Practice Title: Improving Emergency Response and Efficiency by Developing an Electronic 213 (e213) System
Department: Harris County Public Health (HCPH) Harris County, Texas, the third largest county in the country, is located along the Gulf Coast where human health and well-being are continuously impacted by intricately intertwined, man-made and natural events. Harris County Public Health (HCPH) is the local health department for the county’s unincorporated areas and 33 municipalities located outside the City of Houston. HCPH provides comprehensive health services and programs with dedication to improving the health and well-being of Harris County residents and the communities in which they live, learn, work, worship and play. The HCPH jurisdiction serves approximately 2.3 million people within Harris County, not including the City of Houston. For certain public health services, such as mosquito control, Ryan White/Part A HIV funding, and refugee health screening, the HCPH jurisdiction encompasses the entirety of the county, including the City of Houston, thus providing services to 4.7 million people in total. In 2017, as a part of the disaster response to Hurricane Harvey, it became evident to HCPH leadership that a centralized process for creating, approving, and fulfilling resource requests using the Incident Command System (ICS) 213 form was needed. While activated staff were dispersed across the county at various county offices, emergency shelters, and remote locations, the paper-based system being used proved to be outdated and inefficient. As a quick fix, emails and spreadsheets were utilized in communicating across divisions and tracking resources, but this was not a long-term, sustainable solution. The FEMA ICS-213 form is used in disaster response to track resource requests and follow approvals through the chain of command. It is also used to track the status of requests and assist with documenting incident expenditures. The idea for the electronic 213 (e213) web-based application was developed by activated Environmental Public Health (EPH) staff and was built and implemented in partnership with the Office of Public Health Preparedness and Response (OPHPR), Project and Business Technology (PBT) department, and HCPH divisional leadership over a span of 2-3 weeks. The e213 application needed to be developed quickly because of the rapid nature of the Hurricane Harvey response. The initial e213 application development was a first step in making the ICS-213 form and approval process digital, but would later be significantly enhanced for, and beneficial to, the COVID-19 response. What was ultimately needed during the extended COVID-19 response was a centralized system available to multiple users, with the ability to track the progress of requests, and maintain a historical record of response-related information. HCPH sent out its first official notice to regional healthcare partners about COVID-19 on January 9th, 2020 with the first cases of COVID-19 in the county following in late February. On March 4th, Harris County activated the Incident Command System and on March 11th, a Local State of Disaster was declared for the County. The department quickly assembled its COVID-19 response team, ramped up staffing, tightened alliances with local government and community partners, facilitated mass testing logistics, increased surveillance of COVID-19 cases and data, and strengthened community outreach and communications. Within HCPH’s expansive and ongoing COVID-19 response, the e213 program has served as a useful tool for employees at all levels of the response and ultimately allows the Administrative/Finance Section to efficiently track and document expenditures for reimbursements. Through lessons learned during the COVID-19 response, HCPH has been able to advance the health department’s capacity to respond to future disasters by standardizing the communication and documentation of ICS-213 resource requests and ensuring that HCPH maximizes reimbursements for disaster-related expenses. Public health is one of the most underfunded programs in the country, and HCPH must ensure they’re reimbursed for expenses during the COVID-19 response. These reimbursement protocols not only protect HCPH but help the department to continue providing valuable services for all members of the Harris County community.
Size: Large (Population of 500,000+ people)
State: Texas
Summary of Practice:
Improving Emergency Response and Efficiency by Developing an Electronic 213 (e213) System
Category
ePublic Health & Informatics
Description