Part of the EDXL Suite of Data Standards

Hospital AVailability Exchange (HAVE) is a draft XML specification that allows the communication of the status of a hospital and its resources to other emergency agencies, including bed capacity and availability, emergency department status, the available service coverage, and the status of a hospital’s facility and operations.

THE NEED

In a disaster or emergency situation, there is a clear need for hospitals to be able to communicate with each other, and with other members of the emergency response community. The ability to exchange data in regard to hospitals’ bed availability, status, and capacity enables both the hospitals and the other emergency agencies to respond to emergencies or disaster situations with greater efficiency and speed. In particular, it will allow emergency dispatchers and managers to make sound logistics decisions - where to route victims, which hospitals are open. Many hospitals have expressed the need for, and indeed many are currently using, commercial or self-developed information technology that allows them to publish this information to other hospitals in a region, as well as Emergency Operations Centers (EOCs), 9-1-1 centers, and Emergency Medical Services (EMS) responders via a Web-based tool. 

Systems that are available today do not present data in a standardized format, creating a serious barrier to data sharing between hospitals and the latter emergency response groups. Without data standards, a hospital is unable to view data from hospitals in a state or region that uses different systems than it does. State level officials must get special passwords and toggle between web pages to get a full picture. Other local emergency responders are unable to get the data imported into the emergency Information Technology tools they use (e.g. a 9-1-1 computer aided dispatch system, or an EOC consequence information management system). They too must get a password and go to the appropriate web page. This is very inefficient. A uniform data standard will allow different applications and systems to communicate seamlessly.

COMCARE'S APPROACH

The Virginia Hospital and Healthcare Association and COMCARE began to address this issue in 2004, seeking to aggregate in a single, state-level web page for hospital capacity and status information from the products of the two competing vendors selected by Virginia hospitals.  In early 2005, the project leaders of the Virginia effort were introduced to the HAvBed project leaders by members of the Department of Homeland Security’s Disaster Management eGov Initiative (DHS DM) EDXL Project team.  Funded by the Agency for Healthcare Research and Quality (AHRQ), the primary purpose of the HAvBed project is the development of a demonstration prototype “real time” hospital bed availability system to assist in dealing with potential regional and national patient surge capacity needs. Dr. Steve Cantrill, the Associate Director of Emergency Medical Services at Denver Health, headed the project, supported by a nationally representative group of medical institutions and experts.

Dr. Cantrill’s team of practitioners developed the original draft Hospital Resource XML specification; a broad medical advisory committee oversaw their progress. One of the inputs to this specification was the basic prototype standard created in 2004 by VHHA, which was re-used in its entirety.

It became apparent that the HAVE effort was complementary to the EDXL structure. Furthermore, the common objectives and audience of both efforts underscored the synergies between the two. Both used common structures and technology choices. Dr. Cantrill requested that the HAVE draft be incorporated into the EDXL standards development process. 

The DHS DM, with COMCARE and other organizations, facilitated the development of the Emergency Data Exchange Language (EDXL), a collection of standards for information exchange among all emergency professions. The focus of the initiative was to create specific message exchanges in a clearly defined functional context and includes all emergency professions as its actively participating constituencies. DHS DM provided staff support to assist Dr. Cantrill, Mr. Steve Ennis of VHHA and their colleagues in developing this draft standard, including detailed notice and consultation with a large number of experts.

Several successive versions of the draft were circulated very broadly in the medical, EMS, public health and emergency management communities. Multiple open conference calls were held to discuss and amend it. The practitioner organizations listed on the right have been represented in one or more of these calls. When the authors were convinced they had completed appropriate consultation with domain experts, they turned the draft over to the EDXL process. The draft was explained and considered in two meetings of the EDXL project practitioner-dominated Standards Working Group. The HAVE draft was reviewed and approved.

FROM VISION TO REALITY

The draft specification is now before national organizations in the medical, EM and EMS domains to solicit additional input. Following this review, the specification will be submitted to EIC (Emergency Interoperability Consortium) and then to the OASIS international standards organization for its consideration and promulgation as a standard. Simultaneously, demonstrations are planned to validate it from a technical standpoint.

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