Standing on the hard concrete floor in a convention center in 2021, I watched as nurses made frustrated and frantic calls to hospitals and nursing homes. Hurricane Ida had swept through Louisiana one week prior, and now instead of booths with branded giveaways, rows of beds were spaced out in the dimly lit hall. The medical shelter staff were working hard to provide for the treatment, COVID-19 safety, and the privacy of their elderly charges who had been transferred to their care without medical records or caregivers.

Lacking Patient Data in Disaster Response Work

With over 15 years of experience in disaster preparedness and response, I had already learned that in the field, we never have all the things that would be ideal, and sometimes we don’t even have the things we need. I’ve been in places where we’ve struggled to find enough generators or extension cords, have lacked a reliable inventory tracker, passable roads, and often, showers. While we do as much as possible to prepare and encourage states, municipalities, and individuals to do the same, response workers are often improvising while striving to adhere to a best practice in less than perfect circumstances.

Over a year into the devastating COVID-19 pandemic, most of the nurses and medical staff in the shelter had been coping with non-stop death in their day jobs. The news had been covering stories of burnout, staff departures, very high levels of stress, and poor mental health among medical professionals for months already. Ironically, some had selected to deploy for hurricane relief as a temporary escape from the relentless COVID work, only to end up treating COVID patients again under even more challenging circumstances.

How different would it be for these hardworking professionals to deploy into a field setting knowing they could look up a patient’s known allergies within seconds? That they would not have to call five pharmacies to see if they had the exact dosage or name of a prescription a patient could not exactly recall? That they would be able to review previous diagnoses and determine if a patient needed to be transferred to a specialist or could safely be cared for in the field clinic? When considered in this way, having access to patient data in disaster response caregiving goes beyond something that would be “nice” and becomes one critical to life safety and staff support

Hurricane Ida Convention Center Medical Use

A convention center turned field hospital during Hurricane Ida in 2021 for patients displaced from their normal care settings. Photo by Ali Hochreiter.

Filling Data Gaps with Patient Lookup

Only a few weeks after returning from the Louisiana medical shelter in 2021, I started a new job with Audacious Inquiry in support of a solution that fills the precise gap I had observed: the Patient Unified Lookup System for Emergencies (PULSE). PULSE provides medical responders with the ability to search patient documentation and prescription histories in non-traditional care settings—such as a convention center turned into a field clinic—which gives them the information to treat more effectively and quickly. It also reduces unnecessary hospitalization and transfers, not to mention the stressful administrative burden placed on staff who are trying to track down previous doctors to find vital diagnosis, test, or medication information.

PULSE was born out of the U.S. Department of Health and Human Services’ IDEA Lab as a way to support first responders and medical providers working in emergency settings to provide safer and more effective care to individuals. Starting in 2014, Audacious Inquiry worked with ONC and other partners to expand upon a pilot with California and develop an infrastructure that could be deployed nationwide. Today, PULSE Enterprise can be made available in any geographic area to support healthcare professionals and emergency responders caring for displaced individuals, or volunteer healthcare workers who are deployed to a disaster area outside of their normal health IT environment.

Patient Lookup in Action:
After Hurricane Ida, Emergency Census was able to locate over 50% of dialysis patients who remained unaccounted for several weeks after the storm. Providers used the information to reconnect those patients with routine health services.

Preparing for Disaster Response

Climate news over the last decade has highlighted the increased frequency and severity of natural disasters globally. A recent study found that 1 in 6 Americans live in areas with significant wildfire risk, and in just three months in 2021, nearly 1 in 3 Americans experienced a weather-related disaster. What does this mean for emergency response work? It means that more people may need to evacuate to shelters more geographic areas, and that shelters are more likely to be populated with people who have one or more health conditions.

On top of this, the United States has an aging population. Even healthy older people are more likely to have chronic conditions and take more than one medication with names and dosages that can be difficult to remember in the best circumstances, let alone when they’ve had to evacuate from their home with no knowledge of when they’ll return. In 2022, we have the technology to quickly look up that information, bringing peace of mind to caregivers and evacuees alike and improving health outcomes.

Emergency Response Tents Hurricane Ida

Emergency response tents set up to treat displaced patients during Hurricane Ida in 2021. Photo by Ali Hochreiter.

In the United States, wildfire season used to be about four months long, but we now see them year-round. The Atlantic Hurricane Season officially kicks off on June 1, and NOAA is predicting an “above normal” season for the seventh year in a row. This begs the question from many of us in the field about when it’s time to adjust our expectations of “average.” While historically the largest and most destructive fires and storms tend to hit later in the season, there’s no time like the present to prepare in our increasingly unpredictable landscape. There is plenty of great information for individuals and families about how to prepare for emergencies. What about your city government, your state agency, the organizations tasked with sheltering and caring for community members in disasters?

PULSE Enterprise is available in any domestic geographic region for emergency management, and Audacious Inquiry can quickly deploy PULSE Enterprise in coordination with our support services to best meet the needs of tribal, state, or community emergency responses.

To learn more about how PULSE Enterprise can meet the needs of your community or state, contact or download our eBook below.

. Download Care Coordination During Natural Disasters eBook



Ali-Hochreiter-HeadshotAlexandra (Ali) Hochreiter, MPH, has worked in public health and emergency management for 15 years. Ms. Hochreiter currently serves as an Engagement Manager with Audacious Inquiry, a health information technology and policy leader, primarily supporting California and Texas. Previously, Ms. Hochreiter worked as a consultant supporting the Department of Health and Human Services, assisting in COVID-19 analysis and after-action reports, and for FEMA’s National Integration Center, Individual Community and Preparedness Division, and National Preparedness Assessment Division. She also led the development of training and exercise programs for a large investor-owned utility in California, strengthening wildfire preparedness efforts. Ms. Hochreiter’s field work includes hurricane, tornado, and pandemic response, and she is an active volunteer with the Medical Reserve Corps.