An Emergency Database Management System: A Real-Time Public Health System for Disaster Preparedness

This presentation describes the design, development and implementation of an Emergency Database Management System, a computer-based prototype that pulled and electronic medical record data to be used in the event of an emergency and/or crisis. Hospitals used their current electronic management systems to submit a patient file that adheres to the Health Level 7 (HL7) message protocol. The message contains clinical data viewed as necessary to have in the event of a displacement caused by a crisis. This information includes blood type, medications, allergies/contraindications, current diagnoses and procedures and demographics and is part of an “EHR Lite” that uses a layout design and symbols to enhance usability and comprehensibility. The data is stored in MySQL, an open-source relational database, placed within a deduplication algorithm to ensure a consistent patient identity, and then viewed through a restricted access web-portal designed in Ruby on Rails, an advanced web-scripting protocol. The data is in a constant lock-down state, and is only accessible when either the Governor of a State, the Secretary of Health, or another assigned individual declared a state of emergency and mandates patient evacuation. At that time, individuals will be assigned to either another hospital(s) or an alternate care site. The receiving facility then has the ability to view the records of the patients who are relocating. Additionally, the database also allows medical personnel from both the facility being evacuated and the one receiving patients to manage the transfer from the time the individual leaves a hospital until they arrive at another location. At any point, medical personnel and family members will know the location and destination of a patient. This system is thought to be a vital and essential piece of disaster preparedness and response activities within a State.