Identifying and tracking disaster victims: state-of-the-art technology review

Exploring technologies to better link physical evidence and digital information for disaster victim identification

Disaster victim identification (DVI) entails a protracted process of evidence collection and data matching to reconcile physical remains with victim identity. Technology is critical to DVI by enabling the linkage of physical evidence to information. However, labelling physical remains and collecting data at the scene are dominated by low-technology paper-based practices. We ask, how can technology help us tag and track the victims of disaster? Our response to this question has two parts. First, we conducted a human–computer interaction led investigation into the systematic factors impacting DVI tagging and tracking processes. Through interviews with Australian DVI practitioners, we explored how technologies to improve linkage might fit with prevailing work practices and preferences; practical and social considerations; and existing systems and processes. We focused on tagging and tracking activities throughout the DVI process. Using insights from these interviews and relevant literature, we identified four critical themes: protocols and training; stress and stressors; the plurality of information capture and management systems; and practicalities and constraints. Second, these findings were iteratively discussed by the authors, who have combined expertise across electronics, data science, cybersecurity, human–computer interaction and forensic pathology. We applied the themes identified in the first part of the investigation to critically review technologies that could support DVI practitioners by enhancing DVI processes that link physical evidence to information. This resulted in an overview of candidate technologies matched with consideration of their key attributes. This study recognises the importance of considering human factors that can affect technology adoption into existing practices. Consequently, we provide a searchable table (as Supplementary information) that relates technologies to the key considerations and attributes relevant to DVI practice, for readers to apply to their own context. While this research directly contributes to DVI, it also has applications to other domains in which a physical/digital linkage is required, and particularly within high stress environments with little room for error.

Continuous Development of a Major Incident In-Hospital Victim Tracking and Tracing System, Withstanding the Challenges of Time

Objective

To describe the development of the Patient Barcode Registration System (PBRS) over time and confirm the usability and feasibility of the system’s latest version during a large trauma drill.

Methods

The development of a PBRS started around 1993 aiming to provide an effective tool for patient registration, tracking, and tracing during major incidents. The PBRS uses wristbands with barcodes to follow and register patients in the care process. During a large trauma drill, 120 patients and 40 relatives were registered and traced in the system. Errors in registration, tracking, and tracing of persons were registered.

Results

Of the 120 patients, no patient data were lost and patients could be traced in real time throughout the treatment process by the command team. Strategic decisions could be made based on the information provided by the system. Patient relatives were easily matched and government agencies received regular updates on the number and characteristics of the patients.

Conclusion

The PBRS is a usable, feasible, and sustainable patient tracking and tracing tool to be used during the hospital response to major incidents. Lessons learned during the last 20 years include the need for continuous updates to withstand the challenge of time. (Disaster Med Public Health Preparedness. 2017;11:244–250)

Older Adults' Current and Potential Uses of Information Technologies in a Changing World: A Theoretical Perspective

Technologies have become a major force in people's lives. They change how people interact with the environment, even as the environment changes. We propose that technology use in the setting of changing environments is motivated by essential needs and tensions experienced by the individual. We apply three developmental and behavioral theories (Erikson's stages of psychosocial development, Maslow's hierarchy of needs, and Bronfenbrenner's ecological model) to explain technology-related behaviors among older adults. We consider how technology use has addressed and can address major ecological changes, in three areas: health promotion, natural disasters, and disparities. We propose that considering these theories can help researchers and developers ensure that technologies will help promote a healthier world for older adults.

Disaster evacuation for persons with special needs: a content analysis of information on YouTube

Disaster preparedness is more complex for persons with chronic illness, who may require specific planning to address unique needs. Research suggests that advance preparation and evacuation during a disaster leads to better health outcomes. Individuals access, and rely on, health information via online sources. The purpose of this descriptive qualitative study was to examine information that persons who may have special needs receive from an Internet based free sharing source, YouTube, related to disaster evacuation procedures. A content analysis of 51 clips using the Health Literacy Skills Framework revealed themes related to quality and region. Findings suggested concerns such as errors, minimal information about management of conditions during evacuation, and lack of diversity.

Online Victim Tracking and Tracing System (ViTTS) for major incident casualties

INTRODUCTION

Dealing with major incidents requires an immediate and coordinated response by multiple organizations. Communicating and coordinating over multiple geographical locations and organizations is a complex process. One of the greatest challenges is patient tracking and tracing. Often, data about the number of victims, their condition, location and transport is lacking. This hinders an effective response and causes public distress. To address this problem, a Victim Tracing and Tracking system (ViTTS) was developed.

METHODS

An online ViTTS was developed based on a wireless network with routers on ambulances, and direct online registration of victims and their triage data through barcode injury cards. The system was tested for feasibility and usability during disaster drills.

RESULTS

The formation of a local radio network of hotspots with mobile routers and connection over General Packet Radio Service (GPRS) to the central database worked well. ViTTS produced accurately stored data, real-time availability, and a real-time overview of the patients (number, seriousness of injury, and location).

CONCLUSION

The ViTTS provides a system for early, unique registration of victims close to the impact site. Online application and connection of the various systems used by the different chains in disaster relief promotes interoperability and enables patient tracking and tracing. It offers a real-time overview of victims to all involved disaster relief partners, which is necessary to generate an adequate disaster response.

Reports and Session Summaries of the 17thWorld Congress on Disaster and Emergency Medicine

This section ofPrehospital and Disaster Medicine (PDM)presents reports and summaries of the 17th World Congress on Disaster and Emergency Medicine (WCDEM) held in Beijing, China in May and June of 2011. Included are reports and summaries that were submitted for publication inPDM.

Abstracts of Congress oral and poster presentations were published on September 1, 2011 as a supplement toPDM(Volume 26, Supplement 1). The 17th WCDEM was attended by 1,600 representatives from more than 57 nations, and the Congress included 315 oral and 211 poster presentations.

The editorial staff ofPDMis pleased to present the following reports and session summaries of the Beijing 17th WCDEM.

Reports and session summaries of the 17thWorld Congress on Disaster and Emergency Medicine.Prehosp Disaster Med.2012;27(3):1-11.

Design and evaluation of a wireless electronic health records system for field care in mass casualty settings

BACKGROUND

There is growing interest in the use of technology to enhance the tracking and quality of clinical information available for patients in disaster settings. This paper describes the design and evaluation of the Wireless Internet Information System for Medical Response in Disasters (WIISARD).

MATERIALS AND METHODS

WIISARD combined advanced networking technology with electronic triage tags that reported victims' position and recorded medical information, with wireless pulse-oximeters that monitored patient vital signs, and a wireless electronic medical record (EMR) for disaster care. The EMR system included WiFi handheld devices with barcode scanners (used by front-line responders) and computer tablets with role-tailored software (used by managers of the triage, treatment, transport and medical communications teams). An additional software system provided situational awareness for the incident commander. The WIISARD system was evaluated in a large-scale simulation exercise designed for training first responders. A randomized trial was overlaid on this exercise with 100 simulated victims, 50 in a control pathway (paper-based), and 50 in completely electronic WIISARD pathway. All patients in the electronic pathway were cared for within the WIISARD system without paper-based workarounds.

RESULTS

WIISARD reduced the rate of the missing and/or duplicated patient identifiers (0% vs 47%, p<0.001). The total time of the field was nearly identical (38:20 vs 38:23, IQR 26:53-1:05:32 vs 18:55-57:22).

CONCLUSION

Overall, the results of WIISARD show that wireless EMR systems for care of the victims of disasters would be complex to develop but potentially feasible to build and deploy, and likely to improve the quality of information available for the delivery of care during disasters.