• MARCH 2008 FEATURE ARTICLES •
From the Editor
In Defense of a Nation
By Michael McBride, Editor-in-Chief
Healthcare professionals prepare for all types of disaster. ED physicians and first responders plan for mass-casualty events. IT directors plan for network recovery after system failure and data loss. Operations directors consider how to keep hospitals going when Internet access, supplies and power become limited or non-existent. C-level executives examine the overall repercussions and ensure continuity of the business during disaster and its aftermath.
On Oct. 18, 2007, President Bush issued the
"Homeland Security Presidential Directive 21 (HSPD-21)," which
builds on principles laid down in "Biodefense for the 21st
Century," a roadmap for protecting America against bioterrorism,
released by the White House in 2004.
HSPD-21 transmutes the latter, primarily intended to counter
biological attacks, and combines it with principles drawn from
two other national strategies to form a "National Strategy for
Public Health and Medical Preparedness," which provides
directives that organizations should use to prepare for all
types of disasters, including floods, fires, hurricanes and
earthquakes, as well as terrorism. The key principles include:
"Preparedness for all potential catastrophic health events;
vertical and horizontal coordination across levels of
government, jurisdictions and disciplines; a regional approach
to health preparedness; engagement of the private sector,
academia, and other nongovernmental entities in preparedness and
response efforts; and, the important roles of individuals,
families and communities." It's a comprehensive directive and
well worth your time to read.
Among the 20 or so key strategies scheduled to come to fruition
in 2008, is the "implementation of, a plan to use current grant
funding programs, private payer incentives, market forces,
Center for Medicare and Medicaid Services requirements, and
other means to create financial incentives to enhance private
sector health care facility preparedness in such a manner as to
not increase health care costs." Haven't we been doing this all
along?
Another key strategy includes the creation of the Office for
Emergency Medical Care (Office) within the Department of Health
and Human Services (HHS). Its job will be to "promote" — through
funding — research to enhance and improve our EDs, triage,
distribution and disaster preparedness. The Office will analyze
the entire continuum of care in order to make its
recommendations to the HHS Secretary. It will also "coordinate
with existing executive departments and agencies that perform
functions relating to emergency medical systems in order to
ensure unified strategy, policy and implementation." It's the
latter statement that has me concerned. How will the government
"ensure" all this, I wonder.
Regardless, many of the HSPD-21 strategies involve the promotion
or implementation of some form of information technology, which
will no doubt drive standardization, and which should be a boon
to our industry, enabling the growth of regional health
information organizations, and, enabling the National Health
Information Network to finally come into existence.
What do you think? I'd like to hear from HMT's readers on
this issue. Is the government preparing to "federalize" our
hospital emergency systems and departments, and if so, what
effects do you think this will have on healthcare in America?
You'll find links to both directives at the bottom of the online
version of this editorial on HMT's Web site. E-mail me
your thoughts and we'll post them online and in eNews, HMT's
electronic newsletter.
HOMELAND SECURITY PRESIDENTIAL DIRECTIVE/HSPD-21
BIODEFENSE FOR THE 21st CENTURY