Engaging the Private-Sector Health
Care System in Building Capacity to
Respond to Threats to the Public’s
Health and National Security
PROCEEDINGS OF A WORKSHOP
Joe Alper, Rapporteur
Forum on Medical and Public Health Preparedness
for Disasters and Emergencies
Board on Health Sciences Policy
Health and Medicine Division
THE NATIONAL ACADEMIES PRESS
Washington, DC
www.nap.edu
THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001
This activity was supported by a contract between the National Academy of Sciences and the Department of Health and Human Services (HHSO100201750005A). Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.
International Standard Book Number-13: 978-0-309-48212-7
International Standard Book Number-10: 0-309-48212-7
Digital Object Identifier: https://doi.org/10.17226/25203
Additional copies of this publication are available for sale from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu.
Copyright 2018 by the National Academy of Sciences. All rights reserved.
Printed in the United States of America
Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2018. Engaging the private-sector health care system in building capacity to respond to threats to the public’s health and national security: Proceedings of a workshop. Washington, DC: The National Academies Press. doi: https://doi.org/10.17226/25203.
The National Academy of Sciences was established in 1863 by an Act of Congress, signed by President Lincoln, as a private, nongovernmental institution to advise the nation on issues related to science and technology. Members are elected by their peers for outstanding contributions to research. Dr. Marcia McNutt is president.
The National Academy of Engineering was established in 1964 under the charter of the National Academy of Sciences to bring the practices of engineering to advising the nation. Members are elected by their peers for extraordinary contributions to engineering. Dr. C. D. Mote, Jr., is president.
The National Academy of Medicine (formerly the Institute of Medicine) was established in 1970 under the charter of the National Academy of Sciences to advise the nation on medical and health issues. Members are elected by their peers for distinguished contributions to medicine and health. Dr. Victor J. Dzau is president.
The three Academies work together as the National Academies of Sciences, Engineering, and Medicine to provide independent, objective analysis and advice to the nation and conduct other activities to solve complex problems and inform public policy decisions. The National Academies also encourage education and research, recognize outstanding contributions to knowledge, and increase public understanding in matters of science, engineering, and medicine.
Learn more about the National Academies of Sciences, Engineering, and Medicine at www.nationalacademies.org.
Consensus Study Reports published by the National Academies of Sciences, Engineering, and Medicine document the evidence-based consensus on the study’s statement of task by an authoring committee of experts. Reports typically include findings, conclusions, and recommendations based on information gathered by the committee and the committee’s deliberations. Each report has been subjected to a rigorous and independent peer-review process and it represents the position of the National Academies on the statement of task.
Proceedings published by the National Academies of Sciences, Engineering, and Medicine chronicle the presentations and discussions at a workshop, symposium, or other event convened by the National Academies. The statements and opinions contained in proceedings are those of the participants and are not endorsed by other participants, the planning committee, or the National Academies.
For information about other products and activities of the National Academies, please visit www.nationalacademies.org/about/whatwedo.
PLANNING COMMITTEE ON ENGAGING THE PRIVATE-SECTOR HEALTH CARE SYSTEM IN BUILDING CAPACITY TO RESPOND TO THREATS TO THE PUBLIC’S HEALTH AND NATIONAL SECURITY1
HELEN BURSTIN (Co-Chair), Executive Vice President and Chief Executive Officer, Council of Medical Specialty Societies
ARTHUR L. KELLERMANN (Co-Chair), Professor and Dean, F. Edward Hebert School of Medicine, Uniformed Services University of the Health Sciences
MICHAEL ANDERSON, President, UCSF Benioff Children’s Hospital and Senior Vice President, Children’s Services, UCSF Health, University of California, San Francisco
ANGELA BRICE-SMITH, Deputy Consortium Administrator for Quality Improvement and Survey & Certification Operations, Centers for Medicare & Medicaid Services
ERIC EPLEY, Executive Director, Southwest Texas Regional Advisory Council
PAUL HINCHEY, Assistant Medical Director, Wake County EMS
THOMAS KIRSCH, Director, National Center for Disaster Medicine and Public Health and Professor of Military and Emergency Medicine, F. Edward Hebert School of Medicine, Uniformed Services University of the Health Sciences
JON KROHMER, Director, Office of Emergency Medical Services, National Highway Traffic Safety Administration, Department of Transportation
NICOLETTE LOUISSAINT, Executive Director, Healthcare Ready
RICARDO MARTINEZ, Chief Medical Officer, Adeptus Health
CARTER MECHER, Senior Medical Advisor, Office of Public Health, Department of Veterans Affairs
JOHN OSBORN, Operations Manager and Assistant Professor, Health Care Systems Engineering, Department of Surgery, Mayo Clinic College of Medicine
TODD RASMUSSEN, Associate Dean for Research and Harris B. Schumaker, Jr. Professor of Surgery, F. Edward Hebert School of Medicine, Uniformed Services University of the Health Sciences
ROSLYNE SCHULMAN, Director for Policy Development, American Hospital Association
___________________
1 The National Academies of Sciences, Engineering, and Medicine’s planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteur and the institution.
SKIP SKIVINGTON, Vice President of Healthcare Continuity Management and Support Services, Kaiser Permanente
JEFFREY UPPERMAN, Director, Trauma Program and Director, Pediatric Disaster Resource and Training Center, Children’s Hospital of Los Angeles
MICHAEL WARGO, Assistant Vice President, Enterprise Preparedness & Emergency Operations, Hospital Corporation of America
Health and Medicine Division Staff
SCOTT WOLLEK, Senior Program Officer
CLAIRE GIAMMARIA, Associate Program Officer
BEN KAHN, Research Associate
MARIA BABIRYE, Senior Program Assistant (until August 2018)
ANDREW M. POPE, Director, Board on Health Sciences Policy
Consultants
JOE ALPER, Writer, LSN Consulting
LAURA RUNNELS, LAR Consulting
FORUM ON MEDICAL AND PUBLIC HEALTH PREPAREDNESS FOR DISASTERS AND EMERGENCIES1
DAN HANFLING (Co-Chair), Johns Hopkins Center for Health Security
SUZET MCKINNEY (Co-Chair), Illinois Medical District
STACEY ARNESEN, National Library of Medicine, National Institutes of Health
ERIC BLANK, Association of Public Health Laboratories
MARY CASEY-LOCKYER, American Red Cross
BROOKE COURTNEY, Office of Counterterrorism and Emerging Threats, Food and Drug Administration
JOHN DREYZEHNER, Association of State and Territorial Health Officials
DAVID EISENMAN, University of California, Los Angeles
BRUCE EVANS, National Association of Emergency Medical Technicians
LARRY FLUTY, Office of Health Affairs, Department of Homeland Security
JOHN HICK, Hennepin County Medical Center
ROBERT KADLEC, Assistant Secretary for Preparedness and Response, Department of Health and Human Services
CLAUDIA KELLY, Seqirus
THOMAS KIRSCH, Uniformed Services University of the Health Sciences, Department of Defense
DREW LEWIS, Meridian Medical Technologies
NICOLETTE A. LOUISSAINT, Healthcare Ready
FREDA LYON, Emergency Nurses Association
CAROLYN MEIER, Administration for Children and Families, Department of Health and Human Services
AUBREY MILLER, National Institute of Environmental Health Sciences, National Institutes of Health
JOHN OSBORN, Mayo Clinic College of Medicine
TARA O’TOOLE, In-Q-Tel
ANDREW PAVIA, Infectious Diseases Society of America
ALONZO PLOUGH, Robert Wood Johnson Foundation
TERRY RAUCH, Defense Health Agency, Department of Defense
STEPHEN REDD, Office of Public Health Preparedness and Response, Centers for Disease Control and Prevention
SARA ROSZAK, National Association of Chain Drug Stores
ROSLYNE SCHULMAN, American Hospital Association
___________________
1 The National Academies of Sciences, Engineering, and Medicine’s forums and roundtables do not issue, review, or approve individual documents. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteur and the institution.
RICHARD SERINO, Harvard University School of Public Health
ALAN SINISCALCHI, Council of State and Territorial Epidemiologists
CRAIG VANDERWAGEN, East West Protection, LLC
JENNIFER WARD, Trauma Center Association of America
GAMUNU WIJETUNGE, National Highway Traffic Safety Administration, Department of Transportation
MATTHEW WYNIA, University of Colorado Denver
Health and Medicine Division Staff
SCOTT WOLLEK, Senior Program Officer
LISA BROWN, Senior Program Officer
CLAIRE GIAMMARIA, Associate Program Officer
BEN KAHN, Research Associate
MARIA BABIRYE, Senior Program Assistant (until August 2018)
ANDREW M. POPE, Director, Board on Health Sciences Policy
Reviewers
This Proceedings of a Workshop was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published proceedings as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the charge. The review comments and draft manuscript remain confidential to protect the integrity of the process.
We thank the following individuals for their review of this proceedings:
Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the content of the proceedings nor did they see the final draft before its release. The review of this proceedings was overseen by SARA ROSENBAUM, George Washington University. She was responsible for making certain that an independent examination of this proceedings was carried out in accordance with standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the rapporteur and the National Academies.
This page intentionally left blank.
Acronyms and Abbreviations
AMR |
American Medical Response |
ASPR |
Office of the Assistant Secretary for Preparedness and Response |
BARDA |
Biomedical Advanced Research and Development Authority |
CBRN |
chemical, biological, radiological, and nuclear |
CDC |
Centers for Disease Control and Prevention |
CMOC |
Catastrophic Medical Operations Center |
CMS |
Centers for Medicare & Medicaid Services |
DHS |
Department of Homeland Security |
DMAT |
disaster medical assistance team |
DoD |
Department of Defense |
EMS |
emergency medical services |
FAA |
Federal Aviation Administration |
FEMA |
Federal Emergency Management Agency |
GIS |
geographical information system |
HCA |
Hospital Corporation of America |
HHS |
Department of Health and Human Services |
HIPAA |
Health Insurance Portability and Accountability Act |
HPP |
Hospital Preparedness Program |
NDMS |
National Disaster Medical System |
NERC |
North American Electric Reliability Corporation |
NGO |
nongovernmental organization |
NORAD |
North American Aerospace Defense Command |
NTSB |
National Transportation Safety Board |
PAHO |
Pan American Health Organization |
REPLICA |
Recognition of EMS Personnel Licensure Interstate CompAct |
SETRAC |
SouthEast Texas Regional Advisory Council |
SNS |
Strategic National Stockpile |
STRAC |
Southwest Texas Regional Advisory Council |
USNORTHCOM |
U.S. Northern Command |
USUHS |
Uniformed Services University of the Health Sciences |
VA |
Department of Veterans Affairs |
WebEOC |
Web Emergency Operations Center |