 2007 California wildfires burned 1M
acres in SoCal, 1,500 homes
destroyed, killing 14 and injuring 160
of which 124 were firefighters.
• 2008 a 7.9M earthquake in Sichuan
(China) killed 68,712 people were
confirmed dead (with another 17,921
missing but presumed dead)
• 2011 1-mile wide EF5 tornado hit Joplin,
MO killing 158, injuring 1,150, and
causing $2.8B in damages
• 2012 Superstorm Sandy killed 233 and
caused $68B in damages
• 2014 Ebola outbreak
• 2014 20 wildfires in San Diego County
burned 30,000 acres killing one over 17
days
Source: http://www.google.com/

6. Disaster Data Needs
Public
• Am I in danger?
• What is going on?
• Where are my friends/family?
• What should I do?
• Where should I go?
• How long will it last?
• Do I need to evacuate?
• Are my pets safe?
• Can I volunteer?
• What if I need help?
Responders
• Am I in danger?
• Is my family safe?
• What hospitals are open?
• Is there traffic blocking access?
• How long will I be at work?
• What kind of supplies do I need?
• Where will my meals come from?
• Is the incident scaling up?
• Who is in charge?
• How do I use the volunteers?
• How do I communicate with others?

7. Hurricane Katrina
August 29, 2005
• Most destructive natural disaster in
U.S. history
• Large and powerful hurricane as well
as a catastrophic flood
• Impacted nearly 93,000 square miles
across 138 parishes and counties
• Crippled thirty-eight 911 call centers
• Knocked out 3+ million customer
phone lines in Louisiana, Mississippi,
and Alabama
• 50 percent of area radio stations and
44 percent of area television stations
went off the air
• 770,000 people were displaced
• 500+ ambulances plus thousands
of paramedics provided mutual aid

8. Lessons Learned
• The inability to rapidly share data is the #1 problem
• Critical data lives in disparate systems on a day to day basis
• Damaged infrastructure complicates sharing across distance, languages, cultures,
geographic barriers, & borders
• Automating manual records – a reality
• Communication systems may work
• Staff and their families need linkage
• Coordinating out of state resources
Source: http://www.ksdk.com/

9. Pre Disaster Data
• Build in situational awareness
technologies to stay ahead of the
disaster
• Real-time & redundant tools for
communication, data management &
sharing
• To be effective technologies must be
used every day, not just disaster day
• Support mobile technologies and web
based platforms
• Scalable from 1:N
• Information assurance = success
• Empower someone to rapidly adapt
changes to policies & procedures as
needed for effective response
http://google.org/publicalerts

10. Disaster Day Situational Awareness
“Disasters are sites of human innovation” – Leysia Palen
Situational Awareness = information and its interpretation – right type, at the right time,
in the right amount
1) Incident data - Detailed scene information about patients (status, number, triage,
etc)
2) Mission status - Units assigned, resources available, location of responders,
hospital capability, police units assigned, distance to hospitals, etc
3) Area status – Available units (number, type, location), EMS doctor, status of
missions in area, number of non-urgent missions, mutual aid availability, possibility
to assemble ad hoc units, etc
4) Safety status – Risk factors, location of safe zone, permission to go to scene
5) Information Sources & Targets – EMS units, doctors, dispatch, fire/rescue, police,
hospital, participants
6) Information Sharing – EMS radio, cell phone, ePCR, incident management
software, face to face
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2015, 23:4

11. Geospatial Alerting / Notification
http://google.org/
http://firstwatch.net/

12. Post Disaster
• Patient & Pet
Location/Reunification
• Mortuary services
• Medical records
• Fleet tracking records
• Human resources data &
follow-up for exposures
• Resupply for redeployment
• Resuming normal operations
• Communication systems
returning to ‘normal’
• Reimbursement forms &
reports
• Debrief & Lessons Learned
https://www.facebook.com/NWSKansasCity/photos/a.129569323764386.
26179.126747474046571/764153256972653/

13. Don’t Forget The Pets!
http://emergencypetmatcher.com

14. To Do: To Avoid:
• Plan for interoperability on a big scale
• Test for disaster scenarios while
building for daily use
• Develop resiliency plans with
contingencies for data system
• Establish regional data sharing
councils & agreements
• Work out how you will:
– Manage thousands of ad hoc
volunteers
– Integrate disaster assistance
teams from across country
– Move data systems to the cloud
– Train (OJT) for new systems
– Coordinate with NGO & federal
teams
• Don’t wait for FEMA – that is too late
• Hope PH or someone else has the
answers
• Skip testing and drilling with partner
agencies and/or competitors
• Buying off the shelf solutions without
testing them
• Fail to engage “boots on the ground”
users
• Purchasing solutions that tie your hands
for:
– Support
– Data ownership
– Change management
– Upgrades
– Transitional periods
– Sandbox development

15. Discussion
Contact:
Nick Nudell, MS, NRP
nnudell@paramedicfoundation.org
(760) 405-6869
@runmedic #PIPSAA
http://www.emsnerd.com
http://www.paramedicfoundation.org
https://priorihealth.com