1. Sibiu– November 200729th International Conference of the Romanian Medical Informatics Society MEDINF 2007 SIUMSIUM EMIL STĂNESCU National Institute for R&D in Informatics-ICI Bucharest, Maresal Averescu,8-10 stanescu@ici.ro Standards and Geographic Information for Medical Emergency Situations ILEANA STĂNESCU National Institute for R&D in Informatics-ICI Bucharest, Maresal Averescu,8-10 ileanas@ici.ro

2. SIUMSIUM Sibiu– November 200729th International Conference of the Romanian Medical Informatics Society MEDINF 2007 CONTENT TABLE Introduction Geographic information used in emergency standards Geographic midpoints 1.SIRUTA Registry 2.Calculation method for geographic midpoints Conclusions

3. SIUMSIUM Sibiu– November 200729th International Conference of the Romanian Medical Informatics Society MEDINF 2007 INTRODUCTION (1) In the last years a great attention has been granted to the preparedness for emergency situations such as natural disasters, medical urgency etc. We present some issues about using geographic information in emergency standards and analyze emergency hospital distribution in Romanian counties. The actual technological context: Location Based Services and Global Positioning System create premises of using, on a large scale, geographic information in emergency operations Geographic information coordinates of emergency resources are used in almost all messaging protocols, giving necessary accuracy for information in those situations.

4. SIUMSIUM Sibiu– November 200729th International Conference of the Romanian Medical Informatics Society MEDINF 2007 INTRODUCTION (2) We developed some geographic resources, using Romanian SIRUTA nomenclature of populated places, in which we have completed the geographic coordinates. Using this geographic database we established some measures for evaluation of repartition of emergency hospitals in function of their positions and proximity to people from Romanian counties.

5. SIUMSIUM Sibiu– November 200729th International Conference of the Romanian Medical Informatics Society MEDINF 2007 GEOGRAPHIC INFORMATION USED IN EMERGENCY STANDARDS (1) Standards for definition of a unitary interoperability environment for incidents and emergency systems: Common Alerting Protocol (CAP) is a data interchange XML-based data format for exchanging public warnings and emergencies between alerting technologies. CAP allows a warning message to be consistently disseminated simultaneously over many warning systems to many alerting and event notification applications. The current version of CAP is 1.1. CAP is used as a standalone protocol and as a payload for EDXL messages.

6. SIUMSIUM Sibiu– November 200729th International Conference of the Romanian Medical Informatics Society MEDINF 2007 GEOGRAPHIC INFORMATION USED IN EMERGENCY STANDARDS (2) The purpose of the Emergency Data Exchange Language (EDXL) is to provide a common vocabulary, syntax and process for the sharing of data related to all phases of disaster management and emergency response among diverse information systems, disciplines and communities of practice.  EDXL Distribution Element (EDXL-DE) facilitates the routing of any properly formatted XML emergency message to recipients.  EDXL Resource Message (EDXL-RM) Specification provides a set of standard formats for XML emergency messages.  EDXL Hospital Availability Exchange (EDXL-HAVE) is a draft XML specification that allows the communication of the status of a hospital, its services, and its resources. These include bed capacity and availability, emergency department status, available service coverage, and the status of a hospital’s facility and operations

7. SIUMSIUM Sibiu– November 200729th International Conference of the Romanian Medical Informatics Society MEDINF 2007 GEOGRAPHIC ELEMENTS OF EMERGENCY STANDARDS Geographic elements of emergency standards are based on OASIS Geography Markup Language (OASIS GML) profile for specifying the geo-location and its attributes. This profile contains the element, structured as a container with a choice-type component and attributes:,,,. Example of Point representations for Floreasca Emergency Hospital: 44.453894 26.101477

8. SIUMSIUM Sibiu– November 200729th International Conference of the Romanian Medical Informatics Society MEDINF 2007 GEOGRAPHIC MIDPOINTS Geographic midpoint is also known as geographic center, center of mass or center of gravity. The center of mass is a single point somewhere in space (it does not really have to be on the object itself) that represents a point at which you have as much mass on one side as you have on another side. Our object is a geographic map which includes populated places and their geographic coordinates. As attribute of each populated place (locality) we have the number of inhabitants (as mass attribute) obtained from Romanian SIRUTA registry.

9. SIUMSIUM Sibiu– November 200729th International Conference of the Romanian Medical Informatics Society MEDINF 2007 The general formulaGeographic center of the surface of n populated places Geographic center of population of n populated places m i : the weights of the place im i = 1 (for all places)m i = the number of inhabitants of that populated place CALCULATION METHOD FOR GEOGRAPHIC MIDPOINTS

10. SIUMSIUM Sibiu– November 200729th International Conference of the Romanian Medical Informatics Society MEDINF 2007 SIRUTA REGISTRY Locations of Romanian Administrative-Territorial Units (ATU) are recorded by National Institut for Statistics using SIRUTA localities register. SIRUTA is an acronim for Informatics System of Administrative-Territorial Units Registry. Each ATU is identified by an unique numeric code called SIRUTA code. The registry is built on three levels hierarchy: 1.counties, 2.localities (populated places), 3.component parts of a locality.

11. SIUMSIUM Sibiu– November 200729th International Conference of the Romanian Medical Informatics Society MEDINF 2007 SIRUTA REGISTRY AND GEOGRAPHIC COORDINATES We developed a methodology, used for filling, in the last levels of SIRUTA registry, with geographic coordinates of the localities, using Web resources. The geographic data are, then, processed and an association of SIRUTA localities with geographic coordinates was made. For gathering the localities (populated places) we developed a crawling web application for recursive accessing the Web pages and automatic filling in the interogation parameters. An algorithm, for completing data base of populated places from Romania, has been used for this purpose.

12. Sibiu– November 200729th International Conference of the Romanian Medical Informatics Society MEDINF 2007 SIUMSIUM Graphical view: components localities by counties

13. SIUMSIUM Sibiu– November 200729th International Conference of the Romanian Medical Informatics Society MEDINF 2007 CALCULATED DISTANCES Distances divided in two categories: distances from geographic centers to county emergency hospitals (hospitals situated in capitals of counties); distances from centers of population to county emergency hospitals.

14. Sibiu– November 200729th International Conference of the Romanian Medical Informatics Society MEDINF 2007 SIUMSIUM Distances from county emergency hospitals to geographic centers and population centers Most suitable for people’s benefit, in case of emergency services supplyed by a municipal hospital, is the position of Cluj County Mures county: the population is more concentrated to administrative municipality Tirgu Mures (the center of population is in vecinity of the city - distance in yellow), the geographic center has a greater distance to the respective administrative municipality (distance in blue). Also for Salaj county: the population is more concentrated to administrative municipality Zalau (the center of population is in vecinity of the city - distance in yellow), the geographic center has a greater distance to the respective administrative municipality (distance in blue).

15. SIUMSIUM Sibiu– November 200729th International Conference of the Romanian Medical Informatics Society MEDINF 2007 CONCLUSIONS In this paper we depicted the importance of geographic information for emergency situations. Through the excellence project “Integrated system for mobile user- SIUM” we completed SIRUTA registry of Romanian localities with geographic coordinates of populated places and Romanian hospitals. On this base, we calculated some measures of suitability of places where emergency hospitals are located in administrative municipalities. The geographic centers and the population geographic centers of the counties are relevant measures for an assessment on the opportunity of situating emergency hospitals in administrative municipalities. In our future work, we plan to improve accuracy of geographic information from our database and to build some services for emergency situations, using standardized messages for communication.