When Hurricane Sandy flooded lower Manhattan in 2012, knocking out power for days, emergency responders needed to find citizens who survive daily with the help of electricity-dependent medical equipment and health care services. But without data on where they lived, rescuers had to go door to door, searching through buildings for those who were stranded due to nonfunctioning elevators and an inability to walk down stairs.
That dangerous situation galvanized Kristen P. Finne of the Department of Health and Human Services to find a better way to help plan for and in a disaster identify, locate and assist over 4.1 million people who live independently and rely on life-sustaining equipment and health care services. This includes facility-based dialysis and electricity-dependent medical equipment such as portable oxygen, ventilators and electric wheelchairs.
Finne, a program manager with HHS’s Office of the Assistant Secretary for Preparedness and Response, developed and directs the emPOWER Program to help those at risk.
This program consists of three national data and mapping capabilities that use Medicare data, and weather and geographic information, to help community officials and first responders plan for, assist and locate people who rely on electricity-dependent medical equipment and may need help in the event of a natural disaster. This includes hurricanes, wildfires, tornados, floods and other emergencies.
“Kristen is emPOWER. She is the innovator, mastermind and the workhorse behind the entire program,” said Robert Kadlec, the HHS assistant secretary for preparedness and response. “She raised the funding, forged the partnerships and established the technical infrastructure necessary to build and sustain the emPOWER Program.”
In the past five years, emPOWER has supported more than 100 disaster responses. As Hurricanes Irma and Maria devastated the U.S. Virgin Islands in 2017, federal authorities used the program to identify, rescue and evacuate 235 at-risk individuals who were electricity-dependent and required dialysis services for survival.
Rescuers used the data to find at-risk individuals during wildfires in Tennessee, California and Oregon, following floods in Nevada and power outages in New York, and as hurricanes Irma and Matthew stalked Florida.
“Every citizen now has a safety guard for their medical needs thanks to Kristen Finne,” said Dr. Jeffrey Kelman, chief medical officer for the Centers for Medicare & Medicaid Services. “Kristen is available 24 hours a day, seven days a week. She understands that if she isn’t responsive, it could be too late to save someone in need.”
The first pilot study of the program to identify oxygen-dependent individuals was conducted in New Orleans in 2013 with the help of Sarah Babcock from the city’s health department.
When Hurricane Isaac left the city without power for eight days in 2012, “We had no idea where to start,” said Babcock. “But now with emPOWER we have identified our most vulnerable citizens and can reach out to them in an emergency.”
Babcock called emPOWER “a fantastic tool” and praised Finne for seeking feedback from local partners and helping connect them to share information and learn from others.
Finne constantly looks for ways to improve the program and make it useful to local entities, Babcock said, meeting regularly with local partners across the country. She has created educational materials that include online training and an emPOWER map, is developing an online portal to share resources, and is exploring how to speed communications by using additional technology such as artificial intelligence and virtual assistants,
The publicly available, interactive emPOWER map displays the location of at-risk, electricity-dependent Medicare beneficiaries.
“Kristen has been the main driver and the only person who has been a part of every step of the process,” Babcock said.
In addition to saving lives, the program saves money by targeting assistance and reducing the risk to first responders by enabling them to evacuate vulnerable people before a crisis worsens, said Dr. Kevin Yeskey, principal deputy at the Office of the Assistant Secretary for Preparedness and Response. “Kristen isn’t a traditional first responder, but she thinks like a first responder,” he said.
One of Finne’s biggest hurdles was creating a new CMS policy and protocols to allow for de-identified and individual data to be provided to state, local and public health authorities so they can provide life-saving assistance.
Finne has worked with scores of HHS lawyers and technology experts to ensure the data is used only for the specific purpose of the emPOWER program.
“She has shown us how to successfully reach out to what might not be obvious stakeholders to work on solutions that are innovative, creative and have an impact,” Yeskey said.
Currently, Finne is seeking to expand the Medicare model to include other at-risk populations, including veterans and those served by Medicaid and the Children’s Health Insurance Program.
“At first, I wasn’t sure about federal service as I had been working in the startup environment,” Finne said. “But the impact you can have by helping millions of people is life changing and a compelling mission. This work has been one of, if not the most rewarding thing I have done in my lifetime, and I have felt that every step of the way.”