From Pac Man to Public Health: Virtual Disaster Planning Technologies

Fears about a potential H1N1 flu pandemic have abated for the time being. But the outbreak—and the panic that ensued—did shine a light on the healthcare system's disaster preparedness plans. Hospitals and public health officials got a sneak peak at what processes worked well and what areas may need improvement in the event of a pandemic. Soon hospitals won't need an actual event to occur to improve the effectiveness of their disaster planning efforts, however.

Simulation and gaming technology can help healthcare organizations run drills with multiple players on various disaster scenarios. Unlike manual disaster drills, which hospitals only perform once a year or so because of cost constraints and the resources involved, virtual simulations could be used more frequently to help hospitals refine their manual drills and develop the most effective strategy for a plane crash, bioterrorist attack, or pandemic.

Simulators are not new to healthcare. Hospitals have been using mannequins to help clinicians practice clinical or surgical procedures for years. But healthcare organizations are just starting to investigate how virtual gaming technology can improve disaster training and preparedness.

One of the lessons learned during Katrina was that "even if every hospital had a perfect hurricane disaster plan, it didn’t do much good if 75% of hospitals were under water," says Paul Breslin, a senior principal at the Noblis Center for Health Innovation. "It was all about the system of systems."

Keeping clean water running, power on, and communicating when phone lines went down were more critical than anything else, he says, explaining that virtual simulations could enable organizations to test exactly that—what would happen if all the phone lines went down. What would people do and what decisions would they make?

Planning for a pandemic or bioterrorist attack is completely different than planning for a large train or plane crash. Hospitals can still take the lead, Breslin says, but focusing on their internal pandemic plan in terms of operations and isolating patients isn't enough. "We really need to be operating at a much higher level than the local hospital," he says.

Testing the community response to various situations is where virtual gaming technology may benefit health systems the most. It is difficult to run a disaster drill that includes all of the key players, such as local hospitals, clinics, physician offices, fire departments, police departments, and public health officials. But multiplayer gaming technology could enable each of these groups to sit at their desk and participate in a virtual disaster drill, and this reality may be closer than some hospital executives realize.

For example, Zero Hour: America's Medic is a single-player game designed to give EMT/Paramedics the chance to test their skills in response to four different scenarios—a SARS-like pandemic, earthquake, a derailment with chemical leak, and a sports complex explosion. The game, designed by George Washington University, provides first responders the opportunity to practice and refine their skills in four key areas: CBRNE (chemical, biological, radiological, nuclear, and explosives) detection, triage, information collection and threat recognition, and information sharing and collaboration. Players encounter different patients, scene hazards, and have different resources to call upon each time they play the game.

The Stanford University Medical Media and Instructional Technology group has also developed "virtual worlds" in which the patient, the clinical facility, and all personnel are represented as an avatar on the screen. Stanford's 3-D virtual ED, for example, can help train medical students and residents in different trauma scenarios.

Similarly, Noblis researchers developed HotZone, a game that allows first responders to react to a chemical and explosive attack in a virtual shopping mall. The game includes data extraction technology, which can be analyzed to see which strategy saved the most lives.

"One team did the exercise in 20 minutes and had zero fatalities and another took 30 minutes longer and had five fatalities," Breslin says. "The real value is having 50 people playing their roles in an event, looking at same scenario, making their own decision, and seeing how it might impact someone else," he says.

The benefit of this type of gaming technology is organizations can run drills over and over again and evaluate the data to see what strategies have the best results. "That is too cost prohibitive in manual events." Breslin says.