Can we rely on the Internet in emergencies?

When disaster strikes a community, first responders race to the scene. But where does everyone else affected by the event go?

To the hospital.

Whether it's a hurricane, a fire, a flood, a factory explosion, a car pileup on a highway, hospitals are where people congregate. That's where the extent of the human damage is ultimately calculated and communicated to the world at large.

Hospitals are the hub for a community reeling from a catastrophe. They are where individuals seek answers to questions about those who survived and those who did not. People expect doctors, nurses, technicians and other staffers to be on duty and ready to heal and comfort those affected.

Medical authorities understand this. That's why the American Hospital Association requires its nearly 6,000 member hospitals to have disaster preparedness committees that are responsible for planning how they will respond to large-scale emergencies. It's essential that those plans include an effective communication structure.

Hospitals are definitely on the right track, but I'm concerned that their well-laid plans could get derailed.

In the past, many hospitals relied on phone trees to get people where they needed to be. You know, Mary calls John and Sue. They call Bill and Trudy and Donna and Linda. And so on. Sometimes radio and TV stations broadcast calls for emergency personnel to get to the hospital as quickly as possible.

In a pinch, those options are better than nothing. But hospitals have recognized that phone trees and media pleas have limitations. And the AHA thinks a more comprehensive and manageable approach to emergency communication is necessary and -- in an era of instant digital communications technology -- possible. Therefore, the organization's for-profit subsidiary, American Hospital Association Solutions, last year embarked on a review of 75 companies that offer some form of emergency communications systems. Mary Longe, director of patient flow solutions at AHA Solutions, worked with consultants at Ernst & Young to analyze those vendors' products and services and eventually decided to recommend that hospitals use an offering from National Notification Network, which does business as 3n.

3n has a software-as-a-service system that's designed to reach people instantly in multiple ways. If you're, say, a perfusionist (a specialist who runs the heart-lung machine during cardiac surgery) and you aren't answering your land line, the system will track you down over your mobile phone, pager, BlackBerry or whatever method is listed in your profile. If you happen to be scuba diving, it'll track down the next perfusionist on the list. At the same time, the system will be contacting doctors, nurses and anyone else needed. As Longe points out, the system will even know if the hospital needs additional nonmedical personnel in a crunch for vital tasks such as getting nonambulatory patients up and down stairwells. 3n's system has links to all kinds of hospital data, so it will know, for example, which floors have beds available. And it's designed to escalate the communications process to include nearby hospitals when one facility is overwhelmed.

Longe likes the fact that 3n has an "active/active" pair of data centers in the US that use Oracle Streams technology with 15-millisecond bidirectional updates. That setup ensures that the system will be available as long as the Internet has a heartbeat.

That brings me to my one and only concern. As a nation, we are becoming wholly dependent upon the wonders of the Internet. Yet an errant boat anchor was able to disrupt Internet communications in Africa and Asia earlier this year. And as Gary Anthes revealed, ISPs haven't implemented best practices to defend against a concerted online attack. As never before, the condition of the Internet is critical to the health of the US But unfortunately, our plans to keep it healthy are woeful at best.

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