"The capacity and capabilities...required to manage such disaster incidents are in place, albeit in varying states of configuration, maturity, and functionality," the IOM report said. "However, systems to manage the truly catastrophic incidents that are the subject of this report, in which overwhelming numbers of casualties and cascading failures of infrastructure compound the incident, are rudimentary at best.
"As a result, in its renewed deliberations on developing and implementing CSC, the committee recognized the demand for a rigorous systems approach."
Hanfling says there's a lot of "low-hanging fruit," that just hasn't gotten picked. One area "where we have fallen flat on our face at this point" is that private physicians "have not been effectively integrated" into disaster planning and response, he says.
"Private practitioners are very busy running their offices; they're business people...And in many instances, for them to understand what their specific role and responsibilities might be in a disaster is something that I think we have only begun to address," he says.
The report includes templates that various sectors of health providers can use to model their programs, or compare what they should have with what they do have. There are templates for state and local government, prehospital emergency medical responders, hospital and acute care facilities, and out-of-hospital and alternate care systems.