Future Connectivity for Disaster and Emergency Point of Care

Abstract

OBJECTIVE: The goal of this paper is to identify strategies for connectivity that will optimize point-of-care testing (POCT) organized as small-world networks in disaster settings. METHODS: We evaluated connectivity failures during the 2010 Haiti Earthquake, applied small-world network concepts, and reviewed literature for point-of-care (POC) connectivity systems. RESULTS: Medical teams responding to the Haiti Earthquake faced connectivity failures that affected patient outcomes. Deploying robust wireless connectivity systems can enhance the efficiency of the disaster response by improving health care delivery, medical documentation, logistics, response coordination, communication, and telemedicine. Virtual POC connectivity education and training programs can enhance readiness of disaster responders. CONCLUSIONS: The admirable humanitarian efforts of more than 4000 organizations substantially impacted the lives of earthquake victims in Haiti. However, the lack of connectivity and small-world network strategies, combined with communication failures, during early stages of the relief effort must be addressed for future disaster preparedness.

FIGURE 1. High impact of earthquake on health care small-world network in Haiti

Located on an island in the Caribbean Sea, Haiti borders the Dominican Republic to the East. The SWN relates the earthquake epicenter to health care infrastructure destroyed. Victim rescue routes were interrupted. Disaster responders arrived late and, in some cases, carried POC devices, which they discovered were vulnerable to environmental temperature extremes. Hospitals (“H”) are as follows: HAS, Albert Schweitzer; HBDP, Bienfaisance De Pignon; HCHDMD, Claire Heureuse De Marchand Dessalines; HDC, De Carrefour; HDM, De Marmelade; HEDB, Evangelique De Bombardopolis; HICC, Immaculee Conception des Cayes; HJ, Justinien; HLP, La Providence; HSA, St. Antoine De Jeremie; MSH, Mission Saintard; HSN, St. Nicolas; MSH, Maternité Solidarité; SCH, Sainte Croix; TTCH, Trinite Trauma Center.

FIGURE 2. Field area network for victim information connectivity

The diagnostic lab-in-a-backpack (A, B) equips first responders with the tools necessary to perform diagnoses in field settings. Field area networks (FANs) use Bluetooth to connect POC devices to handheld computer nodes (eg, iPhone, satellite phone, and smartphone). Field area networks can be modular (eg, FAN1, 2, 3, and 4), allowing addition and multiplexing of POC tests, such as pathogen detection, pulse oximetry, electrocardiograms, and blood pressure monitors, to fit the diagnostic needs of the disaster response. Bridged by 2-way satellite, FANs provide long- and short-range communication and data management for victim identification, position, history, treatment, and triage (C) that spans geographic barriers or disaster-produced obstacles.