By David E. Hubler
Contributor, EDM Digest
Just as hospital staffs and patients rely on technology to provide most services, hospitals and other healthcare facilities are reliant on “a steady uninterrupted supply of power and access to the digital world,” say the authors of The Resilient Hospitals Handbook, Strengthening Healthcare and Public Health Resilience in Advance of a Prolonged and Widespread Power Outage.
Charles Manto, Earl Motzer, Ph.D., and James Terbush, MD, MPH, write that “Healthcare as practiced in the United States is complex and becoming more so as health facilities become ever more dependent on technology, especially with regard to the U.S. power grid and information technology (IT).”
Protecting the North American power grid, often described as “the largest and most complex machine in the world,” is of paramount importance to ensure a steady, reliable supply of electric power to the U.S. and Canada.
The Handbook does not focus on cybercrime, hacking, electromagnetic impulses (EMIs) or cyberterrorism except as they relate to threats to the power grid.
EMIs can be natural occurrences or manmade attacks designed to take down a foe’s power installations. “Intentional EMI can come from small electronic weapons that can be carried in briefcases or larger ones that can be driven by van or truck,” the Handbook warns.
Moreover, the sophistication and capabilities of these weapons make it possible now “to drive by a targeted control or data center and disable it without ever getting closer than a few hundred yards outside a security fence.”
Although we usually link widespread power failures to natural disasters like hurricanes and floods, solar storms, or space weather, can also do a great deal of damage. In fact, in 1989, “a relatively minor solar event” shut down power for over six million customers in Canada for at least nine hours.
“The sun randomly continues to produce coronal mass ejections (CMEs) sufficient to physically destroy much of the power grid the nation relies upon,” warn authors Manto, Motzer and Terbush.
The Handbook defines resilience as an operational concept meaning “continuity of operations” or, more simply, “the ability to take a blow and come back” after a prolonged power outage from a “once in a generation” or “once in a lifetime” major disaster, such as Hurricane Katrina in 2005 and Super Storm Sandy in 2012.
Two Recent Examples of How Severe Storms Can Affect Hospitals
Hurricane Katrina left New Orleans’ Memorial Hospital structures virtually intact. But “supplies, food, and pharmaceuticals were all in limited supply afterward as the hospital was cut off by the floodwaters. After approximately 48 hours, the backup generator failed due to rising water and, sometime after that potable water to the hospital also ceased,” according to a New York Times account by Dr. Sheri Fink of Memorial Hospital, as reported in the Handbook.
Seven years later Super Storm Sandy left more than 8.5 million households and businesses in the Northeast U.S. without power from the grid. When sensors in the fuel tanks supplying NYU’s Langone Medical Center’s emergency generators detected water from the storm, they shut down. “Without emergency power, NYU Langone was forced to evacuate hundreds of patients to nearby hospitals,” the Handbook relates.
Various experts, including Pete Riley, a senior research scientist at Predictive Science Inc., of San Diego, have estimated the likely chances of a major disaster in any decade at between 6% and 12%.
However, those odds were thrown out the window this past August when a trio of deadly hurricanes—Harvey, Maria and Irma — struck in rapid succession from the U.S. Gulf Coast to the Eastern Caribbean between August 25 and September 20. Harvey and Maria rank among most destructive and expensive disasters in U.S. history.
The Handbook provides a list of recommendations to protect against “High-Impact Hazards Threats to Power Infrastructure,” including:
For Current Power Systems
- Procure redundant power via electrical feeders from different substations and, if possible, different providers. Receiving electrical power from different providers diversifies electrical power sources and thereby mitigates some risk.
- Test generators under full load conditions rather than simply on a monthly basis to determine if they will start and operate as desired.
- Enhance backup power generation. Diesel generators must have sufficient backup power to meet critical mission areas and have a sufficient diesel fuel supply to endure an extended power outage. Hospitals are required to have 96 hours of fuel on hand, but a seven-day supply is a more realistic minimum.
For New Systems
- Create an on-site (or near on-site) power generation and storage capability incorporating on-site energy sources with an appropriate level of energy storage to provide the base loads required to keep the hospital functional (usually 30% to 50% of all power).
- Consider energy savings from local power generation and energy efficient improvements to help discover funding for new microgrids.
- Consider natural gas-fueled generators. They can provide a suitable alternative electrical power energy source.
- Consider creation of electromagnetic pulse (EMP)-protected facilities for power, network, and data center infrastructure.
- Consider developing a system-of-systems evaluation of the facility, which could supply technical and financial support necessary to enhance resilience in light of high-impact threats.
- Consider inclusion of systems modeling and management, which could aid in the development and management of a microgrid.
- Bolster Physical Security with security cameras and motion detectors
- Limit access to only essential personnel who should be screened with at least minimal background checks to minimize the potential for “insider threats.”