Emergency network is vulnerable, county says Officials vow to upgrade medical computer system

By Cheryl Clark UNION-TRIBUNE STAFF WRITER September 24, 2001

On the morning of Sept. 11, just after terrorists crashed hijacked planes into the World Trade Center, the Pentagon and a Pennsylvania field, San Diego County's computer system that enables paramedics to route patients to available hospital beds had to be shut down.

County officials said the system, which operates through telephone lines, is 9 years old, with an operating system that occasionally corrupts files.

It was back up in 20 minutes, with no harm done.

Five days earlier, Sept. 6, the problem was much worse. The mainframe crashed completely -- for 20 hours, from 4 a.m. to midnight.

Though all patients were routed to hospitals without problems, the heightened readiness for terrorism has exposed a major vulnerability in the county's emergency response system, county health officials say.

"The equipment is old and increasingly subject to failure," said Gwen Jones, the county's Emergency Medical Services chief.

It is designed to emulate the Windows operating system rather than run it, and it is incompatible with the latest Windows versions on the market today, Jones said.

Jones said that during those periods of downtime, "we had to go back to the old system of calling each other to find out which hospitals were (able to take emergency patients) and who was down."

"If we'd had a disaster during that period, we would still have gotten the information out, but it would have taken much longer," she said.

Now the county is determined to pay for the upgrades despite the estimated $1 million to $4 million cost, said county Chief Administrative Officer Walt Ekard and Supervisor Dianne Jacob. With so many hospitals so frequently full, it is important that paramedics know as quickly as possible the closest, most appropriate facility to take each patient, they said.

"These terrorist attacks have brought to our attention the need to enhance our medical services and upgrade our current system," said Jacob, who will propose action at a Board of Supervisors meeting next month. "It's essential that this get done."

Despite its age, the county system is said by county officials to be among the state's best. Its patient record form securely handles essential information. Unlike other computer systems linking hospitals with California emergency responders, this one allows hospitals to communicate with paramedics in "real time," with screen updates every 15 seconds.

Patty Skoglund, base hospital coordinator for Scripps Mercy's emergency room, said information obtained from the county's Emergency Medical Services computer system helped "make the case" that the emergency room needed more resources.

Data the system collected helped document how often Mercy had to turn away emergency patients because it was full, and how much revenue the hospital lost when patients with health insurance were admitted elsewhere, Skoglund said.

The statistics also helped Mercy justify a new staff position to oversee patient admissions.

The system did work flawlessly during the Santana and Granite Hills school shootings, Jones and Ekard said.

The county's computer operation is cumbersome in size yet tiny in available data storage, holding the same number of patient records as when it began nearly a decade ago. The number of stations to which it can be connected is limited, too.

While newer systems are no bigger than a few computer towers, this one fills a room in the county's EMS offices on Mission Gorge Road.

Jacob and Ekard said the county intends to fund the computer upgrades with money from tobacco litigation settlement funds. The upgrades may take as long as six months, but Jacob said, "Better late than never."

http://www.uniontrib.com/news/metro/20010924-9999_1m24network.html

-- Martin Thompson (mthom1927@aol.com), September 24, 2001