Planning for a catastrophe involving a disease outbreak or mass casualties is an ongoing challenge for first responders and emergency managers. They must make critical decisions on treatment distribution points, staffing levels, impacted populations and potential impact in a compressed window of time when seconds could mean life or death.

Although extensive resources have been devoted to planning for a worse case scenario on the local, regional and national scale, a June 2008 report issued by the U.S. Government Accountability Office (GAO) found gaps still exist. While many states have made progress in planning for mass casualty events, many noted continued concerns related to maintaining adequate staffing levels and accessing other resources necessary to effectively respond.

Researchers at the Georgia Institute of Technology's Stewart School of Industrial and Systems Engineering have developed a computer software system that allows flexible design of facility models, including various clinical models created by the Centers for Disease Control and Prevention (CDC). The system is designed to help federal, state and local first responders design and test more efficient plans and policies for dealing with health care emergencies.

Known as RealOpt©, the program was created by Dr. Eva Lee, an associate professor of industrial and systems engineering at the Georgia Institute of Technology and director of the Center for Operations Research in the Medicine and HealthCare. Since its initial deployment in 2004, the system currently is approaching 400 users among the emergency preparedness community.

The appeal of RealOpt© is simple. No other system provides such an adaptive planning and assessment tool for large-scale emergencies. The program can assist in the design and of an all-encompassing, flexible and dynamic public health emergency response capability that requires strategic and operational systems planning.

"When it comes to medical emergency preparation, it is difficult to anticipate the outcome of a situation that has never occurred. Decisions must be made quickly," explained Lee. "RealOpt©, not only helps policy makers better prepare and more efficiently deploy available resources, the program also identifies gaps crucial to effective mitigation planning."

Charged with administering medication to an at-risk population during a disease outbreak or exposure to a biological agent, or to radiation or other harmful substances, the CDC and public health administrators must quickly ramp up point-of-dispensing (POD) locations and deliver appropriate emergency medical services in an orderly, expeditious and safe manner. For this reason, they value RealOpt©, as an effective planning tool.

"RealOpt©, is flexible, adaptable, easy-to-use and produces meaningful results to the user," said Bernard Benecke, a CDC staff member at the Coordinating Office for Terrorism Preparedness and Emergency Response. "It allows for complex optimization of PODs that cannot be determined by the naked eye."

According to Benecke, RealOpt©, was used in several major exercises in 2007 and has been funded by the CDC again this year for on-site drills due to its usefulness to local planners in changing standard operating procedures and POD designs that maximize efficiency. One exercise involved a multiple-site analysis that evaluated point of distribution sites for medications in the wake of a pandemic flu outbreak. "We learned that some local health departments had good plans in place, while others had more work to do," noted Lee.

Besides pandemic planning, since 2004, Lee and her research team have participated in strategic planning and in time-motion studies for anthrax and smallpox drills. In addition, RealOpt©, was successfully utilized by the City of New Orleans in 2007 for a mass vaccination drill that actually provided citizens with free flu shots. The program assisted in the clinic design and in determining optimal staffing rates. RealOpt©, was also able to pinpoint bottlenecks and the numbers of individuals receiving flu shots proved to be close to what the system anticipated.

"RealOpt©, is the first system that looks at the design of strategic planning and operational response on the ground," said Lee. "It gives policy makers a tool to assess their capabilities for handling large scale medical emergencies and how they might handle scenarios ranging from local public health emergencies to a situation of national magnitude."

In addition to being robust, RealOpt©, is extremely accessible. As a result of Lee's negotiation with the university, emergency planners can access the program free of charge.

Beyond biological and infectious disease outbreak emergency response, RealOpt© is currently used by first responders in planning for a radiological crisis, especially in radiation contamination screening and health monitoring. Lee also points out that the program is not confined to medical scenarios. It has been successfully deployed in manufacturing and industrial settings to help pinpoint where to locate manufacturing plants, personnel and other resources.

Despite the prospects for new applications, RealOpt© has proven its worth in the emergency response arena.

"First responders are able to use RealOpt's© capabilities to design their own clinics and compare different optimization methodologies. Additionally, it allows the user to optimize staffing and deal with shifting clinic demands during a crisis event. No other modeling software that I am aware of is able to do this," concluded Benecke.