Cornell University and Weill Cornell Medical College (WCMC) are partnering with Lockheed Martin to develop a computerized system to help hospitals nationwide plan for and deal with mass casualties from disasters such as hurricanes, a flu pandemic or bioterrorism. The system will aid in readiness planning, simulate a disaster situation for testing purposes and act as a decision support system in a real disaster.
The system, for which Lockheed is providing the research funding, will be an extension of a prototype already developed at WCMC in collaboration with OR-Manhattan, the New York City program of the School of Operations Research and Industrial Engineering (ORIE) on Cornell's Ithaca campus. The partnership with Lockheed aims to combine Cornell's computer models with command-and-control systems Lockheed has developed for medical services in the military. Other technology companies will be invited to join a consortium on the project.
"In light of the 9-11 attacks, Hurricane Katrina and the persistent threat of terrorism, we believe there is an urgent need to develop logistics solutions for planning and response in the face of mass casualty events," said Jack Muckstadt, the Acheson-Laibe Professor of Operations Research and Industrial Engineering at Cornell and director of OR-Manhattan.
The goal is to create a distributed communications system that would coordinate the work of emergency responders, hospital managers and local and regional officials. It would combine real-time reports from responders in the field with databases of hospital capacity and resources to show, for example, how 100 burn victims might be distributed among three hospitals, or where a ward full of premature infants in intensive care could be moved if a particular hospital needed to be evacuated.
The Cornell prototype, called the Mass Casualty Response Logistics Program, was created by Dr. Nathaniel Hupert, assistant professor of medicine and a researcher in public health and medical decision making in the Departments of Public Health and Medicine, WCMC, in collaboration with Muckstadt.
Hupert has already developed several computer models of public health systems that are in wide use across the country, including the Weill/Cornell Bioterrorism and Epidemic Outbreak Response Model (BERM), the de facto national standard planning tool for designing large-scale mass disease-control campaigns. BERM, which has had more than 1,300 downloads from the Web site of the American Hospital Association, is used by states from New York to Hawaii for emergency-response planning purposes. Hupert's collaboration with ORIE applies supply chain and logistics techniques used in manufacturing to the logistics of hospitals.
The models the Cornell researchers have developed are the first to focus on treatment capacity, according to Hupert. "Other current initiatives are primarily concerned with outbreak detection, health alerts, patient-level medical records and other issues unrelated to managing capacity," Hupert said. The new system would keep track of such resources as beds, intensive care units, emergency departments, operating rooms, doctors, nurses and other health professionals, transportation assets such as ambulances and other EMS units and even supplies like bandages and fuel for generators.
Initially, the system would coordinate activities in a local area, but Muckstadt hopes that eventually the data could move up to the state and federal levels so that officials would know, for example, "where to send the ice trucks." Meanwhile, he added, it should make life easier for hospital administrators on a day-to-day basis, even when there is no emergency.
The researchers have tested their model by running simulations of real disasters, including last summer's London subway bombings and the 2004 Madrid railway attack. The next step, they said, is to create a pilot program involving a group of 29 hospitals in New York City's Presbyterian Hospital system, which is affiliated with WCMC
Development of the system will be based on what Muckstadt calls a "three-legged stool" supported by technology companies, academic researchers and the prospective end-users. He is seeking funding to create a laboratory in which potential users could participate in computer simulations of disaster situations. The simulations would draw on Cornell's high-performance cluster computing facilities in Ithaca and at the OR-Manhattan facility at 55 Broad St. in the financial district of New York City.
Funding for development of the computer models on which the new system will be based was supplied by the U.S. Department of Health and Human Services Agency for Healthcare Research and Quality.