OUR COMMUNITY HOSPITAL Backup Communications

Discussion
Mission: provide essential communications for Our Community
Hospital in the event of failure of the public switched telephone system.

Examples of events that might lead to such a failure include excavation breaching Bell
system cables, in-house failure of the telephone controller, electrical supply problems,
windstorm damage to telephone system essential infrastructure (ref 1998 Deroche
event in central Unnamed State), or other dislocation.

Communication missions include the following:

1. Point-to-point communications within the hospital
2. Communication with Unnamed County Central Dispatch
2.a. ref EMS (dispatch, HEARN traffic)
2.b. ref police requirements (reports or law enforcement assistance
requirements).
2.c. ref fire service requirements (haz mat incidents)
3. Communications with hospitals receiving transfer patients (Unnamed Medical
Center, Anonymous Referral Center, St. Elsewhere, Nowhere Mercy Hospital ,
Nowhere General)
4. Being on standby during circumstances which might complicate the
above communications missions (e.g. telephone system servicing
or upgrades, construction evolutions that might take down phone
service)

Mission Descriptors
A. Independent of Bell System
B. User Friendly (does not add to employee workload) (does not distract
employee from duties) (does not require staff to master the use of new
equipment)
C. Reliable (will batteries last throughout the duration of a communications
failure?) (will the devices communicate with those we need to reach? E.g.
physicians, other hospitals, dispatch?) (do the personnel who will be using the
devices, know how to do so effectively under conditions of high channel loading,
e.g., when everybody tries to speak at once?)
D. Robust. (are these devices resistant to being rendered unusable-e.g.
by inadvertent channel changes, volume changes, or other parameter changes
by personnel unfamiliar with the device?)
E. Readily available/readily recharged power source
F. Secure. (ref patient transfer information)

Mission #1: in house, point-to-point communications

Likely high priority sites
ER/ACU
LTCU
Lab/registration
Radiology
Communication security likely a lesser issue than other missions, due to
likely ability to avoid HIPPA sensitive information.
Non technical users (user friendliness important)
Bell system independence valuable

Candidate Responses to accomplish this mission:

Hard wired, “field telephones”

PRO:
Looks just like a common telephone (ease of training) Secure. System organization not
complicated (switchboard mode: “Please connect me with LTC…”). Robust. Some
models powered by D x 4 batteries.
CON:
“dialing” is novel (crank-to-ring). Investment on the order of $75-$300/instrument
(depends on mil surplus vs. commercial new) Requires wiring in place prior to need.
Lag time to retrieve and employ instruments.

FRS Radios
PRO:
Instruments in house presently, in use presently. Powered by
commonly available batteries. Use not complicated. Reliable. Bell
independent.
CON:
Presence of GMRS frequencies (which are on these radios)
mandates GMRS licensure for legal operation, per FCC regulations.
(GMRS licensure is _not_ available for institutions). Keyboards not locked, leading to
degraded robustness of system dependent upon them. Unsecure communications.
Runners
PRO:
Low tech. Secure. Bell Independent. Robust. User friendly. No power supply issues.
CON:
Where will these personnel come from? How will they be vetted ref HIPPA
compliance? If they do not materialize, very greatly decreased robustness, user
friendliness.

MURS (Multiple Use Radio Service: Unlicensed VHF 2 watt radio service)
PRO:
License free service (no legal issues). Bell independent. Robust (few user adjustable
controls on radio). User friendly (users capable of manipulating FRS radios ought to
find MURS radios to be no challenge). Battery powered, alkaline battery power option
likely available. Reliable at in-house ranges. Mildly secure (small numbers of MURS
radios in circulation)
CON:
Cost approx $60-$200 per instrument. Batteries require maintenance. Access to radios
may be problematic (where stored? How accessed? Who has key?)

Amateur Radio
PRO:
 Equipment generally supplied by the Amateurs. Robust, reliable (the Hams typically
know their radios well, and are generally capable of minor level trouble shooting). User
friendly (Hams manipulate radios, leaving staff to patient care duties). Training
infrastructure is in place presently (Hams trained as any other volunteer) Bell
independent. Mildly secure. Powered by Ham supplied batteries.
CON:
Finding/training/organizing suitable numbers of volunteers who are Hams, or will obtain
licensure may be an issue. Drills required to integrate these personnel into the
response plans of the hospital. HIPPA (etc) training required. How do we call up the
Hams, in time of need?

MISSION 2:
COMMUNICATION WITH UNAMED COUNTY CENTRAL DISPATCH

Issues include communication with ambulances regarding incoming patients, and

communication with dispatch regarding need for additional assets (e.g., transfer
ambulance, police department or fire department assets). These become issues in the
event of a telephone outage.

Candidate responses to accomplish this mission:

800 MHz Radio

PRO:
County owned, county cost. Common (to public safety) equipment. Bell independent (if
local tower connects to central by means independent of Bell system, with independent
power supply on site) Reliable. Robust. Secure (highly so) battery power (spare
battery/-ies?)
CON:
County equipment means hospital does not control. New equipment means training
costs, and decreased familiarity by staff with this equipment. In the event of failure of
the local tower, there are no communications via this means with Central.

FRS/MURS
Unsuitable for communication with central due to range (1-2 miles) and lack of
interoperability options.

Amateur Radio
PRO:
Potentially capable of communication with Central (proven capability of communication
with Neighboring Town Amateur repeaters, which themselves are capable of
communicating with Central). Modest Our Community Hospital cost (perhaps defrayed
by grants from community—Major Employer #1, Major Employer #2, Major Employer
#3, Rotary, unnamed Community Foundation, or from DHS or Unnamed State State
Police-Emergency Management). Bell independent. Reliable (to be proven). User
Friendly (Hams operate radios, staff does nursing, etc. Limited task distraction).
 Robust. Powered by Our Hospital generator or 12 volt battery.
CON:
Cost of training volunteers (HIPPAA, etc). Only mildly secure. Must have antenna/feed
line in place, prior to need, for maximum reliability and effectiveness. Drills required in
order for Hams and staff to understand how to work together. One question yet to be
answered is how Central will achieve Ham capability. How will we call up Hams?
*communication past the ridgeline at Westerly Town may be a problem,
particularly in the event of failure of the Neighboring Town Ham repeaters
*Memorandum of Understanding with the repeater owner(s) is important
for smooth operations in the event of an emergency.

HEARN VHF Radio

PRO:
Already in place. Antenna is in place. Central can monitor. (To Be Verified!)
Ambulances have VHF HEARN Radios in vehicles already (To Be Verified!) Commonly
used technology. Robust. Bell independent. Reliable. Powered by Our Community
Hospital generator (To Be Verified!).
CON:
Is it REALLY in place (Our Community Hospital ) (Ambulances)? Can Central REALLY
monitor HEARN? Is our HEARN radio REALLY powered from Our Community Hospital
generator? How powered in the event of generator failure?

800 MHz Radio

PRO:
County owned, county cost. Common (to public safety) equipment. Bell independent (if
local tower connects to central by means independent of Bell system, with independent
power supply on site) Reliable. Robust. Secure (highly so) battery power (spare
battery/-ies?)
CON:
County equipment means hospital does not control. New equipment means training
costs, and decreased familiarity by staff with this equipment. In the event of failure of
the local tower, there are no communications via this means with central.

MISSION 3: COMMUNICATION WITH RECEIVING HOSPITAL

Candidate responses to accomplish this mission:

HEARN VHF Radio

PRO:
Already in place. Antenna is in place. Receiving Hospital can monitor. (To Be Verified!)
Receiving Hospitals have VHF HEARN Radios in place already (To Be Verified!)
Commonly used technology. Robust. Bell independent. Reliable. Powered by Our
Community Hospital generator (To Be Verified!).
CON:
Is it REALLY in place in receiving hospitals? Can receiving hospitals REALLY
communicate with us via HEARN? (range may be an issue, with Unnamed Southerly
Town being +/- 60 miles away, and Anonymous Metropolis +/- 70 miles distant) (PL
 tones may be an issue: do we have the capability to be compatible with their tones?) Is
our HEARN radio REALLY powered from Our Community Hospital generator? How
powered in the event of generator failure?

800 MHz Radio

PRO:
County owned, county cost. Common (to public safety) equipment. Bell independent (if
local tower connects to central by means independent of Bell system, with independent
power supply on site) Reliable. Robust. Secure (highly so) Battery power (spare
battery/-ies?) Theoretically able to “patch” across the state (!Verify!)
CON:
County equipment means hospital does not control. New equipment means training
costs, and decreased familiarity by staff with this equipment. In the event of failure of
the local tower, there are no communications via this means with central. Does staff @
Central understand how to “patch” to distant hospitals? Would they not have numerous
other tasks demanding their time, besides providing our communications?

FRS/MURS
Unsuitable for communication with central due to range (1-2 miles) and lack of
interoperability options.

Amateur Radio
PRO:
Potentially capable of communication across the state on shortwave frequencies.
Modest Our Community Hospital cost (antenna and feed line) (perhaps defrayed by
grants from community or DHS/ State Police Emergency Management). Bell
independent. Reliable (to be proven). User Friendly (Hams operate radios, staff does
nursing, etc. Limited task distraction). Robust. Powered by Our Community Hospital
generator or 12 volt battery.
Amateur Radio
CON:
Do any Hams, volunteering to assist, have shortwave equipment? Can Anonymous
Referral Center/Unnamed Southerly City hospitals communicate on shortwaves?
Cost of training volunteers (HIPPAA, etc). Only mildly secure. Must have antenna/feed
line in place, prior to need, for maximum reliability and effectiveness. Drills required in
order for Hams and staff to understand how to work together. How will we call up
Hams?