State of the states

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"The weakest link"

Although the anthrax scare has raised the profile of the Health Alert Network (HAN), many states have been at work on the system for several years. Illinois has been there from the start.

Since 1999, the state has received about $565,000 in annual funding for information technology infrastructure improvement, training, purchase of satellite dishes and online training.

The state health department has a high-speed network connection providing T1 lines to its seven regional offices and a 56 kilobits/sec connection to its 94 local jurisdictions. The state now uses HAN to pay for local access charges, said Gary Robinson, the health department's deputy director for finance and administration.

The state has also bought 27 satellite dishes for 55 of the 94 local departments. As a result, every local health jurisdiction is within 30 minutes of a satellite dish. Transmitting information is now more effective and rapid than before, he said.

Prior to HAN, Illinois shared information using telephones, fax machines and an antiquated dial-up information system initiated in 1985. "So it was only as good as people checking their messages and not really what the HAN system is today," Robinson said.

According to Hawaii's HAN program manager, Gerald Ohta, that state already has a robust Internet system, having used its $150,000 for videoconferencing and satellite dish purchases.

In Idaho, state epidemiologist Christine Hahn said that, for the first time, the state received $170,000 in HAN funding on Oct. 1. The state, she said, plans to use the money to purchase computers for some of its district offices and to provide broadcast fax capabilities and pagers. In turn, the state's seven district offices will assess the local public agencies' response capabilities and recommend improvements accordingly, she said.

Hahn said that the health department is confident it can effectively and rapidly communicate emergency information to agencies in local areas, but agencies in rural areas "feel a little bit disconnected" when it comes to getting information. She also said Idaho is focusing on developing more laboratory facilities to handle testing of communicable diseases.

Even prior to HAN, North Carolina's bioterrorism planning involved regular meetings between representatives from all levels of government, public safety and emergency management agencies, and health organizations, said Rajesh Virkar, head of the Health Informatics Branch in North Carolina's Department of Health and Human Services.

North Carolina is currently working on bringing about five to 10 local health agencies up to speed technologically. So far, half of the 87 health departments have T1 connections and local-area networks.

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