Health scare heads-up

The Centers for Disease Control and Prevention is coordinating a national communication network for use in health emergencies

Municipal, state and federal health agencies are devising a way to get warningsout earlier in emergencies such as bio-terrorism or the outbreak of a deadlydisease.

The Centers for Disease Control and Prevention, Atlanta, Ga., has paidfor local agencies to automate their operations as part of a five-year projectdubbed the Health Alert Network (HAN). With the Internet and e-mail, agenciescan send notices much more quickly, increase the number of key recipientsreceiving public health information and get help on the way sooner.

"The Internet has made it possible for health care agencies to streamlinetheir operations, and that is a change that we are encouraging," said KathrynSunnaborg, a public health administrator at CDC.

Historically, health officials relied on telephones or broadcast-faxsystems to deliver time-sensitive information.

The new network will eventually link local health care providers, policeand fire departments, municipal and state health departments, CDC and otherfederal agencies in a communications network.

CDC has granted money to help 37 states upgrade their information technologyinfrastructure. The agency is now focusing on how to deliver the messagesand expects to complete the project by the end of 2003.

A number of factors prompted the development of the network. First isthe ongoing threat of disastrous health problems, such as bioterrorism,improperly discharged chemicals and deadly food or water viruses includingE. coli. These problems cross city lines, state boundaries and nationalborders, yet often first appear at the local level.

Also, CDC and state and municipal agencies have long struggled to sharetheir research information on diseases such as cancer, diabetes and arthritis.And CDC wanted a way to electronically deliver materials to health officials— in a system that could support online training, among other things.

The project is expected to cost $1 billion over a five-year period.A combination of state, local and federal dollars will pay for it, withfederal support expected to cover 20 percent of the total, or $40 millionper year.

Constructing the network will be a significant undertaking. A CDC surveyin January 1999 found that 50 percent of local health agencies lacked high-speedInternet access. Forty-six percent did not have broadcast-fax capabilities,94 percent weren't prepared for bioterrorist incidents, and only 23 percenthad an emergency response plan to address issues such as bioterrorism.

The first phase of the program kicked off in 1999. It focused on improvingagencies' IT infrastructure.

CDC found a range of computer sophistication among the states. New Jersey,for instance, was ahead of the game. "The state has been quite aggressivein using technology to help improve agency operations," said Richard Matzer,a director at the New Jersey Department of Health and Senior Services.

In 1997, New Jersey built the Local Information Network and CommunicationsSystem (LINCS), which has goals similar to HAN's. A year later, the stateopened network connections at 24 county public health agencies and threecities: Jersey City, Paterson and Newark. Each was equipped with hardwareand software for Internet access and secure e-mail via a central servermaintained by the New Jersey Institute of Technology.

By 2000, each of New Jersey's 115 local health departments had connectedto LINCS. Last summer, the state health department used the network to relayinformation to local health departments concerning an outbreak of the WestNile virus.

"We find our new system a lot easier and much faster than telephonesor faxes, which we had relied on previously," said Daniel Regenye, LINCScoordinator at the Ocean County Board of Health.

Health care groups can also participate in the New Jersey ImmunizationInformation System, a statewide electronic registry of children and immunizationrecords designed to improve childhood immunization rates. State and municipalagencies are also developing a Community Health Alert and Information Network,which will connect public health departments with hospitals, laboratories,emergency responders, medical providers, schools and other community organizationsinvolved in public health incidents.

Minnesota was at the other end of the spectrum from New Jersey. Twoyears ago, the state surveyed 91 health agencies and found that 13 lackedbasic network functions, such as e-mail and Internet access.

"Funding is often an issue at the local level, and many of our agencieshad more pressing requirements than buying computer equipment," said MyrlahOlson, HAN coordinator for the Minnesota Department of Health. CDC gavethe state $670,000 so these agencies could upgrade their systems.

The Dakota County Public Health Department, which serves a populationof 325,000, was one of the recipients. The agency had Internet access, butmany of its local community providers, doctors and city agencies did not.

"We didn't have any easy way of relaying information to local healthcare providers," said Kathy Wick, disease prevention and control supervisorat the department.

CDC bought the department a broadcast-fax machine for $4,200. Now, personnelenter an alert once and it is automatically sent to every local agency.Previously, they had to contact each department individually.

HAN officials say their progress with local agencies has been note-worthy."There has been a high level of genuine enthusiasm among health departmentsabout the project," said Michael McGuire, HAN project manager at the OregonHealth Division. "It has not been a top-down, dictated mandate that theyhave been forced to carry out. They see the need and understand the potentialbenefits that HAN offers."

CDC helped 37 state health agencies, three metropolitan health departmentsand three Centers for Public Health Preparedness upgrade their systems.Also, CDC gave money and technical assistance to the Center for the Studyof Bioterrorism and Emerging Infections at St. Louis University's Schoolof Public Health. The school conducts research and provides training onpotential epidemics to the medical community and public health professionals.

Although much of the emphasis has been on infrastructure, health careagencies also have to put managerial checks in place to ensure that thesystem works.

CDC has been pushing local health departments to develop guidelinesfor the diagnosis, treatment and protective steps that should be taken inhealth emergencies. Agency officials are encouraging departments to do morethan just put procedures on paper — they want them to conduct simulationexercises so they understand how an emergency will play out. Most statesare just beginning this phase, which is an area of emphasis for 2001.

"We are meeting with local health care officials so they can help usdesign the proper notification procedures," said Oregon's McGuire, whoplans to oversee a test of the system by the end of the year.

The task is complicated because emergencies can happen at any time,so notifications must be deliverable 24 hours a day, seven days a week."We want to identify at least three persons at each agency so the likelihoodthat a notification will reach the proper person will increase," McGuiresaid.

Once those procedures are in place, then the issue will be maintainingthem. "We are encouraging state health departments to put checks in placeso they know of any changes among local administrators," CDC's Sunnaborgsaid.

Although the focus of HAN has been on slowing the spread of deadly diseases,the network has other potential uses. These include disease surveillanceand epidemiological investigation, electronic laboratory test reportingand professional workforce training through distance learning.

CDC has developed a handful of online training courses so health careadministrators can learn how to react to a health alert. At the 2000 PublicHealth Informatics-Distance Learning Conference, 500 public health professionalslearned about such programs, and more than 100 practitioners were trainedin the principles of public health informatics.

CDC is developing a certification program to ensure that health careprofessionals have the skills to conduct effective responses to bioterrorismand other high-priority health threats.

"While we are pleased with the progress to date, we are looking forwardto completing the network so health care organizations will be better ableto respond to any health emergency," Sunnaborg said.

Korzeniowski is a freelance writer in Sudbury, Mass., who specializes intechnology issues. He can be reached at paulkorzen@aol.com.

NEXT STORY: Sun equips satellite control

X
This website uses cookies to enhance user experience and to analyze performance and traffic on our website. We also share information about your use of our site with our social media, advertising and analytics partners. Learn More / Do Not Sell My Personal Information
Accept Cookies
X
Cookie Preferences Cookie List

Do Not Sell My Personal Information

When you visit our website, we store cookies on your browser to collect information. The information collected might relate to you, your preferences or your device, and is mostly used to make the site work as you expect it to and to provide a more personalized web experience. However, you can choose not to allow certain types of cookies, which may impact your experience of the site and the services we are able to offer. Click on the different category headings to find out more and change our default settings according to your preference. You cannot opt-out of our First Party Strictly Necessary Cookies as they are deployed in order to ensure the proper functioning of our website (such as prompting the cookie banner and remembering your settings, to log into your account, to redirect you when you log out, etc.). For more information about the First and Third Party Cookies used please follow this link.

Allow All Cookies

Manage Consent Preferences

Strictly Necessary Cookies - Always Active

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Sale of Personal Data, Targeting & Social Media Cookies

Under the California Consumer Privacy Act, you have the right to opt-out of the sale of your personal information to third parties. These cookies collect information for analytics and to personalize your experience with targeted ads. You may exercise your right to opt out of the sale of personal information by using this toggle switch. If you opt out we will not be able to offer you personalised ads and will not hand over your personal information to any third parties. Additionally, you may contact our legal department for further clarification about your rights as a California consumer by using this Exercise My Rights link

If you have enabled privacy controls on your browser (such as a plugin), we have to take that as a valid request to opt-out. Therefore we would not be able to track your activity through the web. This may affect our ability to personalize ads according to your preferences.

Targeting cookies may be set through our site by our advertising partners. They may be used by those companies to build a profile of your interests and show you relevant adverts on other sites. They do not store directly personal information, but are based on uniquely identifying your browser and internet device. If you do not allow these cookies, you will experience less targeted advertising.

Social media cookies are set by a range of social media services that we have added to the site to enable you to share our content with your friends and networks. They are capable of tracking your browser across other sites and building up a profile of your interests. This may impact the content and messages you see on other websites you visit. If you do not allow these cookies you may not be able to use or see these sharing tools.

If you want to opt out of all of our lead reports and lists, please submit a privacy request at our Do Not Sell page.

Save Settings
Cookie Preferences Cookie List

Cookie List

A cookie is a small piece of data (text file) that a website – when visited by a user – asks your browser to store on your device in order to remember information about you, such as your language preference or login information. Those cookies are set by us and called first-party cookies. We also use third-party cookies – which are cookies from a domain different than the domain of the website you are visiting – for our advertising and marketing efforts. More specifically, we use cookies and other tracking technologies for the following purposes:

Strictly Necessary Cookies

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Functional Cookies

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Performance Cookies

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Sale of Personal Data

We also use cookies to personalize your experience on our websites, including by determining the most relevant content and advertisements to show you, and to monitor site traffic and performance, so that we may improve our websites and your experience. You may opt out of our use of such cookies (and the associated “sale” of your Personal Information) by using this toggle switch. You will still see some advertising, regardless of your selection. Because we do not track you across different devices, browsers and GEMG properties, your selection will take effect only on this browser, this device and this website.

Social Media Cookies

We also use cookies to personalize your experience on our websites, including by determining the most relevant content and advertisements to show you, and to monitor site traffic and performance, so that we may improve our websites and your experience. You may opt out of our use of such cookies (and the associated “sale” of your Personal Information) by using this toggle switch. You will still see some advertising, regardless of your selection. Because we do not track you across different devices, browsers and GEMG properties, your selection will take effect only on this browser, this device and this website.

Targeting Cookies

We also use cookies to personalize your experience on our websites, including by determining the most relevant content and advertisements to show you, and to monitor site traffic and performance, so that we may improve our websites and your experience. You may opt out of our use of such cookies (and the associated “sale” of your Personal Information) by using this toggle switch. You will still see some advertising, regardless of your selection. Because we do not track you across different devices, browsers and GEMG properties, your selection will take effect only on this browser, this device and this website.