Mass Notification Systems: A Useful Tool during Pandemic Response

March 1, 2010
The recent H1N1 flu pandemic clearly demonstrates why health facility administrators must prepare their responses to large-scale public health emergencies using every tool available. There is much at stake.

Historical pandemics such as smallpox and avian flu have overwhelmed health care infrastructures and spread quickly through populations, causing serious illness and death for thousands of people. Because the potential impact of a pandemic is so great, health facilities and health organizations must be ready to quickly respond to such an event in order to mitigate the damage.

Health care facilities now are using network-centric emergency mass notification to transform their existing Internet protocol (IP) networks and connected devices into highly capable emergency alerting systems. Alerts can be triggered using a Web browser on any network-connected PC (subject to authentication and granted permissions). Once activated, alerts are disseminated across the network in the form of intrusive audio/visual messages to desktop computers, as well as mobile devices such as phones, pagers, BlackBerry devices and personal digital assistants (PDAs).

Since many traditional alerting channels (sirens, telephones, public address systems, etc.) now have IP interfaces, network-centric notification systems can trigger alerts to those channels, extending and unifying these systems under a single alert management platform.


The advantages of a network-based emergency mass notification system for health facilities are numerous, and include:

  • Unified notification: Integrates with many IP-based and legacy notification systems to provide easy and effective emergency notification from a single Web-based console.

  • Rapid and pervasive reach: Distributes emergency alerts to hundreds of thousands of people through network-connected devices in minutes.

  • Web-based system access: Operators can send alerts from anywhere they have a network connection (given authentication and authorization).

  • Richer message delivery: Delivers detailed and tailored communications based on the threat or scenario.

  • Multi-use/full-spectrum threat response: Has greater capability to respond to any pandemic or scenario requiring rapid and pervasive mass notification.

  • Confirmed alert receipt and acknowledgment tracking: Tracks delivery and acknowledges every alert to ensure people have received the information.

  • Personnel accountability: Receives rapid and reliable feedback on status of personnel.

  • Regulatory compliance: IP-based notification complies with federal and Department of Defense (DoD) emergency mass notification guidelines.

  • Cost savings: By leveraging the existing IP network, a health organization realizes substantial cost savings.

  • Quick installation: By leveraging the existing network, installation and infrastructure integration can be completed within hours or very few days.

The network-centric model holds other significant benefits for health emergency managers. A network-centric alerting system gives facility emergency managers the ability to obtain and disseminate critical situational details. Alerts sent through the IP network to computer desktops can include detail unavailable through audio alerts made through a loud speaker, accelerating response times and getting the appropriate personnel to respond to each situation. Alerts can be tailored to target specific groups based on location, role and organizational hierarchy. For example, medical personnel can be directed to the emergency rooms, while non-essential building occupants are advised to stay out of infected areas of the facility. Such on-the-scene information can be invaluable to emergency managers and greatly increase the effectiveness of the response.

Another critical capability of a network-centric mass alerting system is a feedback capability that can communicate the status of alert recipients. When an alert is sent, the system will require a response from recipients to determine their status (available, sick, etc.), locations and their abilities to act. This provides facility emergency managers with a reliable picture of personnel accountability and what resources are available to deploy. This amount of detailed information represents a tremendous asset in helping emergency managers make the best possible operational decisions during an emergency and will help ensure a safe outcome for all personnel.

With third-generation mass notification systems, emergency managers can obtain reliable, detailed status of all impacted personnel in minutes during an emergency, thereby greatly enhancing their response to the pandemic or threat.

Third-generation mass notification systems leverage existing IP networks to communicate rapidly to all connected devices, integrate and unify disparate existing mass notification channels, provide two-way communication from all personnel and achieve enterprise-level scalability and processes.


The use of IP-based alerting in third-generation notification systems is an integral part of systems interoperability and connectivity — both critical attributes necessary to ensure the widest possible reach of any message.

These systems also can leverage “IP aware media gateways,” such as Web sites (commercial, public and government), social networks (Twitter, Facebook, LinkedIn) and other non-traditional channels. Adoption of standards such as common alerting protocol (CAP) can further aid with communication and getting the word out to the appropriate audience by incorporating information feeds from sources such as the Centers for Disease Control and Prevention (CDC) and the National Weather Service.

Already, health facilities nationwide are using network-centric alerting to warn of emergencies, recall personnel and notify emergency workers of where they are needed.


Recently, Irwin Army Hospital in Fort Riley, Kan., announced the deployment of an IP-based mass notification system to protect its personnel. As a hospital located on a fort, Irwin could confront a variety of emergencies such as attacks, pandemics, antibiotic-resistant bacteria outbreaks, hazmat spills and other health and safety concerns.

The hospital's third-generation alerting system significantly increases its ability to contact personnel on and off site when an event occurs. Alerts rapidly are delivered through the IP network to all computer workstations using pop-up visual alerts, and computer speakers broadcast the message. The system also delivers alerts as SMS text messages to cell phones and can send emails to computers and mobile devices. Alerts can reach geographically dispersed people through multiple devices in a matter of minutes.

The hospital benefits from tiered operator permissions, active directory integration and multi-unit support. Emergency operators have the ability to alert all personnel in times of emergency.


Wilford Hall Medical Center serves as the Air Force's largest medical facility and is a national resource, providing complete medical care to military health care beneficiaries in the south central United States as well as specialized care to patients referred from all over the world.

As a military medical facility, Wilford Hall Medical Center uses network-centric alerting system to alert personnel of pandemics and all the types of situations, whether threats posed by weather or man-made sources. Because most people in a hospital cannot be mobilized easily in response to the threat, however, early warning is critical to enable Wilford Hall to effectively respond to emergency situations.

Besides mobility challenges, Wilford Hall faces a different set of emergency scenarios. These emergencies can range from biological or chemical contamination to a large influx of patients coming into the hospital due to an accident. Additionally, the Medical Control Center serves as the eyes and ears for the medical community, and if an emergency situation arises, the group is responsible for alerting Wilford Hall personnel.

When an emergency situation arises, the Medical Control Center uses IP-based mass notification system to alert the more than 5,000 computers distributed across the five-building medical facility.


Lyster Army Health Clinic at Fort Rucker in Alabama relies on third-generation mass notification to notify personnel about threats faced by domestic military installations, whether threats posed by weather or man-made sources. The clinic provides primary care and ancillary services to a military population that consists of active duty service members, their families, a large retiree population and their family members.

Lyster leverages network technology for the rapid delivery of alerts for clinic-related operational communications. These can range from biological or chemical contaminations to communication of epidemic or pandemic information or to a staff recall with a large influx of patients due to a mass casualty incident. In addition to outward-bound notifications, Lyster can connect to external sources of alerts, such as the CDC, to automate the dissemination of local or national CDC information such as recent H1N1 updates.

Maintaining the privacy of personnel information is a requirement of all health care organizations, so it is vital that systems keep clinic personal information deployed behind the firewall and highly secure.

The deployment of emergency mass notification at Lyster represents another step in the DoD medical community's adoption of third-generation mass notification technology. Third-generation systems leverage existing IP networks to communicate rapidly to all IP-connected devices and achieve enterprise-level scalability and processes. The result is the most effective, enterprise-wide mass notification capability with the best cost to benefit ratio.

Investing in an emergency notification system architecture that leverages the existing IP infrastructure and integrates with existing sirens or public address systems promises to be the most effective way of alerting the most people in the shortest amount of time. DoD has placed its stamp of approval on network-centric alerting and health care facilities are following the DoD lead. Third-generation mass notification systems better protect people located in a health facility, but also will go a long way in helping health facility emergency managers perform their missions better.

David Edgar serves as director of Operations — Federal Civilian for AtHoc Inc., San Mateo, Calif. He oversees AtHoc's Federal Civilian and Education sectors, including sales and business development. He spent more than 18 years in the IT industry, including 16 years at Microsoft, where he earned his MCSE.

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