This Computer System Already Promotes Life, Liberty and Domestic Tranquility

 

April 22, 2005 The Department of Homeland Defense is already the federal government's third largest executive department, yet after three years and more than $100 billion in allocations has nothing in place as effective as an often overlooked computer system in Alabama.

This software, called LifeTrac, can provide early detection and warning of potential biological or chemical events, an essential element in protecting Americans from domestic terrorism which curiously has not been directly addressed by proposals in the works at Homeland Defense. In fact, LifeTrac has been performing this surveillance for three years, at least in the Birmingham, Alabama, metropolitan area, where LifeTrac's homeland defense systems have been fully operational since June of 2002.

Homeland Defense's massive effort to fight threats of domestic terror, the $6-billion Project BioSphere, is not only months away from yielding substantive results, BioSphere focuses on developing new medical countermeasures to biochemical terrorism— vaccines and treatments - but not on rapid identification of such events and minimizing exposure to them.

LifeTrac can also be implemented so quickly and cost-effectively in a specified region, within six months it could be in operation throughout the New York and Washington, D.C. metro areas for less than Homeland Defense spent on hotel rooms during its first year of operation. Expanding the system to provide nationwide protection would take less than two years to complete and probably cost only about $100 million, not much more than what the state of Georgia alone spent on homeland security projects during the 2003 fiscal year and less than three-tenths of one percent of the 2005 national Homeland Defense budget.

Public officials have long been challenged with planning for potential nightmare scenarios like the introduction of a biological agent such as anthrax into a public water supply or released airborne at a large public gathering like a sporting event. Hours, even days, could pass before those who were first infected exhibited symptoms, which would be similar enough to those of common ailments like flu that individual medical personnel wouldn't necessarily become alarmed. And since the patient load would be spread across different hospital emergency rooms in the area, the scale of the outbreak could at first be disguised, and even the most observant ER staff members might not appreciate the seriousness of the situation until it had become widespread.

In such an instance, there would literally be no time to lose. The longer a biochemical agent remains undetected, the greater the number of people exposed to it, increasing at an exponential rate.

LifeTrac addresses this complex situation with a surprisingly simple concept, tracking the various medical resources at emergency rooms across a region and relaying the information in real time to a local communications center for analysis. This broad overview of multiple facilities detects atypical trends in the allocation of various emergency medical resources, an extremely early indicator of a potential mass biochemical exposure, and alerts public health authorities immediately so that the situation can be investigated and appropriate countermeasures initiated while there is still opportunity for containment.

Unlike a diagnosis-based warning system, which would be slowed by its dependence on laboratory results, LifeTrac instead exchanges specificity for speed.

Its uniquely comprehensive capability to sample general emergency medical data can quickly indicate the severity of any suddenly emergent health threat even if the qualitative details are still unknown.

LifeTrac was developed initially as an ER routing assist tool to ensure that trauma patients were transported to facilities with immediately available resources appropriate for their specific injuries. The system still links computers in various hospital emergency rooms in real-time communication with a central location, giving emergency transport teams fast access to the current status and availability of all area emergency medical resources and preventing wasted transport time to a less appropriate facility.

In incidences of mass casualty, LifeTrac helps prevent patient overload at hospitals nearest the scene of large-scale trauma like a school bus accident, a tornado touchdown, or an explosion at an office or government building. A stroke component added later helps get victims to available diagnostic equipment and treatment within the narrow window of opportunity following a stroke when brain tissue can still be saved.

LifeTrac was conceived by staff of the Birmingham Regional Emergency Medical Services System (BREMSS), which serves approximately one million people in a six-county area of central Alabama, and developed through the efforts of a number of Birmingham-area physicians, including Dr. Loring W. Rue, III and Dr. William D. Hardin, Jr.

In a public-private partnership with BREMSS, software developer Forté Incorporated absorbed part of the cost of the design and implementation of the system, which went online in 1996 and has since been involved in routing more than 25,000 patients. An early study of LifeTrac's impact, published in the journal "American Surgeon," reported that trauma mortality was reduced by almost 40 percent at one participating Birmingham hospital.

"It's the only system of its type in the world," said Joe Acker of BREMSS.

Designed to run on standard PCs and to require less than an hour of training for hospital staff, LifeTrac's chief developer Glenn Phillips focused on making the system straightforward in function and graphically intuitive. "You can actually be up to speed and ready to work with LifeTrac in ten minutes," Phillips said. "We wrote the software to carry the work load, so the user doesn't have to."

Phillips was in the process of adapting LifeTrac to deal with biochemical catastrophy when the events of 9-11 occurred. In the largely at his own expense, to apply its unique monitoring capabilities in combating the threat of domestic terrorism.

"We already had this extensive communications network that was designed for speed," Phillips said. "After 9-11, it was clear how LifeTrac's basic function could easily bridge a serious information gap in detecting biochemical terrorism."

While LifeTrac is still technically unproven as a domestic security tool, at a minimum the system could economically provide a high level of protection for a majority of the U.S. population long before more elaborate projects will be finalized. So far there has been little state or federal interest in funding an expansion of LifeTrac into areas where it would be more likely to face a legitimate biochemical threat, which has led Phillips to seek private investors and partnerships with larger companies to promote use of the system in other parts of the country.

"An enormous asset of LifeTrac is that its benefit to a city or state is not exclusively tied to the threat of domestic terrorism," Phillips said. "If our country is lucky enough to completely avoid another attack on our soil, the money spent on this system is in no way wasted, because LifeTrac will have been saving the lives of trauma and stroke victims every day."