Leverage relationships and technology to make people safer during disasters

Primary Health Networks (PHNs) have been at the forefront of efforts to support General Practice and other primary health providers caring for communities at times of natural disasters.  How well prepared is your PHN for this role?

Our continent has its share of droughts, floods, bushfires, and cyclones with some regions particularly prone to natural disasters. This article explores the role of regional health authorities including PHNs in supporting communities at times of disaster. Particular attention will be given to the importance of actively leveraging provider relationships through digital enablement to ensure joint working in the mitigation, readiness, response, and recovery phases.

Experience tells us that great relationships with and across healthcare provider networks is foundational to effective disaster management.  Disasters invariably stress-test professional relationships and communities will suffer if people are not ready or able to work collaboratively.  The lessons of the COVID-19 pandemic serve as a timely reminder.

However, while relationships are foundational, and we should not underestimate the challenge of developing and sustaining these relationships, this is insufficient in of itself.  Goodwill needs to be backed-up by systems, and these must be digitally enabled given the complexity of the task, and the vastness of the regions that are often affected.

A cautionary tale:

When working in Northern Australia I personally witnessed the risks and anxieties for those preparing for an imminent cyclone event for a regional city. We knew that our local professional relationships were untested, and that our capacity for a coordinated multi-agency response across primary health was limited. As a freshly minted PHN we had no register of GPs willing to participate in a coordinated response; we had no information on the disaster readiness of practices; and our mechanisms for communicating with providers were highly dependent on the personal relationships of just a few staff members. We were also unclear as to what our role should be. This drew understandable criticism from local disaster agencies and was viewed as unacceptable on every level.  When the cyclone crossed the coastline, it was in a less populated area, but it impacted heavily on some smaller communities. Clearly there are lessons to be learnt and PHNs must help lead the way.  It is too late to attempt to sort these things out when a disaster is looming!

While relationships are foundational, digital enablement is needed to:

• Maintain a whole-of-region electronic register of individual healthcare professionals and organisations agreeing to be part of coordinated efforts for disaster readiness, provider response and community recovery
• Collect and maintain the minimum dataset needed to assess regional primary health system readiness
• Collate the data needed to inform integrated whole-of-region multi-agency planning
• Facilitate timely communications during all phases
• Conduct scenario-based exercises to test readiness- i.e. the relationships, communications, and capacity
• Identify region-specific gaps and unmet needs e.g.  training, equipment, etc.
• Feed in data to the PHNs Health Needs Assessment i.e., the groups most at-risk during disasters

Thought starters

• What roles has the Commonwealth specified for your PHN in times of disaster?
• Does your PHN need to have a formal disaster management function?  If so, how would you decide staffing and resourcing arrangements?
• Does your PHN have a formally agreed role with other local and State disaster management agencies – LHDs, Local Government, SES, Police, Defence, etc.   
• How would you ensure that the relationship that the PHN has with its local primary healthcare professionals will stand-up to the stressors associated with disasters?   How would you test this?

Key take-aways from this post

• The most important role of the primary health sector in a disaster is to resume regular services as soon as possible after the event.  This is so acute health services are not overrun by patients seeking primary care.
• Great relationships are essential during times of disaster, but they must be supported by purpose-designed and well-tested digital information systems.  Your CRM is a good starting point but ultimately PHNs need to specify and acquire purpose-specific Disaster Management Information Systems.
• Timely and accurate information is needed to support all disaster management phases – mitigation, readiness, response and community recovery
• Research suggests that climate change will increase the frequency and intensity of natural disasters globally
• Use your regular provider engagement processes to build local capacity for collaborative working at times of disaster. 
• Incentivise individuals and practices to sign-up for your disaster response ‘register’ – build the business case and show the value proposition
• Participate in scenario testing exercises

This research article from 2019 notes that more work is needed globally for the development of integrated disaster management information systems. This provides an opportunity for Australian PHNs to show global leadership!