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An Analysis of the Use of Medical Applications Required for Complex Humanitarian Disasters and Emergencies Via Hastily Formed Networks (HFN) in the Field

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An Analysis of the Use of Medical Applications Required for Complex Humanitarian Disasters and Emergencies Via Hastily Formed Networks (HFN) in the Field View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Calhoun, Institutional Archive of the Naval Postgraduate School Calhoun: The NPS Institutional Archive Theses and Dissertations Thesis Collection 2005-09 An analysis of the use of medical applications required for complex humanitarian disasters and emergencies via Hastily Formed Networks (HFN) in the field Kelley, Sean William Monterey, California. Naval Postgraduate School http://hdl.handle.net/10945/1946 NAVAL POSTGRADUATE SCHOOL MONTEREY, CALIFORNIA THESIS AN ANALYSIS OF THE USE OF MEDICAL APPLICATIONS REQUIRED FOR COMPLEX HUMANITARIAN DISASTERS OR EMERGENCIES VIA HASTILY FORMED NETWORKS (HFN) IN THE FIELD by Sean W. Kelley September 2005 Thesis Advisor: Brian Steckler Second Reader: James Ehlert Approved for public release; distribution unlimited THIS PAGE INTENTIONALLY LEFT BLANK REPORT DOCUMENTATION PAGE Form Approved OMB No. 0704-0188 Public reporting burden for this collection of information is estimated to average 1 hour per response, including the time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Washington headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188) Washington DC 20503. 1. AGENCY USE ONLY 2. REPORT DATE 3. REPORT TYPE AND DATES COVERED September 2005 Master’s Thesis 4. TITLE AND SUBTITLE: An Analysis of the Use of Medical Applications 5. FUNDING NUMBERS Required for Complex Humanitarian Disasters and Emergencies via Hastily Formed Networks (HFN) in the Field 6. AUTHOR(S) Sean W. Kelley 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) 8. PERFORMING Naval Postgraduate School ORGANIZATION REPORT Monterey, CA 93943-5000 NUMBER 9. SPONSORING /MONITORING AGENCY NAME(S) AND ADDRESS(ES) 10. SPONSORING/MONITORING N/A AGENCY REPORT NUMBER 11. SUPPLEMENTARY NOTES The views expressed in this thesis are those of the author and do not reflect the official policy or position of the Department of Defense or the U.S. Government. 12a. DISTRIBUTION / AVAILABILITY STATEMENT 12b. DISTRIBUTION CODE Approved for public release; distribution unlimited 13. ABSTRACT (maximum 200 words) This thesis analyzes the feasibility, efficacy and usability of medical operations working in concert with a Fly-Away- Kit (FLAK) and the forming of Hastily Formed Networks (HFNs) in support of Humanitarian Assistance and Disaster Relief (HA/DR) operations. The initial focus of this research is on the requirements, situation, area of operations, and mission differences between nongovernmental organizations and governmental organizations. The thesis researches and discusses the possibilities for implementing medical technology in the field and the conditions and scenarios in HA/DR that may affect its success. This process will also define the requirements for medical operations as well as facilitate a methodology for ensuring those requirements are met. This thesis investigates the suitability of currently available COTS hardware and software components for medical operations. In addition, it includes a comprehensive review of the value of electronic medical records and telemedicine technologies. Virtually all organizations responding to the December 26, 2004 Southeast Asia tsunami did not have the benefit of large scale medical information technology. For example, the ability to ascertain the real extent of injuries due to the tsunami was hampered by the lack of a central database. Initial media reports claimed a death toll of over 300,000 people, when in fact hindsight now provides a more accurate tally of just over 200,000 dead. This disparity resulted from an archaic system of tracking and accounting. Undoubtedly, humanitarian medical organizations will greatly benefit from the implementation of medical information technology capabilities. This thesis lays the groundwork for further research into medical technologies that can be deployed in the field with humanitarian medical teams in the near future. 14. SUBJECT TERMS Medical, Hastily Formed Networks, HFN, Rapid Deployable Networking, 15. NUMBER OF Humanitarian Disasters, NGO, Electronic Medical Record, Telemedicine PAGES 189 16. PRICE CODE 17. SECURITY 18. SECURITY 19. SECURITY 20. LIMITATION CLASSIFICATION OF CLASSIFICATION OF THIS CLASSIFICATION OF OF ABSTRACT REPORT PAGE ABSTRACT Unclassified Unclassified Unclassified UL NSN 7540-01-280-5500 Standard Form 298 (Rev. 2-89) Prescribed by ANSI Std. 239-18 i THIS PAGE INTENTIONALLY LEFT BLANK ii Approved for public release; distribution unlimited AN ANALYSIS OF THE USE OF MEDICAL APPLICATIONS REQUIRED FOR COMPLEX HUMANITARIAN DISASTERS AND EMERGENCIES VIA HASTILY FORMED NETWORKS (HFN) IN THE FIELD Sean W. Kelley Lieutenant, United States Navy B.S., Southern Illinois University, 2000 M.A., Webster University, 2001 Submitted in partial fulfillment of the requirements for the degree of MASTER OF SCIENCE IN INFORMATION TECHNOLOGY MANAGEMENT from the NAVAL POSTGRADUATE SCHOOL September 2005 Author: Sean William Kelley Approved by: Brian Steckler Advisor James Ehlert Second Reader Dan Boger Chairman, Department of Information Sciences iii THIS PAGE INTENTIONALLY LEFT BLANK iv ABSTRACT This thesis analyzes the feasibility, efficacy and usability of medical operations working in concert with a Fly-Away-Kit (FLAK) and the forming of Hastily Formed Networks (HFNs) in support of Humanitarian Assistance and Disaster Relief (HA/DR) operations. The initial focus of this research is on the requirements, situation, area of operations, and mission differences between nongovernmental organizations and governmental organizations. The thesis researches and discusses the possibilities for implementing medical technology in the field and the conditions and scenarios in HA/DR that may affect its success. This process will also define the requirements for medical operations as well as facilitate a methodology for ensuring those requirements are met. This thesis investigates the suitability of currently available COTS hardware and software components for medical operations. In addition, it includes a comprehensive review of the value of electronic medical records and telemedicine technologies. Virtually all organizations responding to the December 26, 2004 Southeast Asia tsunami did not have the benefit of large scale medical information technology. For example, the ability to ascertain the real extent of injuries due to the tsunami was hampered by the lack of a central database. Initial media reports claimed a death toll of over 300,000 people, when in fact hindsight now provides a more accurate tally of just over 200,000 dead. This disparity resulted from an archaic system of tracking and accounting. Undoubtedly, humanitarian medical organizations will greatly benefit from the implementation of medical information technology capabilities. This thesis lays the groundwork for further research into medical technologies that can be deployed in the field with humanitarian medical teams in the near future. v THIS PAGE INTENTIONALLY LEFT BLANK vi TABLE OF CONTENTS I. INTRODUCTION........................................................................................................1 A. BACKGROUND ..............................................................................................1 B. OBJECTIVES ..................................................................................................2 C. RESEARCH QUESTIONS.............................................................................2 D. SCOPE ..............................................................................................................3 II. TRIP REPORT AND LESSONS LEARNED FROM TRIP TO THAILAND, MAY 7 -12, 2005...........................................................................................................5 A. PURPOSE OF THE VISIT.............................................................................7 B. LESSONS LEARNED...................................................................................11 III. BACKGROUND: HUMANITARIAN AND OPERATIONAL MEDICAL MISSIONS..................................................................................................................13 A. DISASTERS ...................................................................................................13 B. UNITED NATIONS RESPONSE TO DISASTERS...................................15 1. Basic Level ..........................................................................................15 2. Level One Medical Support ..............................................................16 3. Level Two Medical Support..............................................................16 C. U.S. MILITARY MEDICINE’S ECHELON OF CARE ...........................18 D. NON-GOVERNMENTAL ORGANIZATIONS AND INTERNATIONAL ORGANIZATIONS (NGO) .......................................20 E. NGOS AND MILITARY MEDICAL UNITS WORKING TOGETHER...................................................................................................21 IV. THE ELECTRONIC MEDICAL RECORD ..........................................................27 A. INTRODUCTION..........................................................................................27
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