How communities can better prepare for post-emergency telehealth deployments

On December 10 and 11, 2021, a series of major tornadoes devastated the south and lower midwest. A bend broke 200 miles in one fell swoop in Kentucky. The total death toll was at least 90.

Dawson Springs, Kentucky, is a city of about 2,700 people. The initial list of missing persons was about eight pages, in a single space.

Communities are facing increasingly destructive unnatural disasters: catastrophic wildfires and fears of earthquakes on the west coast, tornadoes in the midwest, hurricanes and floods on the Gulf and east coasts, and an occasional freezing of New England.

At first glance, some might think that talking about telehealth is not logical here. But what is telehealth? Rather than making videos with doctors, she uses Internet and intranet technologies to facilitate many medical activities associated with the health and well-being of her body and mind. Telehealth is either real-time appointments, some variation of storage and forwarding data exchange, or digitized medical knowledge.

Telehealth disaster solutions are obviously an inaccurate science, but there are many components that can make powerful solutions. Next year, the federal government will release billions for broadband, telehealth, and healthcare, so now is a good time to formulate some disaster recovery strategies driven by telehealth and broadband. as long as there is money, even as pilot tests.

In general, a natural disaster has at least three phases: 1) the initial impact is often unpredictable when everyone is hiding or running for their loved ones, 2) the immediate response and assessment of harm to people, and 3) the slow recovery path. to normal. The many variations of telehealth can affect these phases.

Expanding the reach of those responsible

The first culprits have the lion’s share of immediate medical responses when disasters occur. They have equipment that helps those responsible for the intervention to communicate with hospitals, clinics, etc., so that they can choose and manage injuries. Paramedic vehicles are being equipped with more powerful wireless technology to facilitate the treatment of patients en route to hospitals.

In many parts of the country, cities are customizing recreational vehicles, vans, buses and ambulances with telemedicine tools, expanded medical capabilities and wireless connectivity to bring health care directly to neglected populations in particular and parts of the general public.

For example, Flagstaff, Arizona, has a mobile medical unit called the Big Orange Bus that visits shelters, schools, and businesses for the homeless.

One of the advantages of these vehicles is that there is a trust created between the community and the participants that facilitates people management and health during disasters. Also, these programs dedicated specifically to telehealth are more versatile with people receiving a wide range of treatments and consultation, possibly in residences or sheltered places. Communities may want to increase these mobile units.

Creation of emergency telehealth centers

There are many places in the U.S., urban and rural, where a major disaster can cut off electricity for a week or two while leaving highways and streets unused for a month. In Bowling Green, Kentucky, there were 12,000 homes without electricity at the time of writing, more than 500 homes and dozens of businesses were destroyed.

Before a disaster strikes, consider designating several buildings across the city (libraries, auditoriums, gyms) as “generating and telehealth areas” where you can move around with the right equipment and telehealth kiosks. Use them for Store & Forward telehealth applications for the homeless, electricity and / or Internet access. Bring telehealth kiosks for real-time treatments and mental health sessions.

Make pre-arrangements with hotels, college dorms, warehouses, other facilities where you can bring generators, computers, telehealth equipment, and wireless (private) intranets. Use these buildings if they survive the disaster for elderly people with health problems who have been displaced, people with chronic illnesses and patients with non-serious disaster injuries if these residents do not have easy access to other residential or health centers.

Low-income urban residents seem to easily forget when a disaster strikes. When Hurricane Katrina crashed in New Orleans in 2005 and caused more than 1,800 deaths, it was also one of the most epic public health failures in U.S. history, as these images show. It was months before slums recovered from broadband, if they ever did.

Learning from the lesson, cities should take money from broadband and health care, build emergency health care facilities in public housing facilities in times of disaster, and take advantage of technology in normal times. .

A broadband base

We accept the obvious: if homes and buildings are destroyed, telehealth will be questionable depending on how long the batteries of computer devices and telephones and the infrastructure that conducts electricity last. Quality and speed if you have a community broadband network have a big impact on the ability of your technology to survive a disaster and get back on the line quickly.

Our network provides broadband and private connections to several 911 centers in northern Georgia, “said David Little, vice president of network operations for the North George Network. Both data and electricity are immediately redirected by floods or other damage anywhere on the network These networks rarely have downtime, despite disasters.

Communities need to take charge of their digital destiny. More cities and towns have the opportunity to build the best. Telehealth stakeholders should be involved in their city’s broadband or digital efforts, or at least a community broadband initiative to support telehealth and disaster response.

Grayson, Kentucky has a population of 4,217. They are using their federal funds American Rescue Plan Act to build a huge 100 gigabit per second network (upload and download speeds) that feeds every home. That is an estimated 100,000 novels written. Per second!

Grayson and many other communities in Kentucky and elsewhere dodged a serious bullet. Some are working hard to put their digital and broadband homes in order. Innovations are coming down such as continuous monitoring medical devices and artificial intelligence “health trainers” that will help communities weather storms.

“Public access to telehealth in our community will be light years away,” says Duane Suttles, Grayson’s city secretary. “In the event of a natural disaster, once emergency power supply is established, access to 1 gigabit fiber for each building will allow emergency services to greatly improve medical treatment in the field and at home when the transport may be delayed due to closed roads and bridges. “

Saved from a stroke by telehealth, Craig Settles pays for it by uniting community broadband teams and health workers through telehealth and broadband integration initiatives. Follow him on Twitter @ cjsettles101.

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