Reform strategies and implementation approaches

¶ … health management systems designed to serve public needs during disasters and emergencies, two are discussed here: Emergency Prescription Assistance Program (EPAP) and state social media platforms. Each system addresses a different aspect of health management during disasters and emergencies. The EPAP is a highly formalized system -- as it must be since it deals with prescription drugs and equipment -- yet, the rigidity of the system may limit its effectiveness or, minimally, its responsiveness early in an emergency or disaster. The state's social media platforms have limited utility if electrical supplies are interrupted during a disaster. Even though the systems may depend on servers that are located out of harms way, the individuals who are impacted by a disaster may not be able to access the state's social media sites.

Introduction

The two approaches to emergency management discussed in this paper address two very different aspects of emergency preparedness and disaster response. The Emergency Prescription Assistance Program is focused on the provision of medications and durable medical equipment to people in need following a declared emergency. The use of state social media platforms is intended to address issues of communication before, during, and after emergencies or disasters. The purpose of this paper is to briefly outline the two approaches and to discuss the associated benefits and the barriers.

Emergency Prescription Assistance Program

Benefits

The Emergency Prescription Assistance Program (EPAP) is designed to bridge the gaps and overcome the barriers to providing medications and durable medical equipment (DME) to people during disasters ("EPAP," 2012). The normal means of communicating about prescribed drugs and equipment for people are subverted or destroyed during times of emergency and disaster ("EPAP," 2012). The Emergency Prescription Assistance Program (EPAP) acts to facilitate the implementation of these systems through alternative avenues when the systems that people have depended on are no longer functioning or in place ("EPAP," 2012). Through the Emergency Prescription Assistance Program (EPAP), enrolled pharmacies in the United States and its territories may have access to existing electronic pharmacy systems and infrastructure in order to process prescriptions and DME efficiently ("EPAP," 2012). Moreover, the enrolled pharmacies may leverage -- through the Emergency Prescription Assistance Program (EPAP) -- private sector resources in order to distribute prescription medications efficiently ("EPAP," 2012). That the EPAP system extends to all enrolled pharmacies throughout the U.S. And its territories, and additionally permits access to private sector resources, holds promise for adequately providing these services to people who are displaced -- often widely -- during times of nationally significant disasters ("EPAP," 2012).

When the infrastructure that supports healthcare and the provision of medical services is destroyed in a disaster, people with both acute and chronic conditions are left in vulnerable circumstances -- often with little hope for expedient relief, a condition which can result in untimely death and unnecessary suffering (Krisberg, 2010).

Effective Management

Introduction

An exploration of management practices in a military organization is substantively different in a number of ways from the same type of exploration conducted in the world of civilian enterprise. In the military, there is a cord extending from Pentagon-level leadership to down range command. This cord is an articulation of myriad rules and regulations that are not vulnerable to managerial whimsy or subject to the next-new-best-management-practice being promulgated in Ivy League business schools as the enlightened way forward. This is not to say that military management cannot or does not access the rich store of contemporary management theory. Rather, it is a validation of the place reasoned change has in the military machination. For military management practices to be revised, there must be a clear-cut advantage to capacity and force development. ARFOGEN was established for just those reasons -- to ensure that the Army regained its balance in order to meet the "requirements to operate in an environment of prolonged conflict against a hybrid threat" ("Stand To!," 2010).

Planning. In 2006, the United States Army took planning steps to move away from a de facto demand-driven process of force generation that left the forces, in the words of Army Chief of Staff General George Casey, "out of balance" ("Stand To!," 2010). The demand for forces in the protracted conflicts in Afghanistan and Iran was met without conscription -- a first time circumstance for military campaigns of such length. Forces were readied and supplied rapidly, but with great fiscal, organizational, and personal cost, stress, and inefficiencies. This new force generation plan that was designed to address these dynamics and problems is called Army Force Generation (ARFOGEN).