1

COMCARE Overview

• A national advocacy organization with over 100 members dedicated to advancing emergency response

• Our goal: seamless, geographically targeted information sharing for the most advanced response to emergencies

2

Emergency Med and Public Health Reality

• Excluded from the big IT dollars, plans SIECs, state plans, PSIC

• Big CDC $ narrowly spent on one way broadcast alerts (HAN); get hospital data

• Stove piping what they have CDC to public health; HRSA to hospitals EMS, 9-1-1, private sources left out of both

• Weak politics; no centralizing forces• Emergency is outside the “real” HIT

world

3

Fed Comm Policy - Fund Silos

• Big money for radios, but mostly only for police and fire

• Minimum of 80% of money for locals, when IT needs are regional, state

• Where is the integrated emergency communications program for all orgs?

• Where is the special application layer focus on medicine?

• Where is the focus on the center?

4

What Needs to Be Done?

• Transport

• Standards

• Agency and business applications: build interfaces to standard messages

• Enterprise services

• Core services and policies using them

• Economics and funding

5

Transport

• Medicine no different than others Architecturally another node on the net

Fiber all over; agencies slow to connect

Share networks and enterprise services

• Run networks at national, region, state

• Broadband between organizations, not just to field

• Follow Morgan

6

What Morgan Did

• Separate content from carriage• National instead of local• Safety leaders focused on setting

requirements, not running networks• Knock down public/private wall• Benefit from private R&D and

economies of scale• Copy this outcome for every other

network -- but not for info use

7

Standards

• All domain, all hazards messaging: OASIS CAP, OASIS EDXL Done for alerting and warning; HAVE DHS: Weak federal commitment now

• Health standards HITSP: Strong HHS commitment to EHR, but ER? Public health in, EMS coming; no others; conflict

with NEMSIS; documents v. data

• Dictionaries NIEM: hope for core gathering place; justice only DEEDS, NEMSIS, PHIN, HL7

8

Concept of Enterprise Services

Agency Applications

Core Services

Shared Services

LOB Services

CAD EOCRun

ReportTraffic

NLETS PHINEPA’s EIEN RHIOs

GIS IMB Radio over

IP

Agency Locator

Identity Mgmt

Digital Rights Other

Information Discovery

9

EoIP; Radio over IP

• Follow the military and finance• Copy telephone and IT experience• Convert everything to IP• Expand radio interop to include any

form of communications• Flexible, cheap, dynamic; 2-3%/user• Accommodate the very different

needs, $, and timetables of agencies

10

What are Core Services?

• Services necessary for interoperability of broad, diverse, safety enterprise

• Business case is compelling to provide jointly to all domains (directly, or standardized), e.g. Every agency records CODECs of possible partners? Every agency makes its own “phone book”? Sign bi-lateral MOUs with all agencies for data sharing? One-off rights management? Every application has its own rights management?

• Non-profit consortium of emergency and safety organizations has requirements and then sets stds

11

Policy and Protocol Issues

• Who can do what? Get leaders to make the policies to enter in core service tools

• Develop initial protocols to benefit from new data sources

• Develop research capabilities to study end to end inputs and outcomes

• Refine protocols and decision support tools

12

Primary Public Policy Concerns (1)

• Treat as safety virtual enterprise; TCO as if one

• Separate network from data going over it• Extend operability and interoperability to

all involved organizations, using all forms of communications Inter-organization, voice and data, fixed and

mobile “Software, services and training”, not just

“equipment” Silo-busting: shared networks, systems, RoIP

13

Primary Public Policy Concerns (2)

• Comprehensive, inclusive fed & state planning

• First responders + all other responders • Get DHS, DOJ and HHS together (and DOT, Ag)

• Interoperability with legacy equipment, software apps Require use of gateways, standards, and interfaces

• Focus on “what needs to be in the middle” Standards, open architecture, IP transformation

(voice/data) Shared services: GIS, RoIP Core services tools: agency locator, IM/AC, data Policy bodies and policies to implement with them

14

What Local/State Govt Needs to Do

• Take charge of safety as an enterprise• Focus on interoperability -- domains won’t• Measure TCO and outcomes• Broadband backbone for all agencies• Give up local control over networks• Institute best practices on use of new data• Locals: worry about what to do with the

data, not how it gets there

15

What Feds Need To Do

• Mean it when they say “all hazards”• Get coordinated; stop funding silos

SAFECOM, PHIN, DOT NG 9-1-1, DOJ, HazCollect IPAWS, HSIN, OPEN, FEMA’s EOC network HTSIP, DHS DM, NIEM, Global Justice

• Fund the middle Standards Core services

• Stop building and buying proprietary applications

• Where are Medicare and Medicaid????

16

Economics, Policy and Funding

• Most efficient networks, managing information? • Who will benefit? What are the savings they

make? Walk through the chain Better outcomes Direct government spending; savings by

sharing Impact on individuals and businesses Insurance

• What is government doing today to advance or retard recommendations? Itemize funding sources and analyze their

contribution to interoperability