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Communication Systems
Topic Collection
September 20, 2018

Topic Collection: Communication Systems

Robust communication systems can allow first responders and medical professionals to maintain communication after a disaster. Back-up systems should be established based on best practices and tested regularly. The resources in this Topic Collection include promising practices, reports, evaluations, and overviews of programs focused on creating and maintain resilient emergency communication systems.

Each resource in this Topic Collection is placed into one or more of the following categories (click on the category name to be taken directly to that set of resources). Resources marked with an asterisk (*) appear in more than one category.

Must Reads


Bellini, P., Boncinelli, S., Grossi, F. et al. (2013). Mobile Emergency, an Emergency Support System for Hospitals in Mobile Devices: Pilot Study. JMIR Research Protocols. 2(1): e19.
The authors discuss communicating among medical personnel during disasters and highlight findings from the use of a mobile emergency application (which is not available anymore) and server device to cope with emergencies and facilitate all the related activities and communications (e.g., tracking patients, contacting others, and guiding medical personnel with help from the command center). The research was conducted in Italy, but may be useful to healthcare practitioners and planners in other countries to suggest system features or development ideas.
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European Union of General Practitioners. (2013). Report on Health Care Professional Communication Requirements.
This EU based research report discusses the needs and methods for communicating to health professionals in epidemic situations, based on challenges in reaching all of these professionals during the 2009 H1N1 outbreak.
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Radio Amateur Civil Emergency Service. (2006). RACES Library: Amateur Radio Emergency Network for Hospitals.
The resources on this page provide an overview of the program, history of the program, standard operating procedures for hospital disaster teams, and two training resources (one for hospital staff and another on message handling).
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SAFECOM and the National Council of Statewide Interoperability Coordinators. (2015). Emergency Communications Governance Guide for State, Local, Tribal, and Territorial Officials.
This guidance document lays out governance challenges, best practices, and recommendations for emergency managers at all levels to use in assessing, establishing, and maintaining communications governance. The document includes on the government landscape; charters, bylaws, and memorandum of agreement; the key elements of a governance body; and components of inter and intrastate local governance bodies.
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Amateur/Ham Radio Resources


This list of frequently asked questions can help hospital staff understand the use of ham radios as an alternative when traditional communication tools fail (e.g., during a disaster). While the information is specific to operators in Orange County, California, it can be applied by others across the country.
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Hospital Disaster Support Communications System. (2016). Hospital Disaster Support Communications System.
The Hospital Disaster Support Communications System (HDSCS) is a group of volunteer Amateur Radio ("ham") operators who are available to provide backup internal and external communications for critical medical facilities in Orange County, California when necessary. HDSCS has been operational for more than 35 years; their website includes links to relevant resources.
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Kent County Radio Amateur Civil Emergency Service. (2016). Hospital Communications.
This page is home to the Kent County HosCom, the amateur radio link between emergency services in Kent County, Michigan. It is a free service that, when enacted, supports federal, state, and local agencies (including healthcare facilities) with backup communication tools.
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The author emphasizes the importance of emergency preparedness for amateur radio operators who support medical facilities.
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Radio Amateur Civil Emergency Service. (2006). RACES Library: Amateur Radio Emergency Network for Hospitals.
The resources on this page provide an overview of the program, history of the program, standard operating procedures for hospital disaster teams, and two training resources (one for hospital staff and another on message handling).
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Applications and Technology


Bellini, P., Boncinelli, S., Grossi, F. et al. (2013). Mobile Emergency, an Emergency Support System for Hospitals in Mobile Devices: Pilot Study. JMIR Research Protocols. 2(1): e19.
The authors discuss communicating among medical personnel during disasters and highlight findings from the use of a mobile emergency application (which is not available anymore) and server device to cope with emergencies and facilitate all the related activities and communications (e.g., tracking patients, contacting others, and guiding medical personnel with help from the command center). The research was conducted in Italy, but may be useful to healthcare practitioners and planners in other countries to suggest system features or development ideas.
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Bouri, N. and Ravi, S. (2014). Going Mobile: How Mobile Personal Health Records Can Improve Health Care During Emergencies. Journal of Medical Internet Research-mHealth. 2(1):e8.
This article describes personal health records (PHRs) and their utility in disaster situations. It contrasts the instant availability of PHRs against the electronic medical record/health records that require 3rd party (provider) routing.
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Chatfield, A., Wamba, S., and Kirokasu, T. (2010). E-Government Challenge in Disaster Evacuation Response: The Role of RFID Technology in Building Safe and Secure Local Communities. Hawaii International Conferences on System Sciences (HICSS), Electronic Government, Emerging Topics.
This position paper, which is based on a review of the literature and a field case study, discusses the strategic value of integrating RFID into e-government development and government's comprehensive natural disaster management policy for improved preparedness, response, recovery, and mitigation.
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Gao, T., Pesto, C., Selavo, L., et al. (2008). Wireless Medical Sensor Networks in Emergency Response: Implementation and Pilot Results. (Abstract only.) Technologies for Homeland Security IEEE Conference.
This presentation demonstrates the feasibility of using cost-effective, flexible, and scalable sensor networks to address critical bottlenecks of the emergency response process in lieu of manual vital measurements, paper documentation, and radio communication.
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Gao, T., Pesto, C., Selavo, L., et al. (2008). Wireless Medical Sensor Networks in Emergency Response: Implementation and Pilot Results. (Abstract only.) Technologies for Homeland Security IEEE Conference.
The presenters demonstrated the feasibility of using electronic medical information tags to track patients through the disaster response process. They also reviewed positive results from two pilot tests.
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Magee, M., Isakov, A., Paradise, H., and Sullivan, P. (2011). Mobile Phones and Short Message Service Texts to Collect Situational Awareness Data During Simulated Public Health Critical Events. (Abstract only.) American Journal of Disaster Medicine. 6(6):379-85.
The authors studied the feasibility of using mobile phones and short message service (SMS) texts to collect situational awareness data through surveys during simulated public health critical events during a university-based pilot study.
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The authors discuss the wireless transmission of vital health data in disaster situations and a fair way to prioritize patient data categorization and transmission when there is bandwidth congestion or connectivity issues.
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Morris, M. and Carter, K. (2015). A Blended Transfer and Communications Center- Designing a State-of-the-Art Mission Control. (Abstract only.) Nursing Administration Quarterly. 39(4):357-361.
This article discusses the benefits of an interdepartmental mission control system that can help healthcare providers visualize throughput, flow, and real-time bed capacity in a hospital or hospital system.
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Pate, B. (2008). Identifying and Tracking Disaster Victims: State-of-the-Art Technology Review. (Abstract only.) Family and Community Health. 31(1):23-34.
This article is a review of electronic patient tracking systems and their ability to mitigate problems experienced with tracking patient movement in Hurricane Katrina.
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Reina, D., Askalani, M, Toral, S., Barrero, F., et al. (2015). A Survey on Multihop Ad Hoc Networks for Disaster Response Scenarios. International Journal of Distributed Sensor Networks. 2015: 1-16.
The authors reviewed a variety of ad hoc networks in disaster scenarios. They found these networks feasible and emphasized the importance of smartphone interoperability because of their wide use by the healthcare and other responder populations.
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Education and Training


* Interoperable Communications Technical Assistance Program. (n.d.). Public Safety Tools. (Accessed 3/29/2016.)
This website includes links to a variety of tools, resources, and courses geared towards first responder communications.
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General Information


Centers for Disease Control and PreventionNational Center for Environmental HealthDivision of Environmental Hazards and Health EffectsRadiation Studies Branch. (2003). Roundtable on Hospital Communications in a Mass Casualty Radiological Event.
This expert roundtable summary includes recommendations for communications policies, protocols, and capabilities during a large-scale radiological event. Overall, participants recommended that hazard-specific communications plans be integrated into a hospital's all-hazards communications plan.
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The author provides an overview of traditional communications tools and related failure modes, followed by an overview of alternative strategies (e.g., infrared, microwave, and satellite).
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McClendon, S. and Robinson, A. (2013). Leveraging Geospatially-Oriented Social Media Communications in Disaster Response. (Abstract only.) International Journal of Information Systems for Crisis Response and Management. 5(1).
The authors compare the capabilities of two popular systems used to collect and map open source disaster information: Project Epic’s Tweak the Tweet (TtT) and Ushahidi. The research compares and contrasts the frequency, content, and location components of information in both systems. Based on the results, the authors identify considerations for future social media mapping tools to support crisis management.
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The author emphasizes the need to consider multiple factors when considering eliminating pagers for cellular devices.
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Reddy, M., Paul, S., Abraham, J. et al. (2009). Challenges to Effective Crisis Management: Using Information and Communication Technologies to Coordinate Emergency Medical Services and Emergency Department Teams. abstract only International Journal of Medical Informatics. 78(4):259-269.
This article describes study results outlining technological and communication issues between Emergency Medical Services (EMS) and Emergency Department (ED) teams. The authors note that the coordination of awareness, context, and workflow are key for next generation communication tools.
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Thompson, S., Altay, N., Green, W., and Lapetina, J. (2006). Improving Disaster Response Efforts with Decision Support Systems. (Abstract only.) International Journal of Emergency Management. 3(4):250.
The authors discuss the use of decision support systems for improving instant communication regarding command/control and resource allocation during disasters.
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Guidance/Guidelines


The Centers for Medicare & Medicaid Services issued the Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers Final Rule to establish consistency for healthcare providers participating in Medicare and Medicaid, increase patient safety during emergencies, and establish a more coordinated response to natural and human-caused disasters. This document provides links to numerous related resources applicable to a variety of providers and suppliers.
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Hyde, J., Tsoi, J., Worden Kenefick, H., and Cox, H. (n.d.). Use of a Theoretical Framework for Coalition Building and Evaluation Among Five Healthcare Disciplines in Massachusetts. (Accessed 3/8/2016.) U.S. Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Health.
This PowerPoint presentation is a summary of the Partnership for Effective Emergency Response (PEER) project, which enhances communication to health agencies in the greater Boston area during emergencies and disasters.
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SAFECOM and the National Council of Statewide Interoperability Coordinators. (2015). Emergency Communications Governance Guide for State, Local, Tribal, and Territorial Officials.
This guidance document lays out governance challenges, best practices, and recommendations for emergency managers at all levels to use in assessing, establishing, and maintaining communications governance. The document includes on the government landscape; charters, bylaws, and memorandum of agreement; the key elements of a governance body; and components of inter and intrastate local governance bodies.
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This call summary describes the National Hospital Preparedness Program Information Sharing Capability. Participants highlight patient tracking systems, communications equipment interoperability, and other points outlined in this capability.
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U.S. Department of Health and Human Services, Healthcare and Public Health Sector Coordinating Councils. (n.d.). Working Without Technology: How Hospitals and Healthcare Organizations Can Manage Communication Failure. (Accessed 7/12/2019.)
This article discusses redundant lower-tech methods for communicating to ensure staff are able to stay in touch in case of a loss of technological capability.
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U.S. Department of Homeland Security. (2015). GETS FAQ.
This webpage includes answers to frequently asked questions about the Government Emergency Telecommunications Service.
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U.S. Department of Homeland Security. (2015). TSP FAQ.
This webpage includes answers to frequently asked questions about the Telecommunications Service Priority program.
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Lessons Learned


The authors highlight communications challenges associated with recent incidents involving violent acts committed against hospital staff; brief suggestions for overcoming these challenges are also listed.
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Radio devices typically cannot communicate with each other unless they operate on the same frequency and use the same mode without a dispatcher. This vendor-produced case study described the use of a Land Mobile Radio-over-IP option to address this challenge and found it increased communications, reduced costs, and was a flexible and resilient tool.
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This vendor-produced case study details how two companies designed the "Rapid Emergency Satellite Communications" system for Rhode Island Hospital (who in turn shared the system throughout the state).
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The authors conducted a qualitative study and share anecdotal evidence suggesting communication mistakes (e.g., interoperability, infrastructure issues) are still being repeated, incident after incident. Suggestions for improvement on a variety of disaster-related topics are included.
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European Union of General Practitioners. (2013). Report on Health Care Professional Communication Requirements.
This EU based research report discusses the needs and methods for communicating to health professionals in epidemic situations, based on challenges in reaching all of these professionals during the 2009 H1N1 outbreak.
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Goldman, M., Anderson, T., Zehtabchi, S., and Arquilla, B. (2007). Testing Hospital Disaster Communication Plan has Immense Value. Disaster Management and Response. 5(2):27.
This article discusses the utility of phone tree protocols for mobilization of ED staff in a New York City Hospital, and the importance of testing them in advance of an emergency.
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Martindell, D. (2011). Survey of Emergency Department Practices in Pennsylvania Hospitals to Protect Patients and Staff. Pennsylvania Patient Safety Advisory. 8(4):126-130.
This article describes research showing preparedness gaps in Pennsylvania Hospitals and the importance of emergency communications equipment for increasing worker safety in relation to violent patients and visitors.
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Medford-Davis, L. and Kapur, B. (2014). Preparing for Effective Communications during Disasters: Lessons from a World Health Organization Quality Improvement Project. International Journal of Emergency Medicine. 7:15.
This article describes a World Health Organization Quality Improvement Study for disaster communications. Findings include the need for employee listservs, international media contacts, pre-written public service announcements in multiple languages on questions that frequently arise during disasters, and a central database that can house this information.
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Pages 21-23 of this document focus on communications lessons learned by staff from Mercy Hospital in Joplin and how they can be incorporated into healthcare facility emergency plans.
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Operational Policies/Procedures


Minnesota Department of Health. (2016). MNTracOverview.
MNTrac (Minnesota system for Tracking Resources, Alerts and Communication) is a database-driven, password-protected web application designed to track bed capacity, but it also supports emergency incident planning, emergency communication, and emergency alert notifications in real time. It serves a variety of healthcare agencies, including hospitals, emergency medical services, public health, poison control, the state department of health, and skilled nursing facilities.
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U.S. Federal Emergency Management Agency. (2016). Disaster Emergency Communications Division.
This webpage highlights the role of this federal division (to establish, maintain, and coordinate emergency communications services and information systems critical the coordination of the federal government’s response before, during, and after an incident or planned event). Information on the six Mobile Emergency Response Support detachments and numerous Mobile Communications Office Vehicles is also included.
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Plans, Tools, and Templates


Federal Emergency Management Agency, Incident Management Systems Integration Division. (2009). Acronyms, Abbreviations, and Terms: A Capability Assurance Job Aid.
Emergency planners can use the information contained in this guide to develop materials based on commonly-used abbreviations, acronyms, and terms.
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* Interoperable Communications Technical Assistance Program. (n.d.). Public Safety Tools. (Accessed 3/29/2016.)
This website includes links to a variety of tools, resources, and courses geared towards first responder communications.
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Massachusetts Executive Office of Public Safety and Security. (2007). Statewide Communications Interoperability Plan.
This state plan is in a standard template form that illustrates how most states organize themselves for communications across different levels of government, vocational fields, and into non-governmental organizations such as hospitals.
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Pressman, H. (n.d.). Free Tools for Communicating During Disasters and Emergencies. (Accessed 3/7/2016.) Central Coast Childrens Foundation, Inc.
This resource list contains links to tools and apps for disaster communication with an emphasis on reaching people with communication challenges.
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SAFECOM and Disaster Management. (n.d.). Creating a Charter for a Multi-Agency Communications Interoperability Committee: Template and Questions to Consider. (Accessed 3/21/2017.) U.S. Department of Homeland Security.
This template--geared towards a local, regional level--can help planners create a charter for an interoperability committee or governance group. It is laid out as a sample charter and includes suggested headings for each section as well as potential issues/questions that should be addressed when developing a committee.
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U.S. Department of Homeland Security. (2014). National Emergency Communications Plan.
This 5-year strategy document outlines the federal direction for getting the latest interoperable communication technology to all disaster response entities across the nation.
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U.S. Department of Homeland Security. (2015). Government Emergency Telecommunications Service (GETS).
The Government Emergency Telecommunications Service is a federal communications system meant to be used in an emergency or crisis situation when the landline network is congested and the likelihood of completing a call using traditional methods is reduced.
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U.S. Department of Homeland Security. (2018). Telecommunications Service Priority (TSP).
This federal program authorizes national security and emergency preparedness organizations to receive priority treatment for telecommunications services. Qualified applicants may request a code from the Department of Homeland Security that mandates telecommunications service providers to prioritize requests for new service, or to repair existing service if it lost, after a disaster.
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U.S. Department of Homeland Security. (2018). Wireless Priority Service (WPS).
This webpage provides information on the Wireless Priority Service (WPS), a priority telecommunications service that improves the connection capabilities for authorized public safety and national security and emergency preparedness (NS/EP) cell phone users during emergencies.
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Agencies and Organizations


Federal Emergency Management Agency. Disaster Emergency Communications Division.
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Radio Amateur Civil Emergency Service. RACES Resource Library.
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