Tracking patients during a large-scale emergency, such as a mass casualty incident or a natural disaster, is a complex logistical operation. This process ensures that limited medical resources are allocated effectively and maintains continuity of care as patients move through different treatment phases. Establishing a continuous record of a patient’s location and medical status is essential for effective management. Accurate tracking also supports the public health goals of family reunification and provides data for post-incident analysis.
Immediate Patient Identification and Triage
The first step in patient tracking begins with a low-technology system applied directly at the scene of the crisis. Standardized triage protocols, such as Simple Triage and Rapid Treatment (START) or Sort, Assess, Lifesaving Interventions, Treatment/Transport (SALT), are used to quickly assess patients in 30 to 60 seconds. These protocols assign a color-coded category based on the severity of the patient’s injuries and their potential for survival.
Patients are physically marked with a triage tag that corresponds to their assigned category. Responders use these tags to quickly identify patients based on color, providing immediate situational awareness for resource management.
The color codes typically include:
- Red for immediate life-threatening injuries.
- Yellow for serious injuries where treatment can be delayed.
- Green for minor, or “walking wounded,” injuries.
- Black for patients who are deceased or whose injuries are incompatible with life given current resources.
- The SALT protocol also includes a Gray or “Expectant” category for patients who are still alive but are not expected to survive.
The physical triage tag serves as the foundational tracking document, providing a unique identification number, preliminary medical status, and space to log basic interventions performed and the transport destination.
Leveraging Existing Digital Health Records
Once a patient is moved from the immediate disaster zone, the focus shifts to utilizing pre-existing medical documentation systems. Electronic Health Records (EHRs) are a primary tool, allowing authorized medical personnel to access a patient’s comprehensive medical history, including allergies, medications, and pre-existing conditions. Access to this historical data is necessary for making informed treatment decisions.
A significant hurdle in a widespread emergency is the lack of interoperability between different healthcare systems, which complicates data sharing across multiple hospitals and jurisdictions.
To address this, centralized disaster registries or Health Information Exchanges (HIEs) aggregate patient data from various sources into a single, accessible platform. This aggregation allows for a systemic view of patient movement, ensuring that a patient’s record follows them even if they are transferred across state lines.
The aggregated data from EHRs can be used for public health surveillance, helping officials monitor disease spread or track injury patterns following a mass casualty event. Physicians also utilize these systems to track the outcomes of discharged patients, improving learning and quality of care.
Dedicated Patient Tracking Technologies
Beyond paper tags and digital records, specific technologies track patient location and status in real-time within the emergency response architecture. Radio Frequency Identification (RFID) tags and Real-Time Location Systems (RTLS) are frequently utilized for in-facility tracking, particularly within hospitals or temporary evacuation centers. Patients may wear wristbands embedded with an RFID chip, which is read by sensors placed throughout the facility, pinpointing their exact location.
RTLS information helps manage patient flow, locate individuals quickly, and prevent misidentification errors. Geospatial mapping and Global Positioning System (GPS) data extend this capability to the field. GPS receivers track the location of ambulances and mobile medical units.
This provides incident commanders and receiving hospitals with real-time geolocation of incoming patients, enhancing situational awareness and allowing the hospital to prepare resources before arrival.
Specialized patient tracking software allows first responders to enter triage data, injury details, and the patient’s GPS coordinates using a mobile device. This data is instantly shared to a common operating picture, providing a centralized platform for multiple agencies to coordinate efforts. Aggregated mobile phone location data, often anonymized, can also be used to estimate population movement patterns for family reunification and targeting relief efforts.
Safeguarding Health Information During Emergencies
The collection and sharing of sensitive patient information during a crisis must be balanced with strict privacy and security requirements. In the United States, the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule sets the standard for protecting health information.
Certain HIPAA provisions may be temporarily suspended or waived during a declared public health emergency. For example, sanctions may be waived against hospitals that do not comply with requirements regarding obtaining a patient’s agreement to speak with family members or their right to request privacy restrictions.
These waivers do not eliminate the need for security. Healthcare organizations must continue to implement reasonable safeguards to protect electronic health information, maintaining protocols that ensure only necessary personnel can access the data. HIPAA already permits sharing information without patient authorization for treatment purposes and with public health authorities to prevent or control disease.
After the emergency declaration is lifted, standard privacy rules are reinstated. Organizations must have clear protocols for data archiving and storage, as accurate records are necessary for billing, post-incident analysis, and future continuity of care. The goal is to enable rapid information flow for immediate care while ensuring long-term security and confidentiality.