Telehealth is the use of electronic information and telecommunications technologies to support long-distance medical care, health-related education, public health and health administration. The Southern Governors’ Association (SGA) understood the potential of telehealth from the initial meeting of the SGA’s Task Force on Medical Technology in 1997. After the terrorist attacks of 9/11, the telehealth community became more focused on how the technology can support disaster preparedness and response efforts. Missouri led the efforts to illustrate telehealth’s role in disaster response by conducting a four-state disaster drill in May 2004. Since that time, Kentucky Gov. Ernie Fletcher has taken the lead to help SGA states develop a cohesive plan to utilize telehealth for disaster preparedness and response. Hurricanes Katrina and Rita helped prove that Kentucky's telehealth efforts can play a vital role when disaster strikes.
When Hurricane Katrina struck on August 29, Kentucky's efforts to provide assistance to the Gulf states of Louisiana, Mississippi and Alabama became a top priority. Dr. James Holsinger, Jr., MD, Secretary for the Cabinet for Health and Family Services (CHFS) asked Dr. William Hacker MD, FAAP, CPE to lead the Cabinet’s response to Katrina. Dr. Hacker is the commissioner for the Department for Public Health (DPH) and is also the CHFS representative for the Kentucky Emergency Operations Center (KyEOC) directed by Gen. Clay Bailey.
In conjunction with Bailey’s efforts in setting up the KyEOC’s Donation Management Call Center, the Public Health Preparedness Branch managed by Peggy Ware set up an operation center on Aug. 31, 2005. The DPH Operation Center had two purposes: (1) to gather volunteer information about medical, nursing, public health, social workers and mental health specialists willing to deploy to the Gulf Coast states; and, (2) to assist evacuees in their displacement to Kentucky by gathering demographic information and information concerning their basic medical, welfare, mental health/retardation, educational and employment needs.
Because of an overwhelming response from volunteers, the IT staff within the DPH began developing a disaster relief Web site (http://chfs.ky.gov/katrina.htm). By Sept. 2, a Web site was established for direct volunteer registration. By Sept. 7, a registration form for displaced persons was also on the Web site. IT staff worked nonstop to get both of these initiatives operating as soon as possible. The databases associated with the Web sites are used by the CHFS to establish a list of potential volunteers to be called and collect information on evacuees' friends or family members that may be living in Kentucky and whom the evacuees are trying to locate.
On the morning of Sept. 7, the Preparation and Response On Advanced Communications Technology (PROACT) network was activated to connect 42 telehealth sites in Kentucky and to aid the volunteer and evacuee coordination efforts. PROACT is a Kentucky network of interactive videoconference telehealth facilities committed to participating in disaster preparedness and response efforts. The logistics were coordinated by Rob Sprang, director of Kentucky TeleCare at the University of Kentucky, who contacted the telehealth members and engaged the PROACT network. PROACT was used last December to provide video conferencing capabilities for troops stationed in Iraq to talk to their families (Freedom Calls from Freedom Hall). However, before Hurricane Katrina, PROACT had never been used in an actual disaster situation.
In addition to the PROACT sites, 25 health departments connected to the PROACT teleconference using datacasting, a technology utilized by Kentucky Educational Television. Datacasting is over-the-air broadcasting of data embedded within a digital television signal for sending data to schools, offices, public safety, and other local, state and federal offices. Although datacasting participants were able to view the PROACT video conference, they could not interact directly with participants. Instead, e-mail was used for asking questions and to communicate with the PROACT participants.
Over 400 medical, public health, Medicaid, social services, mental health, pharmacists, environmentalists, emergency management and IT specialists participated at the state and local levels, connected via the PROACT network or datacasting technology. The use of these two technologies made it possible for DPH to coordinate and integrate the overwhelming response by state agencies and local communities seeking to help in the hurricane relief efforts.
In addition to assisting the victims of Katrina, the relief effort expanded to also assist the victims of Hurricane Rita. On Sept. 23, Kentucky received airlifted patients, nursing home residents and family members that were evacuated due to Hurricane Rita. As a result of the DPH's coordination of the state and local community volunteer relief efforts, as of Sept. 28, over 1,400 health and medical professionals have registered to volunteer in Kentucky, and 33,000 individuals have volunteered nationwide with Health and Human Services. In addition, 94 out of Kentucky’s 120 counties have received at least one evacuee.
To date, five volunteer teams have been deployed to Mississippi: two Environmental Strike Teams, two Public Health Administrative Strike Teams and a Health and Medical Services Strike Team. The Environmental Strike Teams’ mission was to inspect restaurants for possible reopening, collect water samples and inspect shelters. The Public Health Administrative Strike Teams’ mission was to provide coordination and resource support for all public health activities in the six most southern Mississippi counties including primary care, sheltering and public health operations. A pharmacist was deployed to coordinate pharmaceutical distribution in the same area. A Health and Medical Services Strike Team was also deployed. Its mission was to coordinate the Operations and Planning Branch for the Mississippi Emergency Management Agency's (MEMA's) Regional ESF-8 Emergency Operations Center (EOC), and continue field support of environmental health operations. MEMA's ESF-8 EOC is the emergency support function (ESF) that provides health and medical services. In addition to the teams coordinated by DPH, the Northern Kentucky Independent District Health Department sent two teams of nurses and support staff to assist a Red Cross Shelter in Mississippi.
Although the hurricane disaster relief effort within DPH is lessening, the DPH continues to collect volunteer information and assist evacuees. The Emergency Preparedness Branch is compiling an After Action Report and incorporating what they have learned from their disaster relief efforts into the Cabinet’s Disaster Recovery and Response Plan. The PROACT network and datacasting technology greatly assisted DPH in coordinating Kentucky’s volunteer and evacuee relief efforts. As a result, the PROACT Network has now been proven in a disaster situation.
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