Formed in the aftermath of Hurricane Sandy, Powered for Patients works closely with public health preparedness leaders, emergency managers, healthcare facility managers, emergency power industry leaders and utilities to help safeguard backup power and expedite power restoration for critical healthcare facilities. Powered for Patients is also working with these and other stakeholders to help address the needs of at-risk citizens living at home who depend on life support equipment and other electric-powered medical devices during prolonged power outages.
The success of Powered for Patients has come in large part from the initiative’s ability to bring critical public and private sector stakeholders together for vitally important discussions and much needed collaboration. Funding for the initial Powered for Patients Stakeholder Meeting was provided by the Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response (ASPR), through a cooperative agreement with the Association for State and Territorial Health Officials (ASTHO). Other federal agencies participating in the meeting included the CDC, FEMA, the Department of Homeland Security, the Department of Veterans Affairs, and the Department of Energy.
Powered for Patients has since received funding from the U.S. Department of Homeland Security through a grant provided to the Rhode Island Emergency Management Agency that enabled the launch of a stakeholder engagement initiative that culminated in the publication of Protecting Patients When Disaster Strikes, a Playbook on safeguarding emergency power and expediting power restoration.
Powered for Patients has also worked closely with the American Society of Healthcare Engineering (ASHE), a personal membership group of the American Hospital Association. The two organizations published Roadmap to Resiliency in 2017, a white paper detailing the advanced technologies available to safeguard emergency power.
First Powered for Patients Emergency Power Resilience Initiative Launches in Rhode Island
Eric Cote met Pete Gaynor, who served as the FEMA administrator during the first Trump administration, when Gaynor was the Director of Emergency Management for the City of Providence. Gaynor always had an interest in emergency power, and in 2015, when serving as the Director of the Rhode Island Emergency Management Agency (RIEMA), Gaynor hired Cote to help assess the generator fleet in Rhode Island’s 15 hospitals and evaluate existing protocols for generator status reporting during outages. Cote facilitated a census of the emergency power systems in the state’s hospitals and worked with RIEMA to create a new protocol to accelerate emergency power threat reporting. He also authored Protecting Patients When Disaster Strikes, a heralded RIEMA Playbook that introduced the new protocol and other best practices to better safeguard emergency power.
Florida Nursing Home Deaths Following Hurricane Irma Highlight Need to Improve Power Outage Planning
When power outages triggered by Hurricane Irma in 2017 led to the deaths of 11 elderly residents at the Hollywood Hills Rehabilitation Center, U.S. Congresswoman Frederica Wilson, whose district included the facility, sought Cote’s counsel on ways increase federal support for power outage planning by hospitals and nursing homes. Cote’s advice was incorporated into the Disaster Recovery Reform Act of 2018, which called on FEMA to provide enhanced training resources to help hospitals and nursing homes boost power outage preparedness on an annual basis.
When FEMA began this work, they sought Cote’s counsel and later hired him to develop additional materials addressing how hospitals and nursing homes could partner with government agencies and utilities to boost power outage readiness and emergency power resilience.
Department of Homeland Security Turns to Powered for Patients to Boost Situational Awareness of Emergency Power Threats in Hospitals
In September 2018, the Department of Homeland Security awarded a competitive $300,000 Security and Resilience Challenge contract to Powered for Patients and a technology partner, Talus Analytics, to develop a prototype tool that would aggregate real time, automated alerts from multiple remote monitoring systems deployed in hospitals across the U.S. A number of the leading providers of these remote monitoring systems partnered with P4P to create the prototype. Hospitals had begun deploying remote monitoring technology years earlier to provide facility management staff with real time alerts anytime a generator kicked on or experienced a problem while operating. Aggregating these data feeds from competing technology providers into a single dashboard would, for the first time, give government emergency managers real time access to emergency power status reports at monitored facilities. These real time reports would dramatically accelerate government response to a stricken facility, minimizing the risk that an emergency power failure would trigger an emergency evacuation.
Powered for Patients’ project director, Eric Cote, subsequently developed Power P.I.O.N.E.E.R., a tool that captured and reported Power Information Needed to Expedite Emergency Response. Power P.I.O.N.E.E.R. would see its first deployment in 2021 in three Los Angeles County hospitals.
Lessons of RIEMA Initiative Inspire Similar Project In Los Angeles
In 2019, the Los Angeles County Emergency Medical Services (EMS) Agency hired Cote to launch an initiative modeled after his work with RIEMA. Cote assessed vulnerabilities in hospital emergency power systems across Los Angeles county and reviewed government response plans when failures arise during power outages.
Cote’s work over a four-year period included a census of emergency power systems in 80 hospitals that participate in the U.S. Department of Health and Human Services (HHS) Hospital Preparedness Program (HPP). Cote uncovered major vulnerabilities, including seriously outdated generators with some in excess of 50 and 60 years of age. Cote also found facilities with limited onsite fuel storage and fourteen hospitals with no redundant emergency power, some of which also relied on outdated generators. LA County EMS Agency leaders were deeply concerned by the findings and enlisted Cote’s help to develop a response plan.
To address the risks posed by facilities with no redundant emergency power, Cote recommended that the EMS Agency offer funding to its 14 single generator hospitals to install Power P.I.O.N.E.E.R., the real-time emergency power status reporting tool Cote developed with DHS funding. This would give EMS Agency officials real time alerts anytime emergency power kicked on in these facilities or experienced a problem while operating. Two of the hospitals had the technology installed in 2021.
Cote also recommended an accelerated emergency power status reporting requirement and he proposed the nation’s first confidential risk rating by a health agency of hospital emergency power systems. Both recommendations were accepted by the EMS Agency. The confidential risk assessment places hospitals with emergency power systems considered at higher risk of failure or whose failure would pose a greater threat to patients in a higher risk tier.
During power outages, EMS Agency personnel can review the confidential list to maintain closer vigilance of facilities considered at greater risk, a move that can help accelerate response to any problem that arises. Other protocols recommended by Cote and adopted by the EMS Agency included a rigorous vulnerability assessment by hospitals and an internal discussion among hospital leadership to review the findings and address any significant emergency power system vulnerabilities that were discovered.
Cote said the beefed-up protocols should be considered the new gold standard for emergency power resilience since they far exceed any state or federal requirements around emergency power status reporting.
Cote’s work with the LA County EMS Agency culminated with the 2023 publication of the Los Angeles County Healthcare Facility Emergency Power Resilience Playbook, which Cote co-authored with his client. The Playbook introduced the new protocols, other best practices and resources to help hospitals ensure that emergency power systems continue to operate during outages.