States Seek Emergency Medical Compacts

In the event of a natural or manmade disaster, states can legally share fire trucks and helicopters, but state laws currently prohibit sharing medical expertise. Hoping to change what some consider outdated state laws, 10 Midwestern states are making arrangements to share medical personnel and communications capabilities. Separately, 16 southern governors and the territories of Puerto Rico and the Virgin Islands are working through the Southern Governors’ Association to develop an interstate emergency medical response system. The SGA project relies on telemedicine, which uses communications and information technology to deliver healthcare services over long distances.

“This project originated right after September 11,” says Lee Stevens, SGA’s legislative director. “We had done a little work on telemedicine before, but it picked up steam after the anthrax attacks in the Southeast, which drew everyone’s attention to the fact that it was hard to share information across state lines.”

When funding was not forthcoming from Capitol Hill, several governors committed state resources, says Stevens. With advances in technology, the network is close to being up and running, he says. “In the event of any type of disaster, we hope this will be a seamless network that will enable all states to be connected visually via computer. In the frenzy after 9/11, we were all focused on bioterrorism. I think we’re now realizing that, while it is still an imminent threat, there are natural disasters that happen every year, and we need to change our focus to something we can use on a day-to-day basis.”

Jay Sanders, MD, adjunct professor of medicine at Johns Hopkins University, CEO of The Global Telemedicine Group and an SGA project director, views the proposed network as a national health highway system that will definitely impact EMS, particularly in the event of a bioterrorist attack.

“One of the foci for early identification and treatment has to be prehospital,” he says. “The worst place to make a diagnosis of smallpox is in a hospital ED, because you have now created a secondary weapon by contaminating the hospital. Therefore, the more we can provide an information base to first responders to help them quickly identify, treat and isolate the individual who is exposed, the more we’ll be able to deal with a bioterrorist event appropriately. Most of the enabling technologies we now have allow us to make the exam room where the patient is, not where the doctor is. If we can extend the ED out to the patient, we’ve done a lot in terms of not only dealing with the potential impact of bioterrorism, but in terms of the impact on our general healthcare delivery system.

“My hope is that within the next year and a half we’ll have a template that every state can follow,” says Sanders, “but a lot will be predicated on the availability of funding, and we are seeking both private foundation and federal funding.”

—MN