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U.S. Department of Health and Human Services

Enhancing Public Health, Healthcare, and Emergency Management Systems

National Health Security Strategy Strategic Objective 4

The public health, healthcare, and emergency management systems represent a cornerstone of national health security. Responses to adverse health incidents, such as the 2014 Ebola epidemic, demonstrate that much work remains to be done to ensure that public health, healthcare, and emergency services systems are able to work together day-to-day, mutually supporting one another so that they can seamlessly scale up to handle increased requirements or demands during the mitigation, response, and recovery phases of the incident life-cycle. All of these systems rely on a skilled workforce.

The nation has made progress toward establishing the foundation for such integration. Regional planning alliances and healthcare coalitions have proliferated. The Hospital Preparedness Program  (HPP), for example, has expanded its focus on building community health resilience by fostering the development of health care coalitions (HCCs) that include hospitals, long-term-care facilities, community health centers, emergency management, and public health agencies, in planning of building emergency response capabilities into routine public health and healthcare delivery systems. In addition, the growing adoption of electronic health records  is facilitating health system integration. 

Integrating the expertise and specialized knowledge and skills found in the public health, healthcare, and emergency management systems will enhance a community’s resilience without duplicating services under different organizations or strategies.  Activities have been undertaken to build a highly competent health security workforce, including the identification core competencies for disaster medicine and public health.

The six priorities for this objective seek to sustain and build on recent progress by strengthening healthcare coalitions and planning alliances, building on and improving routine services and systems, focusing on the needs of at-risk individuals, strengthening workforce education, increasing the number of trained workers and volunteers, and effectively managing and using that workforce.


Actions to Support these Priorities

Healthcare Coalitions and Regional Planning Alliances

Federal partners will

  • Develop tools and guidance for including nontraditional organizations in the regional preparedness planning process
  • Work with academia and the community to build the evidence base around coalition effectiveness
  • Work with coalitions to establish guidance for development, implementation, evaluation, and improvement of health system emergency management programs

Additional actions partners can take

  • Local health departments can work with nonprofit hospitals to identify hospitals’ contributions to community health resilience 
  • Healthcare coalitions can work with member hospitals and the state to define response roles for coalitions beyond pre-incident planning
  • Healthcare coalitions can encourage members to share information about their mobile medical assets and training

Building Upon and Improve Routine Systems and Services

Federal partners will

  • Incentivize the use of existing tools  that promote the coordination of care (e.g., patient-tracking tools, EHR compatibility features)
  • Provide guidance for how to modify  existing information systems (e.g., EHR, immunization data systems) to better support national health security goals
  • Work with non-federal stakeholders to support the widespread application of disaster risk reduction and mitigation principles
  • Develop policy and procedural recommendations for a mass fatality response in a resource-scarce environment

Additional actions partners can take

  • Hospitals, providers, and academia can explore how existing telemedicine programs and technologies can address healthcare surge and access needs 
  • Non-federal stakeholders can develop continuity-of-operations plans that address relocation of personnel, the performance of essential functions, and devolution of services
  • SLTT government planners can evaluate their continuity plans and capabilities  using the Continuity Assistance Tool (CAT), published by FEMA

Access and Functional Needs of At-Risk Individuals

Federal partners will

  • Develop quality measures to provide guidance regarding incidents impacting children
  • Work with academia, private industry, and SLTT to conduct research on the use of social media and other sources to locate at-risk individuals
  • Work with non-federal stakeholders to create guidance on planning for and engaging populations with enhanced privacy needs (e.g., domestic violence victims) for evacuation and sheltering
  • Work with non-federal stakeholders to facilitate communication among at-risk individuals and the public health, healthcare, and emergency management systems

Additional actions partners can take

  • Non-federal stakeholders can explore options to incentivize providers to counsel at-risk populations about preparedness 
  • SLTT governments can work with schools and day care centers to increase awareness of the need for family reunification plans.

Health-Security-Related Workforce Education

Federal partners will

  • Work with non-federal stakeholders to identify cybersecurity awareness and training
  • Work with stakeholders to develop a national plan for disaster health education and training 
  • Work with stakeholders to establish disaster health education credentials in fields that currently lack them
  • Review, adapt, and disseminate Incident Command System (ICS) and other training materials 
  • Work with academia and other stakeholders to develop consensus-based national health security competencies, and create metrics to evaluate them 

Additional actions partners can take

  • Academia and professional associations can create tailored trainings in emergency response for specialty providers and government employees
  • State governments can coordinate training at the regional level to ensure consistency across potential responder groups
  • SLTT governments can assess the return on investment of workforce training

Number of Trained Workers and Volunteers

Federal partners will

Additional actions partners can take

  • Non-federal stakeholders can participate in public-private initiatives to facilitate workforce expansion during a response
  • Non-federal stakeholders can engage national temporary staffing agencies before incidents and conduct advanced credentialing to facilitate rapid deployment
  • SLTT governments and private sector businesses can identify sources of surge staff outside of health department and assign them to likely response tasks

Nonmedical Volunteers and Affiliated, Credentialed, and Licensed Healthcare Workers

The federal government will

  • Work with voluntary organizations not traditionally involved in national health security to assist them in defining their potential incident response roles and contributions to community resilience in incident prevention, protection, mitigation, and recovery phases

Additional actions partners can take

  • Non-federal stakeholders can adopt common standards (pathogen-specific) for personal protective equipment 
  • SLTT governments can leverage credentialing efforts for routine healthcare needs for use in incident response
  • SLTT governments can work with institutions of higher education to ensure that individuals who volunteered as students continue to be engaged and informed of opportunities after graduation

  • This page last reviewed: February 13, 2015