Lenert, L AKirsh, DGriswold, W GBuono, CLyon, JRao, RChan, T C2020-02-062020-02-062011-10-19http://dx.doi.org/10.1136/amiajnl-2011-000229https://lib.digitalsquare.io/xmlui/handle/123456789/188BACKGROUND There is growing interest in the use of technology to enhance the tracking and quality of clinical information available for patients in disaster settings This paper describes the design and evaluation of the Wireless Internet Information System for Medical Response in Disasters WIISARD MATERIALS AND METHODS WIISARD combined advanced networking technology with electronic triage tags that reported victims position and recorded medical information with wireless pulse oximeters that monitored patient vital signs and a wireless electronic medical record EMR for disaster care The EMR system included WiFi handheld devices with barcode scanners used by front line responders and computer tablets with role tailored software used by managers of the triage treatment transport and medical communications teams An additional software system provided situational awareness for the incident commander The WIISARD system was evaluated in a large scale simulation exercise designed for training first responders A randomized trial was overlaid on this exercise with 100 simulated victims 50 in a control pathway paper based and 50 in completely electronic WIISARD pathway All patients in the electronic pathway were cared for within the WIISARD system without paper based workarounds RESULTS WIISARD reduced the rate of the missing and or duplicated patient identifiers 0 vs 47 pUnder0 001 The total time of the field was nearly identical 38 20 vs 38 23 IQR 26 53 1 05 32 vs 18 55 57 22 CONCLUSION Overall the results of WIISARD show that wireless EMR systems for care of the victims of disasters would be complex to develop but potentially feasible to build and deploy and likely to improve the quality of information available for the delivery of care during disastersManagerAccess to information or dataLack of population enumerationDemand for servicesGeographic inaccessibilityEffective resource allocationPlanning and coordinationTimeliness of carePilotUsabilityAcute or emergencyData collection and reportingElectronic health recordsInternetRaw dataElectronic case lists