Patient Prep

A new mapping tool helps health professionals prepare DME patients for emergencies – including prolonged power outages. BY LIZ LANGLEY

Severe weather and disasters that cause power outages can be deadly for people using electrically powered durable medical equipment, or DME. To address those safety concerns, in June the U.S. Department of Health and Human Services (HHS) launched the HHS emPOWER initiative, a program that helps emergency personnel assist patients who rely on electrically powered DME prepare for a disaster and ensure they’re okay following one.

The first element of emPOWER is an interactive map, available at phe.gov/empowermap, that can show the specific locations of monthly Medicare fee-for-service beneficiaries’ claims for electricity-dependent equipment at the national, state, territory, county, and zip code levels. The tool incorporates these data with real-time severe weather tracking services from the National Oceanic and Atmospheric Administration in a geographic information system.

According to HHS, more than 3.8 million Medicare beneficiaries are vulnerable in disasters because of their health conditions; 2.4 million of them rely on electricity-dependent medical and assistive equipment such as oxygen concentrators and ventilators, as well as home-health services such as hemodialysis.

There are three levels to the emPOWER initiative. First is the emPOWER map, where anyone can plug in their zip code and see the total number of DME users in their area. The second level, for use only by health departments, uses de-identified data to supply the number of people who are using various types of DME and home health services in a particular area. The third level, for use only in life-threatening emergencies by health authorities who can secure the information, provides specific addresses of people reliant on DME and home health services. This level is available only via special request to HHS, which works with the Centers for Medicare & Medicaid Services to provide access to the data.

The possibilities presented by this data could be significant. “Your health department or your emergency medical services could know about everyone in dialysis, and they could ensure all of those people had dialysis before the storm hit,” says Dr. Nicole Lurie, Assistant Secretary for Preparedness and Response at HHS. More generally, Lurie says, the tool helps emergency managers and health professionals make sure DME patients have an emergency plan, including the location of the nearest shelter, who can get them there, and where can they charge backup batteries for DME equipment. Power companies can also use the map to provide charging stations in areas with high DME concentrations.

In test drills for hurricane preparedness in upstate New York and New Orleans, teams tested the system by knocking on doors to find out if the patients matched the addresses and machines indicated in the source data. In both tests, the results were accurate more than 90 percent of the time.

“It’s incredibly useful data for planning,” Lurie says, especially for knowing where to put battery-charging stations to help people stay home in disasters. After Hurricane Isaac in 2012, Lurie says, many DME patients in New Orleans went to shelters to charge batteries, but some shelters weren’t wired to carry that kind electrical load and blew circuit breakers. Knowing the DME population, Lurie says, can help jurisdictions plan the necessary power capacity for shelters. Hospitals could also provide charging stations outside the facilities so that DME patients wouldn’t have to be admitted just to get their batteries charged.

Robert Solomon, division manager of Building and Life Safety at NFPA, describes the emPOWER map as “an awesome start, and we need to take advantage of that,” but notes that it doesn’t cover privately insured patients or others using DME who aren’t making Medicare claims. Jurisdictions need to make sure they can identify as many DME patients as possible, Solomon says. The HHS says it welcomes participation in the emPOWER program from states and private insurers.

LIZ LANGLEY is a writer in Orlando, Florida. Top Map: United States Department of Health and Human Services.