HIMSS19: Open Source Software for Disaster Preparedness and Response

Although not officially listed as a track at the HIMSS19 conference, there are a series of very important presentations on the use of open source software for disaster preparedness and response. This is a critical topic that we have covered extensively in Open Health News. As we detailed in this article, there was a major failure in being able to provide victims of Hurricane Harvey, as well as Hurricane Irma and Hurricane Maria with access to their medical records. Few emergency medical responders could access their records either. The two success stories that came out of the hurricanes were two open source electronic health record (EHR) systems, OpenEMR, and the VA's open source VistA EHR.

President Donald J. Trump, California Governor Jerry Brown, Governor-elect Gavin Newsom, FEMA Administrator Brock Long and Paradise, Calif., Mayor Jody Jones, survey fire damage to Paradise. Credit Shealah CraigheadThe failures in health information technology and interoperability is what led Jared Kushner and Seema Verma to start a series of meetings and discussions on how to fix the interoperability and medical record exchange crisis. This led to the Blue Button 2.0 Developers conference at the White House in August of last year.

One of the most important of those sessions of the HIMSS19 conference will be Cloud Providers: Addressing the Barriers to Interoperability in Healthcare. That session, to take place at 1 pm, is going to be moderated by Hal Wolf, President & CEO of HIMSS and will include Peter Lee, VP of Microsoft and their chief health IT strategist, Aashima Gupta, director, Global Healthcare Solutions for Google Cloud, and Mark Dudman representing IBM. As we detailed in our article Tech Giants Back White House Open Source Health IT Initiative stepped forward to publicly support the White House open source and free market health IT strategy. This session should be very interesting.

Below we list the most important sessions related to disaster preparedness and response. Wew will have more to say in future articles. Our Open Health News Guide to the HIMSS19 conference will be updated regularly throughout the conference with additional content.

Tuesday

PULSE: A Health IT Disaster Response Platform

When disaster strikes and families are relocated to shelters in their community or even further afield, prescription refills and other healthcare needs become more challenging. The Sequoia Project is leading the Patient Unified Lookup System for Emergencies (PULSE), a nationwide health IT disaster response platform that can be deployed at the city, county or state level to authenticate disaster healthcare volunteer providers. It was conceived by the Office of the National Coordinator for Health IT (ONC) and the Office of the Assistant Secretary for Preparedness and Response (ASPR) following experiences in Hurricanes Katrina and Sandy. Well-meaning physicians and providers flocked to shelters to help, but the shelters could not confirm medical credentials of the volunteers, and the volunteers could not access evacuee health records. Learn how your community can leverage health IT and existing connectivity in your disaster planning.

• Leslie Witten-Rood, MA, Program Manager, California EMS Authority
• Mariann Yeager, Chief Executive Officer, The Sequoia Project

Defeat Nation State Actors Stalking the Healthcare Sector

Retired Brigadier General Greg Touhill, the first Chief Information Security Officer of the United States government and current president of the Cyxtera Federal Group, will discuss the current cyber threat environment; the tactics, techniques, and procedures used by nation state actors and cyber criminal groups to threaten organizations; why the health care environment is at high risk; and what the health care sector should do to better manage their risk.

• Greg Touhill, President, Cyxtera Technologies

Wednesday

HIE Emergency Preparedness and Response: RSVPs from Florence and Michael

HIEs have served their communities well during times of crisis this past year. Learn how the Georgia Regional Academic Community Health Information Exchange (GRAChIE) and Alabama's State HIE Program, One Health Record, supported Hurricane Florence and Michael victims by making their health records available at evacuation sites. Find out how these HIEs helped deliver coordinated care to patients impacted by these natural disasters. Access to health information is critical during emergencies, and HIEs are delivering patient records during our country's most vulnerable situations.

• Gary Parker, Chief Data Officer, Alabama Medicaid Agency
• Tara Cramer, Executive Director, GRAChIE

Wearables, Sensors and the Digital First Responder

From First Responders in natural disasters to the digital hospitals of tomorrow, advances in wearables, sensors and next-gen technologies are reshaping speed and quality in the clinical enterprise. Hear real-world examples of changes in emergency management, training, and the digital hospital.

• David Metcalf, PhD, Director, UCF Institute for Simulation and Training, UCF
• Roger Smith, CTO for Research, Florida Hospital, Nicholson Center

 Adapting Guidelines for Emergencies in the Digital Age

Operationalizing clinical decision support (CDS) from clinical guidelines is challenging and particularly difficult during emergencies when recommendations are often developed in real time. This is an overview of a CDC-led, multi-stakeholder initiative, Adapting Clinical Guidelines for the Digital Age. This initiative aims to redesign the guideline development process to better enable representation in CDS and help apply scientific evidence in patient care more easily, quickly, accurately, and consistently. In the case of emergency preparedness, based on the redesigned process, we are developing CDS for post-exposure prophylaxis to anthrax in the event of a bioterrorism attack. The speakers will discuss the approach, issues with integrating multiple guidelines and translating them into machine-readable language, piloting the CDS, steps required for local systems integration and lessons learned for future use and iterative improvement of the redesigned clinical guidelines development process.

• Maria Michaels, Public Health Advisor, Centers For Disease Control & Prevention
• Sharon Pacchiana, APRN-BC, FACHE, Principal Health Systems Analyst, Health Informaticist, The MITRE Corporation

Thursday

Cloud Providers: Addressing the Barriers to Interoperability in Healthcare

In 2018, a coalition of technology giants took the stage at the CMS Blue Button 2.0 Developer Conference, pledging to remove "barriers for the adoption of technologies for healthcare interoperability, particularly those that are enabled through the cloud and AI." HIMSS CEO Hal Wolf will build on this robust conversation at HIMSS19 by exploring the progress several leading providers of cloud solutions have made since the initial pledge and discuss the strategies needed to achieve the goal of a frictionless exchange of healthcare data in today's global health ecosystem.

• Aashima Gupta, Director, Global Healthcare Solutions, Google Cloud,
  Google, Inc
• Hal Wolf, HIMSS President & CEO, HIMSS
• Mark Dudman, VP, Development Watson Health, IBM
• Peter Lee, Corporate Vice President, Microsoft Corporation

Health IT in Emergency Preparedness and Response

The current threat environment faced by our nation requires US Department of Health and Human Services (HHS) to adopt 21st-century approaches to protect the health security of Americans, especially in regards to accessing and coordinating the use of health data. This session will highlight three HHS initiatives (emPOWER, PULSE, and PCORT) that exhibit how HIT can be utilized in disaster and other emergencies to save lives.

• Kristen Finne, Senior Program Analyst, HHS/ASPR
• Leremy Colf, Ph.D, Director, Disaster Science, HHS/ASPR

Deploying a Disaster Response HIE Platform: PULSE California

The Patient Unified Lookup System (PULSE) for our patients is a web application that connects existing health information exchange organizations and other data sources to be used explicitly during disaster scenarios. PULSE was developed through funding and oversight from the Office of the National Coordinator for Health IT (ONC) and the California Emergency Medical Services Authority (Cal EMSA). It was originally deployed in July 2017 and has been activated twice for wildfires in California.

• Leslie Witten-Rood, MA, Program Manager, California EMS Authority
• Robert M. Cothren, PhD, Executive Director, California Association of HIEs

Medical Device Cybersecurity Incident Preparedness/Response

The healthcare sector knows how to prepare for and respond to natural disasters; it is less prepared to handle cybersecurity incidents. Global cyberattacks like WannaCry have highlighted the need for more robust cybersecurity preparedness to ensure a real-time response that enables continuity of clinical operations. The FDA, in partnership with the MITRE Corporation, has championed two initiatives to improve medical device cybersecurity incident preparedness and response: (1) the development and use of a medical device cybersecurity sandbox to enable security research and technical evaluation of medical device vulnerabilities and potential mitigations across Health Delivery Organizations (HDOs), medical device manufacturers and the FDA, and (2) the development of a regional medical device cybersecurity incident preparedness and response playbook. This session will explain medical device cybersecurity preparedness and response challenges and describe the sandbox and playbook initiatives.

• Suzanne B. Schwartz, MD, MBA, Associate Director for Science & Strategic Partnerships, Food and Drug Administration (FDA)
• Margie Zuk, MS, Senior Principal Cybersecurity Engineer, The MITRE Corporation

State Policy Learning Lab: Bridging the Gap: Health IT Policy Strategies to Connect the Spectrum of Care During Emergencies

Join us to share state/local opportunities to influence the policy process for improving health outcomes through cross-sector data sharing and interoperability during natural disasters and health emergencies.