States, hospitals harness technology to track vacant beds and avert overcrowding
A flu outbreak. A terrorist attack. A natural disaster. Any one of these events could flood emergency departments with patients, forcing hospitals to scramble for beds or divert ambulances to other medical facilities.
To avoid such a mess, some states are turning to high-tech solutions. In Massachusetts, for instance, hospitals are required every day to report the number of vacant beds they have to a special Web site maintained by the state Department of Public Health. The bed tracking system was launched in July during the Democratic National Convention held in Boston.
The agency can also ask hospitals to cancel or postpone elective surgeries to gain extra beds during emergencies, in addition to appropriating beds in acute and long-term care facilities, according to Nicole St. Peter, a Massachusetts DPH spokesperson.
The Massachusetts system is similar to one New York public health officials developed following Sept. 11, 2001. Called Health Emergency Response Data System, the Web-based New York scheme tracks beds, vaccine stocks and the availability of isolation rooms. In both states, health care officials use the data to direct patients to less crowded hospitals during emergencies.
"We found in the aftermath of Sept. 11 that this information was critical not only to emergency management, but also to calm the public," says Susan Waltman, senior vice president of the Greater New York Hospital Association.
Bed tracking is seen as one way to reduce the strain on the emergency medicine infrastructure. A 2002 American Hospital Association survey found that 52 percent of New England and 45 percent of mid-Atlantic emergency departments, for instance, were operating beyond capacity.
"Bed tracking can be very useful, not only for monitoring surge capacity in the event of terrorism, natural disaster and epidemics, but also in monitoring overall levels of system capacity, ED crowding, ambulance diversion--all important statistics to track community access to emergency care," says Arthur Kellerman, M.D., chair, department of emergency medicine, Emory University in Atlanta.
The problem is finding a source to fund them, and getting hospitals to cooperate with data sharing.
"Hospitals would rather not publicize their crowded conditions for fear it will hurt referral business," Kellerman says.
A bed tracking system at Johns Hopkins University Hospital in Baltimore evolved as much in response to the inefficiencies inherent in the current method of dispatching nurses on foot to determine bed census as it did to terror threats.
"Federal Express can tell you exactly where a package is anywhere in the world, but we can't tell you whether or not we have an empty bed," says Paul J. Scheel Jr., M.D., vice chair of the department of medicine at Johns Hopkins.
Stirred by the paradox, Scheel was instrumental in Johns Hopkins designing a paperless, Web-based patient assignment system called MedBed that yields a real-time glimpse of open beds at a mouse click when patients are waiting to be admitted.