States play vital role

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Bugs in the system

Many of the national systems being developed to spot possible bioterrorism attacks will rely on data supplied by state governments and other locally based health care organizations. To ensure that they can fulfill this role, many state government officials are reorganizing health care and emergency response agencies and investing in new technologies.

Last year, for example, Iowa combined three Department of Public Health (DPH) offices — the Center for Acute Disease Epidemiology, the Center for Disaster Operations and Response, and the Bureau of Emergency Medical Services (EMS) — into the Division of Epidemiology, EMS and Disaster Operations. State officials hope the change will help them better integrate and coordinate the efforts of the previously separate agencies.

One of the first tasks for officials at the new division was to develop a comprehensive information technology plan for the state's Web-based epidemiological surveillance program. The program will use software developed originally by Deloitte Inc.

for Pennsylvania health officials, called the National Electronic Disease Surveillance System (PA-NEDSS).

The Web-based application, created with awards from the Centers for Disease Control and Prevention, has been running successfully in Pennsylvania for two years, according to David Andrews, applications developer administrator for the Pennsylvania Health Department's Bureau of Information Technology.

Andrews said that physicians, hospital officials, infection-control employees, laboratory officials and other health care providers report disease and epidemic incidents to state public health officials via PA-NEDSS in near-real time. Then, "the appropriate health jurisdictions have instantaneous access to that data," he said.

The IT bureau is working to build identifiers into PA-NEDSS that will pinpoint a single incidence of severe acute respiratory syndrome or anthrax. Andrews said the Web-based application was used last October to identify and promptly control an outbreak of some 500 cases of hepatitis A in western Pennsylvania.

"With this kind of a condition, typically what you would find is that it would be years before the levels of hepatitis in the area would return to normal," he said. "Utilizing the PA-NEDSS tool and patient management system, the levels of hepatitis in that area are actually now returning to normal."

Dale Anthony, operations supervisor of the Iowa health department's Bureau of Information Management in Des Moines, expects that the state will start testing

PA-NEDSS next month. The state is divided into six regions, each of which studies bioterrorism via a regional steering committee and various local infrastructures, including IT and communications.

About the Author

David Hubler is the former print managing editor for GCN and senior editor for Washington Technology. He is freelance writer living in Annandale, Va.

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