- Health IT Infrastructure, Costs Hinder Health Data Exchange
The PULSE platform enables emergency responders to search for information on disaster victims, such as medications, allergies, diagnoses, and lab results, outside of the normal healthcare environment. It would limit access to only authorized personnel and to a “view only” format for medical information.
During Hurricane Harvey in 2017, the state did not have the PULSE capability in place because it was only in the pilot phase in California and was not widely available to other states, Gooch told the committee. Currently, California has moved PULSE into the operational phase.
Texas, along with Florida and North Carolina, are looking to deploy PULSE in the event of hurricanes. PULSE could be used in other emergencies in addition to hurricanes. “We would want to make sure that this is deeply embedded in the disaster response plan of the state,” he said.
PULSE grew out of the aftermath of Hurricane Katrina and the reason that the THSA was created.
“Just after Hurricane Katrina, we had a lot of people showing up to shelters with medications they had fished out of their flooded homes. They would say things like, ‘I think the pink pills are for my heart.’ That’s when Texas realized that we needed a secure electronic means to exchange patient health information,” Gooch related.
“Fast forward to Hurricane Harvey, we realized that health information exchange generally had advanced leaps and bounds, but as far as it pertained to natural disaster response, we hadn’t moved the needle very much,” he said.
PULSE “takes all of the disparate health information networks that are at the local, state, and national levels and provides a secure means to access that information through a smartphone or tablet. So a disaster response volunteer we have authorized, vetted, and trained on the system would be able to access the disparate and siloed health information across different regions and different healthcare providers in medical tents during an emergency,” he related.
“That is something that the THSA is working very hard to implement today,” he added.
California piloted the PULSE platform during its recent wildfires. The California Emergency Medical Services Authority (EMSA) activated the PULSE platform for the first time in October 2017 in response to the fires in Napa, Lake, Sonoma, Mendocino, Butte, and Solano Counties.
The California Association of Health Information Exchanges (CAHIE) supports PULSE through the California Trusted Exchange Network (CTEN) and through operation of the CTEN Services Registry, which PULSE uses to retrieve updates on participating organizations.
“National interoperability connectivity has reached a breadth and maturity where it can be leveraged in new ways, such as disaster response. PULSE is a public-private collaborative that includes HHS, ASPR, ONC and state agencies to support Americans in times of disaster,” said Mariann Yeager, CEO of the Sequoia Project, which oversees PULSE implementation.
The Sequoia Project was chartered as a non-profit organization to advance the implementation of secure, interoperable national health information exchange. ONC transitioned management of its eHealth Exchange to the Sequoia Project for maintenance. Since 2012, the exchange has grown to become the largest health information exchange network in the United States.
