# Presentation: 160869

## COMCARE Overview

- A national advocacy organization with over 100 members dedicated to advancing emergency response
- Our goal: seamless, geographically targeted information sharing for the most advanced response to emergencies

## Emergency Med and Public Health Reality

- Excluded from the big IT dollars, plans
- SIECs, state plans, PSIC
- Big CDC $ narrowly spent on one way broadcast alerts (HAN); get hospital data
- Stove piping what they have
- CDC to public health; HRSA to hospitals
- EMS, 9-1-1, private sources left out of both
- Weak politics; no centralizing forces
- Emergency is outside the “real” HIT world

## Fed Comm Policy - Fund Silos

- Big money for radios, but mostly only for police and fire
- Minimum of 80% of money for locals, when IT needs are regional, state
- Where is the integrated emergency communications program for all orgs?
- Where is the special application layer focus on medicine?
- Where is the focus on the center?

## What Needs to Be Done?

- Transport
- Standards
- Agency and business applications: build interfaces to standard messages
- Enterprise services
- Core services and policies using them
- Economics and funding

## Transport

- Medicine no different than others
- Architecturally another node on the net
- Fiber all over; agencies slow to connect
- Share networks and enterprise services
- Run networks at national, region, state
- Broadband between organizations, not just to field
- Follow Morgan

## What Morgan Did

- Separate content from carriage
- National instead of local
- Safety leaders focused on setting requirements, not running networks
- Knock down public/private wall
- Benefit from private R&D and economies of scale
- Copy this outcome for every other network -- but not for info use

## Standards

- All domain, all hazards messaging: OASIS CAP, OASIS EDXL
- Done for alerting and warning; HAVE
- DHS: Weak federal commitment now
- Health standards
- HITSP: Strong HHS commitment to EHR, but ER?
- Public health in, EMS coming; no others; conflict with NEMSIS; documents v. data
- Dictionaries
- NIEM: hope for core gathering place; justice only
- DEEDS, NEMSIS, PHIN, HL7

## Concept of Enterprise Services 

- Concept of Enterprise Services

**Agency Applications**

**Core Services**

**Shared Services**

**LOB Services**

**CAD**

**EOC**

**Run Report**

**Traffic**

**NLETS**

**PHIN**

**EPA’s EIEN**

**RHIOs**

**GIS**

**IMB**

**Radio over**
**IP**

**Agency Locator**

**Identity Mgmt**

**Digital Rights**

**Other**

**Information Discovery**

## EoIP; Radio over IP

- Follow the military and finance
- Copy telephone and IT experience
- Convert everything to IP
- Expand radio interop to include any form of communications
- Flexible, cheap, dynamic; 2-3%/user
- Accommodate the very different needs, $, and timetables of agencies

## What are Core Services?

- Services necessary for interoperability of broad, diverse, safety enterprise
- Business case is compelling to provide jointly to all domains (directly, or standardized), e.g.
- Every agency records CODECs of possible partners?
- Every agency makes its own “phone book”?
- Sign bi-lateral MOUs with all agencies for data sharing?
- One-off rights management?
- Every application has its own rights management?
- Non-profit consortium of emergency and safety organizations has requirements and then sets stds

## Policy and Protocol Issues

- Who can do what?  Get leaders to make the policies to enter in core service tools
- Develop initial protocols to benefit from new data sources
- Develop research capabilities to study end to end inputs and outcomes
- Refine protocols and decision support tools

## Primary Public Policy Concerns (1)

- Treat as safety virtual enterprise; TCO as if one
- Separate network from data going over it
- Extend operability and interoperability to all involved organizations, using all forms of communications
- Inter-organization, voice and data, fixed and mobile
- “Software, services and training”, not just “equipment”
- Silo-busting: shared networks, systems, RoIP

## Primary Public Policy Concerns (2)

- Comprehensive, inclusive fed & state planning
- First responders + all other responders
- Get DHS, DOJ and HHS together (and DOT, Ag)
- Interoperability with legacy equipment, software apps
- Require use of gateways, standards, and interfaces
- Focus on “what needs to be in the middle”
- Standards, open architecture, IP transformation (voice/data)
- Shared services: GIS, RoIP
- Core services tools: agency locator, IM/AC, data
- Policy bodies and policies to implement with them

## What Local/State Govt Needs to Do

- Take charge of safety as an enterprise
- Focus on interoperability -- domains won’t
- Measure TCO and outcomes
- Broadband backbone for all agencies
- Give up local control over networks
- Institute best practices on use of new data
- Locals: worry about what to do with the data, not how it gets there

## What Feds Need To Do

- Mean it when they say “all hazards”
- Get coordinated; stop funding silos
- SAFECOM, PHIN, DOT NG 9-1-1, DOJ, HazCollect
- IPAWS, HSIN, OPEN, FEMA’s EOC network
- HTSIP, DHS DM, NIEM, Global Justice
- Fund the middle
- Standards
- Core services
- Stop building and buying proprietary applications
- Where are Medicare and Medicaid????

- G

## Economics, Policy and Funding

- Most efficient networks, managing information?
- Who will benefit? What are the savings they make? Walk through the chain
- Better outcomes
- Direct government spending; savings by sharing
- Impact on individuals and businesses
- Insurance
- What is government doing today to advance or retard recommendations?
- Itemize funding sources and analyze their contribution to interoperability