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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.

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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 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 used by the Arlington County (VA) Auxiliary Communications Service, a 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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Amateur/Ham Radio Resources

Hospital Disaster Support Communications System. (2023). 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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Moell, J. (2015). When the Shaking Starts, It's Too Late to Plan.
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 used by the Arlington County (VA) Auxiliary Communications Service, a 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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Misra, S. and Chatterjee, S. (2014). Social Choice Considerations in Cloud-Assisted WBAN Architecture for Post-Disaster Healthcare: Data Aggregation and Channelization. (Abstract only.) Information Sciences. 284:95-117.
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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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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Kennedy, J. (2006). Alternate Communications During Times of Disaster.
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. (2012). Leveraging Geospatially-Oriented Social Media Communications in Disaster Response. 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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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

ASPR TRACIE. (2019). CMS and Disasters: Resources at Your Fingertips.
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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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

Cisco. (2007). Mobility Case Study: How Wireless IP Communications Supports Fast Emergency Response.
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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Donahue, A. and Tuohy, R. (2006). Lessons We Don't Learn: A Study of the Lessons of Disasters, Why We Repeat Them, and How We Can Learn From Them. Homeland Security Affairs. 2(4).
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 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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Missouri Hospital Association. (2012). Preparedness and Partnerships: Lessons Learned From the Missouri Disasters of 2011.
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

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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Minnesota Department of Health. (2023). 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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Plans, Tools, and Templates

Federal Emergency Management Agency, Incident Management Systems Integration Division. (2023). 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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Pressman, H. (n.d.). Free Tools for Communicating During Disasters and Emergencies. (Accessed 7/5/2024.) Central Coast Children's 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 7/5/2024.) 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. (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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U.S. Department of Homeland Security. (2019). 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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Agencies and Organizations

Cybersecurity & Infrastructure Security Agency (CISA). Emergency Communications.
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Federal Emergency Management Agency. Disaster Emergency Communications Division.
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Hospital Disaster Support Communications System (HDSCS).
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Radio Amateur Civil Emergency Service. RACES Resource Library.
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This ASPR TRACIE Topic Collection was comprehensively reviewed in March 2016 by the following subject matter experts (listed in alphabetical order): Julie Bulson, MPA, BSN, RN, Director, Emergency Preparedness, Spectrum Health; John Hick, MD, HHS ASPR and Hennepin County Medical Center; and Christopher Riccardi, CHSP, CHEP, Emergency Management Officer, Disaster Preparedness and Project Coordinator, Providence Little Company of Mary Medical Center Torrance.
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