Mapping Interoperability: A Network Analysis of Collaborations within the National Disaster Medical System Pilot Program

Abstract Information: For public health emergencies of extreme magnitude, such as a terrorist attack, global disease outbreak, or catastrophic natural disaster, the U.S. military often collaborates with civilian healthcare and emergency services to mount an effective response. One military-civilian capability activated during such events is the National Disaster Medical System (NDMS), a national network of civilian, military, and government healthcare entities that agree to provide definitive medical care in the event of a disaster health emergency. In 2020, a Congressionally-authorized NDMS Pilot Program was established to bolster the U.S.’s readiness for large-scale disasters by expanding and strengthening interoperable partnerships in the NDMS. Interoperability is commonly understood as the ability of diverse organizations to work together seamlessly, yet the concept is difficult to measure and evaluate as it represents a vaguely defined relationship. Social network analysis is a useful method for understanding the structure of a set of connections between individuals or groups. The NDMS Pilot’s evaluation is employing social network analysis intermediate- and post-program implementation to both describe and analyze local NDMS response communities and determine the strength of interoperable partnerships. Each captured relationship is assigned an interoperability metric, which is then used to determine the overall level of collaboration within each NDMS response network. Intermediate data on existing NDMS partnerships were collected via a survey of organizations within five major metropolitan areas across the United States that participated in a discussion-based activity simulating an activation of the NDMS. Networks were elicited through an unrestricted name-generator (free-list) approach, followed by a 4-point ordinal survey to qualify the level of formal agreement, frequency of interaction, and self-reported confidence in the partnership. Stata/SE 18.0 was used to convert partnerships into a matrix of existing relationships, and each reported partnership was assigned an interoperability scale score based on the agreement, frequency, and confidence survey items. Initial results provided an understanding of existing NDMS response community networks, the structure of diverse partnership collaborations within each network, and an intermediate assessment of interoperability. Conducting this analysis at multiple time-points will enable the evaluation to assess progress towards the Pilot’s overall desired outcome of improving interoperability.