By Carl Schultz, MD
Vol. 10, Issue 1, June 2001
For all of us interested in improving the care of disaster victims, there is good news to report. The ACEP Board of Directors approved a policy, supporting the reporting of all injuries and illnesses resulting from officially declared disasters, at their meeting just prior to the 2000 Scientific Assembly. The policy presented to the board reads as follows:
The American College of Emergency Physicians (ACEP) believes that research in disaster epidemiology is critical for future disaster preparedness. Accurate data collection in a disaster can be difficult without government mandate and assistance. Although the public health system gathers mass epidemiologic data, public health departments play little role in disaster data collection. Therefore, ACEP supports the following:
I initially proposed this idea two years ago at the Disaster Steering Committee meeting during the 1998 Scientific Assembly. It was a modification of the strategy Dr. Hogan used to obtain data for his work on the Oklahoma City bombing. Over the ensuing time period, many individuals have contributed to the process including Dr. Oster, Mr. Murray, Dr. Kallus, and those on the EMS Committee. By making this a priority, the Section of Disaster Medicine refined and improved the original concept into a potential policy that the ACEP Board could support. Through patience and persistence, success was finally achieved.
If fully implemented across the country, the impact of this policy on the quality of care for disaster victims will be significant. For the first time, it will be possible to efficiently collect data on disaster victims. Obtaining this information from hospitals is currently difficult because of concerns about confidentiality and liability. By making these conditions reportable, the hospital is absolved of the liabilities and it will be possible for researchers to obtain more accurate, complete, and timely data on all disaster victims.
The hospitals will benefit as well. Funding is often made available to compensate institutions for the medical care of victims following a disaster. However, hospitals have had difficulty capturing data to support their claims. A mechanism could now be in place to accurately capture the real amount of care provided by hospitals and provide a mechanism to improve reimbursement. This reporting requirement is just for declared disasters, so hospitals will not face an undue burden from excessive reporting. The next step is persuading counties and states to enact this policy, or something similar to it. No definitive strategy exists at this time to accomplish this. However, getting the support of the CDC, ACEP state chapters, and possibly Society for Academic Emergency Medicine (SAEM) would be one method of strengthening our case. I suspect public health organizations would also be in favor of this policy, and encouraging their involvement is a good idea. This continues to be a work in progress.
Interestingly, this is the first ACEP policy ever to have originated as a section proposal. Our patients and our specialty will be enriched if this policy can be implemented. Congratulations to all who worked to make this a reality.