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Practice Correctly, Perform Correctly

Pat AndersManager, Health Emergency Preparedness ExercisesOffice of Health Emergency Preparedness

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Informational Webinar

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Background

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Background of IOC Drills• The U.S. Department of Health and Human Services (HHS)

and CDC identified biannual Interoperable Communications (IOC) Drills as priority exercises for Local Health Departments and healthcare partners for 2019-2024.– New York State Department of Health has been conducting IOC

drills since 2010

• Communications systems should be implemented based on State and local plans.

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Today’s Objectives

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Briefing Objectives• Understand the background and rationale for the

IOC Drills

• Understand the capability tested and the objectives of the exercise

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Capability To Be Tested

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Capabilities

• Information Sharing– Interoperable

Communications Drills

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Performance Measures• Allows National Hospital Preparedness Program to

objectively track HEPC performance in:– Engagement, coordination, communication, patient load-

sharing, & continuous learning

• 28 Total Performance Measures developed– 8 performance measures linked to Coalition Surge Test

(CST); IOC drill will be integrated into CST and achieve 2 additional performance measures

• Performance measures integrated into HERDS survey

10# Performance Measure Data Point

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PM12: HCCs that have drilled their redundant communications plans and systems and platforms at least once every six months.

Drill #1:What is the status of this drill?

If "completed" or "scheduled," input the date (mm/dd/yyyy):

(Note**: if not scheduled yet, enter 00/00/0000)

If "completed" or  "scheduled," input the date (mm/dd/yyyy):

(Note**: if not scheduled yet, enter 00/00/0000)

10/9/2018

04/11/2019

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PM13: HCC member organizations that responded during a redundant communications drill by system and platform used.

Primary communication system used by the HCC during the drill and number of core and additional member organizations responding.

Select primary communication system used:

Drill #1:

Telephone (landline, fax, Government Emergency Telecommunications Service)Internet (cable, fiber‐optic, VOIP)Radio (Land Mobile Radio system, amateur, two‐way)Cellular (text, calls, data, pager, Wireless Priority Service)Satellite (phone, data)

Drill #2:

Telephone (landline, fax, Government Emergency Telecommunications Service)Internet (cable, fiber‐optic, VOIP)Radio (Land Mobile Radio system, amateur, two‐way)Cellular (text, calls, data, pager, Wireless Priority Service)Satellite (phone, data)

Total number of core member organizations responding (digits only)

Drill #1: Drill #2:

Total number of additional member organizations responding (digits only)

Drill #1: Drill #2:

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PM13: HCC member organizations that responded during a redundant communications drill by system and platform used.

Backup communication system used by the HCC during the drill and number of core and additional member organizations responding.

Select all that apply and input number of member organizations responding:

Drill #1:

Telephone (landline, fax, Government Emergency Telecommunications Service)Internet (cable, fiber‐optic, VOIP)Radio (Land Mobile Radio system, amateur, two‐way)Cellular (text, calls, data, pager, Wireless Priority Service)Satellite (phone, data)

Drill #2:

Telephone (landline, fax, Government Emergency Telecommunications Service)Internet (cable, fiber‐optic, VOIP)Radio (Land Mobile Radio system, amateur, two‐way)Cellular (text, calls, data, pager, Wireless Priority Service)Satellite (phone, data)

Total number of core member organizations responding (digits only)

Drill #1: Drill #2:

Total number of additional member organizations responding (digits only)

D ill #1 D ill #2

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Benefits of Drills• Designed to help Health Emergency Preparedness

Coalitions (HEPC) partners ensure that they have redundant forms of communication among their members. – Refers to having multiple back-up communication

modalities, and is critical to emergency preparedness planning.

• Cell phones, satellite phones, HAM radios, VOIP, HCS• Landlines and fax machines were not utilized in the drill

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Past as Prologue• Past exercise and real-world events

demonstrate that health care coalitions cannot depend on just one or even two means for communication.– Corrective actions from previous exercises and real-

life events– HPP requirement of two drills per year

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Interoperable Communications DrillExercise Conduct

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Objectives for All Partners• Health Care and Medical Response Coordination

and Information Sharing• Demonstrate the ability to use a primary and back-up

communications system (internet – including VOIP, radio, cellular, and satellite) to communicate with coalition partners (LHD, hospitals, EMS, EM, and other partners).

• Complete the NYSDOH Health Commerce System (HCS) Health Emergency Response Data System (HERDS) survey within the timeframe outlined in the IHANS alert.

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HEPCRegional Office

Other Healthcare Partners +

IOC Drill

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Exercise Communications

• The primary means of communications was cell phone– Text, VOIP, email, radios were used

• Similar to previous IOC drills– IHANS alert, text, cell phone alerts

• Directed recipient to email to access the link to the HERDS survey

• Complete and submit survey

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So – How Did This Happen?

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IOC Drill #1• Drill #1 – 8/16/19 as a component of Crimson

Contagion– Inclusive of multiple partners (LHDs, nursing homes,

adult care facilities, community health centers, homecare, hospice)

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Exercise Scenario • Crimson Contagion

– Federal exercise with CDC, HHS, and numerous other Federal agencies, and nine states

– Occurred in August, 2019– IOC Drill #1 was conducted the week of

August 12-16, 2019– International influenza outbreak of H7N9

• US cases identified in June and July linked to travelers from Tibet or China

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Exercise Participants• Local health departments• Hospitals• Emergency Managers• EMS• Home Care• Nursing Homes• Community Health Centers• Adult Care Facilities• Hospice

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IOC Exercise Algorithm0900 STARTEX

• 0830 STARTEX – August 16, 2019– NYSDOH Office of Health Emergency Preparedness (OHEP)

Central Office (CO) sent email to Regional Offices (ROs), including message for an IOC Drill alert (voice alert to text, cell and email).

– ROs provided with the roles to which to send the IHANS alert. Additional roles added at the discretion of the RO.

• Hospitals, Local Health Departments, and non-acute healthcare providers alerted via phone, text, and email.

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IOC Exercise Algorithm• Regional Phased Distribution

– 9:00 – 10:00 am Capital District sent alert– 10:00 – 11:00 am Central New York sent alert– 11:00 – 12:00 pm Western New York sent alert– 12:00 – 1:00 pm MARO sent alert to both Lower

Hudson Valley and Long Island– 2:00 – 3:00 pm OHEP sent alert to NYC

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IOC Exercise Algorithm• ROs sent IHANS alert to coalition members with details of

scenario via phone, text, and email, directing partners to HERDS survey on Health Commerce System (HCS) with name of drill survey (IOC Drill 8-16-19).

• Phone and text alerts directed partners to check their emails.

• Email alert directed all HEPC members to complete HERDS survey within 4 hours.

• If coalition members did not have access to HCS, ROs determined different mechanism to get message out.

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Within 6 hours• ROs collected responses to HERDS Survey

• RO reported back to CO the number/types of partners reached

Element of Completion

• Hospitals - complete HERDS survey.

• LHDs – complete HERDS survey and provide IHANS Completion Report with end of quarter reporting.

• Non-Acute Partners – complete HERDS survey and document in a streamlined After-Action Report/Improvement Plan.

• HEPCs – report of completion status, # and types of coalition partners reached to Pat Anders.

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IOC Drill #2• Drill #2 – between February and April, 2020

– Five regional drills• Low-notice - Two week timeframe• Will not know exact date

– Inclusive of multiple partners (LHDs, nursing homes, adult care facilities, community health centers, homecare, hospice)

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Exercise Scenario• Will be conducted in parallel with the Coalition Surge

Test (CST) exercise.• All five regions are using severe weather.• One survey for all organization types.• Collect Essential Elements of Information.

– Federal requirements– Establish baseline information NYSDOH would collect in

any type of event• IHANS notification in email will note name of HERDS

survey to access on the Health Commerce System.

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CliffsNote Version of CST• CST

– Tests Coalition’s ability to:• Respond to a LOW / NO-Notice exercise – within a

two week window• Focuses on the following patients for evacuation to

staffed acute care beds– Long-term care - Pediatric– General med/surge - NICU– ICU - Labor and Delivery– Psychiatric

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CliffsNote Version of CST• CST

– Tests Coalition’s ability to:• Find clinically appropriate beds for evacuating patients

with the assistance of other coalition members• Uses a simulated evacuation (no actual patient

movement) of hospitals– Evacuating facilities (collectively representing 20% of a

Health Care Coalition's acute-care bed capacity) enlist the help of other coalition members to find safe destinations for their patients/arrange transportation.

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CliffsNote Version of CST• CST

– Tests Coalition’s ability to:• Communicate & coordinate with medically appropriate

transportation • Identify essential elements of information that helps

inform situational awareness among HEPC members and partners

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IOC Exercise Algorithm• ROs will send IHANS alert to coalition members with

details of scenario via phone, text, and email, directing partners to HERDS survey on Health Commerce System (HCS) with name of drill survey

• Phone and text alerts will direct partners to check their emails.

• Email alert directs all HEPC members to complete HERDS survey within 4 hours.

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Documentation• Simplified After-Action Template available

• Can count this towards CMS Emergency Preparedness Exercise Requirements

• Maintain documentation on-site for 3 years

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Reminders for Successful Exercise• Ensure Communications Directory on the Health

Commerce System is current and accurate

• Ensure back-up staff available

• Remember to Submit HERDS survey when complete!

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Questions

patricia.anders@health.ny.gov