NLM BHEPP - Part of the "Lost Person Finder" (LPF) Project

An overview and non-technical pre-deployment case study during an October, 2009 drill is available.

Introduction to NLM and BHEPP

The U.S. National Library of Medicine (NLM) is located on the National Institutes of Health (NIH) campus in Bethesda, Maryland, within the Washington, DC region. NLM is in a community partnership with 3 nearby hospitals (National Naval Medical Center, NIH Clinical Center, Suburban Hospital) to improve emergency responses to a mass disaster impacting those hospitals, including patient transfers. The partnership, called the Bethesda Hospitals Emergency Preparedness Partnership (BHEPP), received federal funding for IT projects beginning in July, 2008. There are 11 mostly-small BHEPP projects in progress that NLM is managing or directly developing (that will be named and described informally here):

Lost Person Finder (LPF)
Digital pen (“smart paper” triage form with dockable camera pen)
Emergency prescription retrieval from wholesaler RxHub/SureScript
Line-of-sight laser for inter-hospital backup private-network communications
Dark fiber for inter-hospital backup private-network communications
Wireless voice bridge between responders
Backup email via digital ham radio
Patient RFID tracking within (and eventually between) hospitals (this was last to be funded and is therefore not far along)
Disaster information specialist/librarian - for listserv, web site for searching “gray literature” about emergency health issues.
Patient data exchange (transfer of e-records between hospitals, of near-release patients transferred to free up beds for disaster survivors)
Virtual world disaster training

Although not discussed here, there are long-term plans for how these projects can interact with each other and with other IT systems.

Overview of LPF

As its name suggests, the purpose of LPF is to help with family reunification in a disaster. Broadly, it is conceived as having both public-facing and hospital-facing aspects, and eventually interact with other regional and nation-wide systems of similar purpose.

The LPF website and database are under construction, based mostly on a customization of Sahana, particularly the Missing Person Registry (MPR), with additional aspects. Administrators new to Sahana may be interested in how we configured our database content for customization.

Among additional aspects, being developed in PHP:

“Snapshot” module to backup/restore versions of the database (already contributed to Sahana, see snapshot)
Extension to the Messaging module to take in and parse email information about missing/found/in-hospital individuals (see TriagePic below)
“Other Resources” module
Notification Wall
Stats

We have also done the first-draft “American English” Pootle translation for Sahana as a whole.

Overview of "TriagePic" - Specialized Input Source To LPF

Currently, in disaster drills at Suburban Hospital, victims that arrive at the hospital's perimeter triage station have their picture taken, a mass disaster ID assigned (NOT the same as a regular admitted-patient ID), and a routing quickly assigned to a colored zone (e.g., green, yellow, red, gray) based on severity. Specifically, a Polaroid is taken and a colored sticker, with ID number, peeled from a sheet. Because time is of the essence, little info is collected at this station, only:

picture(s)
ID (auto-assigned)
gender
child vs adult

A new Windows app, TriagePic, will replace this process (probably collecting name as well). Written in C#/WinForms, TriagePic runs on a laptop at the triage station. It receives photos wirelessly transmitted from a digital camera (e.g., via Bluetooth), and quickly associates them with mass disaster IDs. Once the photos and information for a new arrival are collected, they are immediately sent by email (in various formats) to designated recipients (e.g., hospital staff), including the LPF/Sahana system. This is seen as one input source to the LPF database, to pre-identify “found” injured people.

Currently, two types of per-patient email, namely anonymized and non-anonymized, are generated for different lists of recipients. The anonymized email has less information (e.g., no photos). The non-anonymized output has an email body and attached .jpg photo(s). It also has several text attachments: a human-readable “boilerplate” legal statement, and per-patient information in PFIF (http://zesty.ca/pfif/1.1) and “Native LPF” formats. The latter two are XML files. Native LPF format has a “distribution envelope” surrounding a payload. The envelope is in Oasis EDXL-DE format (see also Open-DM). The payload is derived from “PTL” format. PTL refers to a prototype “Patient/Tracker Locator”, developed during 2005-7 by RTI, Inc, Research Triangle Park, NC, under contract to the U.S. government Agency for Healthcare Research and Quality (AHRQ). The format incorporates elements from a number of pre-existing standards.

Project Personnel

LPF is being developed in the Communications Engineering Branch (CEB) of the Lister Hill National Center for Biomedical Communications (LHNCBC), the R&D arm of NLM.