Friday, April 13, 2007

Jake's Deadly Dilemma

My two previous posts about the plight of the modern healthcare consumer focused on Jane’s exasperating treatment decision and John’s health insurance ordeal. This post examines a life-threatening scenario any of us could face in a disaster.

As he regained consciousness after the explosion, Jake found himself pinned under a beam, unable to move; he was trapped in his office building. To make matters worse, he kept loosing consciousness. Thankfully, 1st responders (fireman, police, and emergency medical units) were arriving outside. Unfortunately, they didn't know where in the building victims were located, or which stairways, hallways and rooms were safe to enter.

Several 1st responders reached Jake eventually. Sadly, there were two "men down" from serious injuries during the search.

Jake's rescuers began to evacuate him, but they didn't know his medical history, nor could they determine the trauma centers best suited to treat his injuries. There was also difficulty maintaining communications between the 1st responders and trauma center staff since telephone and Internet services were sporadic. The ambulance driver ended up taking Jake to a nearby emergency room hoping it had sufficient beds, surgeons and other resources needed to treat him.

When they arrived, things were chaotic. Due to widespread devastation, the doctors and nurses in the ER were inundated with injured patients. When they got around to Jake, they had trouble delivering the care he needed due to problems allocating their medical equipment, directing their staff, and keeping track of their medicines and materials. Since Jake was unconsciousness and didn't have any identifying documents, the trauma team couldn't obtain important information about his allergies and pre-existing medical problems. They couldn't even notify family about Jake's condition, nor have someone with power of attorney make a life-saving decision.

What's the problem here?

Not enough is being done to equip 1st responders and trauma center staff with information they need to evacuate victims safely, transport them to the right trauma centers, and treat them effectively in the emergency room and beyond. In disasters, pandemics and terrorist attacks, an information system is needed that helps save lives and property through rapid response by enabling emergency preparedness and providing assistance for 1st responders and trauma center staff.

If the 1st responders assisting Jake had been using such a system, there may not have been any "men down." They would have known where Jake was located in the building and would have followed the safest path to him. That would have protected the 1st responders and got them to Jake more quickly. It would have also identified the trauma center best able to care for his injuries and would have instructed the ambulance driver to take him there. It would have also maintained communications between the emergency personnel at the scene of the explosion and the hospital staff. In addition, it would have been able to obtain Jake's medical history from any health record systems using "biometrics" (such as fingerprints and retinal scans). And it would have helped the nurses and doctors deliver the necessary care with minimal disruption and error.

My next posts will examine solutions for empowering and supporting modern consumers when making important healthcare and insurance decisions, and for helping victims by assisting 1st responders and emergency room personnel in disasters.

Click here for the next post in this series.

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