The future of command and control for disaster response

We have developed a bioresponse system concept to respond to large-scale medical disasters, including overwhelming, contagious bioagent events such as smallpox, plague, and influenza. This system, called Cybercare, aims to substantially increase the surge capacity of the healthcare system by allowing healthcare systems throughout the country to link together to provide specialists and other resources to augment those available at a disaster site. Key to the concept of Cybercare is the notion of a robust, distributed command and control system that will enable rapid and sustained responses to large-scale medical disasters. The Cybercare information infrastructure can also be utilized to support training and analysis of response procedures as well as a wide range of medical and disaster applications that occur on a frequent basis, such as home healthcare monitoring and rural and remote medical treatment. The purposes of this article are to: 1) define the problem set addressed by the Cybercare concept, 2) provide the reader with a fundamental knowledge of command and control and an emerging paradigm shift in command structure for the medical and disaster management domain, 3) define technologies that can be used to create a command and control system, and 4) illustrate how the technologies can be integrated into a disaster response system using the command and control paradigm.