Obtaining and Maintaining Local Interoperability

In June 2001, the federal government held a tabletop terrorism exercise, known as Dark Winter, involving a simulated smallpox attack. In the exercise, the spread of the smallpox and its morbidity and mortality were charted. In testimony to Congress on July 23, 2001, Margaret Hamburg, M.D., former assistant secretary for planning and evaluation at the Department of Health and Human Services (DHHS) stated (Committee on Government Reform 2001):

Dark Winter…demonstrated how poorly current organizational structures and capabilities fit with the management needs and operational requirements of an effective bioterrorism response. Responding to a bioterrorist attack will require new levels of partnership between public health and medicine, law enforcement and intelligence. However these communities have little past experience working together and vast differences in their professional cultures, missions and needs.

The solution to eliminating this void in interagency cooperation is to work toward achieving interoperability on local, county, and state levels and to coordinate with federal agencies.

An early example of military interoperability was the Blitzkrieg plan, or “lightning war,” used successfully by the Germans in the early years of World War II. During the years between World War I and World War II, the German General Staff developed a doctrine and tactics that combined the infantry, armor, artillery, and support units with the air force, creating one striking force aimed at the enemy. The U.S. military learned from this example and successfully organized integrated techniques in all of its military services that eventually destroyed Germany’s ability to wage war. The allied troops’ D-Day invasion assembled the mightiest armada of ships, planes, and soldiers in history; it was organized by flag officers and involved troops from many countries. Working together as one unit, they forced their way onto the continent and eventually liberated Europe.

The EMS of the United Kingdom’s Ministry of Health, not to be confused with the American EMS, was among the first examples of medical interoperability. During the incessant German bombing of World War II and the attacks by V-1 and V-2 rockets, the British EMS functioned as a planning, control, and operational program that integrated the casualty plan with the various components and levels of healthcare, from first aid to tertiary care and rehabilitation. London, for example, was divided into ten hospital sectors radiating from the city center outward, like a wagon wheel, into the surrounding counties. This organization was fully coordinated with first responders and civil-government authorities. The entire country had an EMS organization based on 12 national regions (Shirlaw 1940; Dunn 1952).

Interoperability is the effective interfacing of all medical and ancillary service providers (e.g., hospitals, public health agencies, emergency medical services [EMS], pharmacies, and medical suppliers) with public safety agencies (e.g., fire, rescue, and police services), Red Cross, Salvation Army, communications centers, public works, and utility companies. These agencies, in turn, must coordinate with political leadership and the media. To be effective, this all-encompassing effort requires each agency to deliberately and rigorously act to identify the strengths, weaknesses, opportunities, and threats (also known as a SWOT analysis) in their community and among themselves. Finally, the agencies must determine the best use of each other ’s assets for disaster mitigation, preparedness, response, and recovery in various disaster scenarios. This description of interoperability goes far beyond the usual use of the term by public safety agencies, which often simply define it as the ability to communicate—by radio or other means— with each other. While this ability is key to successful interoperability at the scene of a disaster, it is the planning and integration of services that precede the disaster that result in an effective response.

Popular Posts