The U.S. Needs a Disaster Health Response System to Save Lives After an Emergency

Bombings, multi-country cyberattacks, severe natural disasters and deliberate chemical attacks reflect the real and complicated threats our nation faces in the 21st century. To save lives, the nation’s health care systems must be ready. Combating modern threats requires innovative solutions to train, equip, and organize our health care systems in ways that make our local communities more resilient.

The U.S. Department of Health and Human Services’ Assistant Secretary for Preparedness and Response – ASPR – advocates for using established investments in health care preparedness and trauma systems to serve as the foundation of a new, “regional disaster health response system.” 

This approach builds on existing health care coalitions – more than 28,000 health care businesses, emergency medical services, state public health agencies and local health departments across the country that work together with funding and guidance from ASPR’s Hospital Preparedness Program. The regional disaster health response system will expand this public-private partnership, adding trauma centers, burn centers, pediatric hospitals, public health labs, outpatient services, and federal facilities like Veterans Affairs clinics to better meet the health care needs of the public in a disaster.

The system will take a tiered approach, much like trauma care is handled across the country. HHS used trauma care as a model for the tiered approach to Ebola treatment and identified frontline hospitals, assessment hospitals, regional treatment centers, and national treatment centers. A regional disaster health response system combines the best of the health care coalition approach with this tiered model, thereby building coordinated capabilities for all types of disasters by expanding the concept beyond diseases to include readiness for chemical, biological, and radiological attacks.

While it may be counterintuitive in the highly competitive health care industry, collaborating to meet demand in a crisis is essential to saving lives. Consider the stress already placed on emergency departments:  more than 141 million people visit U.S. emergency departments each year; 50 percent of emergency departments operated over capacity, and 500,000 ambulances are diverted each year from the nearest hospital due to emergency department overcrowding. Disasters place additional stress on these already overwhelmed community resources. Collaborating during large-scale emergencies to distribute the patient load could mean the difference between positive or negative patient outcomes. 

To meet anticipated needs for health care during disasters, particularly those involving chemical, biological or radiological weapons, a regional disaster health response system could provide impacted communities with mutual aid – doctors, nurses, and other health care workers from health care facilities in other communities or other states. Today, concerns about medical licensing and liability slow the process. The regional system would coordinate the medical response in the region, providing training, equipping health care facilities, and breaking down licensing and liability barriers that impede response and recovery to make more providers and care available faster.

Many steps are needed to create this system. Building disaster readiness is a shared responsibility. The federal government must provide adequate incentive funding and guidance, but state governments must have licensing agreements in place. Every state and U.S. territory needs laws in place, such as the Uniform Emergency Volunteer Health Practitioners Act, to allow people with medical licenses (doctors, nurses, EMS, etc.) to work in different states during emergencies, much like federal responders from the National Disaster Medical System can. Health care facilities also need plans to incorporate surge personnel.

Health care workers need specialized training to provide medical care safely and effectively for all hazards. ASPR has made significant investments in a National Ebola Training and Education Center to provide training (with no tuition costs) for highly infectious diseases like Ebola. The regional disaster healthcare response system will expand that training to other modern health threats including the medical trauma caused by chemical, biological, radiological or nuclear weapons. 

To save lives in the face of modern health threats, hospital systems and other healthcare entities must step up their engagement in healthcare readiness. As recent hurricanes and other large-scale emergencies show, being able to function effectively in a crisis provides a competitive advantage. A regional disaster health response system makes sense for businesses; the approach allows healthcare facilities to provide care when staff and other resources are scarce and keeps facilities from being overwhelmed. Most importantly, a regional disaster health response system can help save lives when every moment counts.

Robert Kadlec, M.D., is the Assistant Secretary for Preparedness and Response at the Department of Health and Human Services.