DAVE PARKS
The Birmingham News

Emergency medical authorities and hospitals in the Birmingham area have launched one of the nation's first systems to monitor continuously for casualties from a chemical or biological attack.

The computerized system has been operating since July and is attracting attention from major metropolitan areas interested in developing similar surveillance systems following the terror attacks on America that began nearly a year ago.

"This is a premier system," said Joe Acker, director of the Birmingham Regional Emergency Medical Services System, or BREMSS. "It protects 50 percent of the population of the state."

For years, public health authorities have envisioned a nightmare scenario such as an anthrax attack at a football game. It would take days for symptoms to start, and the first sign of trouble would likely be victims heading to hospital emergency rooms.

Unfortunately, the symptoms of many biological agents are similar to the flu, and it could be difficult for individual hospitals to quickly determine a biological attack had occurred.

But an unusual pattern or high volume of patients at several hospitals could trigger an early warning system to speed up diagnosis, treatment and counter-measures.

Acker said that's what the new system does. It is an outgrowth of an advanced computer network his agency has been relying upon to route ambulances to hospitals in Blount, Chilton, Jefferson, St. Clair, Shelby and Walker counties.

Hospitals routinely report information to BREMSS such as availability of beds, equipment, doctors and critical care units. In turn, ambulance crews report the type of patients they are transporting and their conditions.

This allows BREMSS to send ambulances to hospitals where patients can get the quickest, best care. "It's the only trauma and stroke system of its type in the world," Acker said.

Keys to the system are its software, designed by LifeTrac Technologies of Birmingham, and its secure computer network.

Adding the capability to monitor for a chemical or biological attack required rewriting software. Here are the new system's three escalating stages of alert:

It is always running, continuously listing the status of each hospital's medical/surgical beds, critical care unit and emergency department. It notes when any of these areas reach capacity and patients are diverted to other hospitals for that type of care.

If the computer detects an unusual diversion pattern, such as four hospital emergency rooms filling up at once, it issues an alert. The hospitals are asked for additional information, including symptoms of patients.

If the situation still seems suspicious, public health authorities are notified along with other emergency agencies. The computer keeps monitoring hospitals, and data from clinics is added to provide a central point of information for routing patients and crisis management.

John Hoyle, director of the Noble Training Center in Anniston, a federal facility that teaches hospital workers how to manage disasters, called the system a "tremendous public health asset."

Not only is it capable of detecting a chemical or biological attack, it can also speed up responses to natural disasters, accidents, outbreaks of food-borne illnesses or emerging diseases.

He said several communities began developing chemical and biological surveillance systems after the Sept. 11 attacks, and the federal government is funding some of these initiatives.

Dr. Don Williamson, state health officer, said the Birmingham-area system is the first of its kind in the state and one of the first in the nation that actually works. He said the state Department of Public Health is developing a statewide system that would essentially do the same thing.

"Birmingham is ahead of the curve," Williamson said.

Acker said design of the Birmingham-area system began before the terrorist attacks. That's given the area a head start in preparedness, and he's gotten calls for information from places such as New York, Chicago, Dallas and San Francisco. Some officials have visited Birmingham to see the system work.

The system was paid for almost entirely with local money and was not the product of a federal grant.

Rewriting the software cost $50,000, and new computers at the hospitals cost another $50,000. Acker said he requested financial assistance from the governor's office but was told no money was available. So hospitals in the system's six counties kicked in the money, Acker said.

The Birmingham VA Medical System, which is part of a federal system that coordinates disaster management, doesn't participate in BREMSS, Acker said.

Jeff Hester, a spokesman for the VA, said the medical center is limited in whom it may accept as patients, and officials believe that makes participating in BREMSS unnecessary.

"We can only have veterans brought here," he said.

The VA may have to reexamine the issue, given BREMSS' growing role in disaster management, Hester said.