Advancing PH Emergency Preparedness Informatics to Support Emergency Responses

Nikolay Lipskiy, James Tyson


ObjectiveThe purpose of this project is to demonstrate progress in developinga scientific and practical approach for public health (PH) emergencypreparedness and response informatics (EPRI) that supports theNational Health Security Strategy and Global Health SecurityAgenda (GHSA) objectives. PH emergency operations centers (EOC)contribute to health security objectives because they operationalizeresponse, recovery and mitigation activities during national andinternational PH events. The primary focus of this presentation is todescribe the results of an analysis of CDC’s EOC, and other EOCs, inbuilding their EPRI capabilities.IntroductionGlobal travel and human migration patterns facilitate the spreadof diseases such as influenza A/H1N1, Ebola, and Zika, increasingpressure to PH systems to protect their constituents against globalhealth threats. Effective prevention, detection, and rapid response tothreats rely heavily on adequate information sharing. This requireseffective information management through PH EPRI applicationssuch as information systems and tools, knowledge management,and a continuous cycle improvement to maintain system quality.Enhancement of PH EPRI capabilities contributes to improveddecision making during emergencies1. It transforms public healthpractice and improves health outcomes through better surveillance,epidemiology, integrated delivery of services, and other emergencypreparedness and response activities.EPRI activities depend on both technical systems and the peoplewho use them. Without adequate training, these systems cannot beeffective. CDC’s PH EOC information processes and data flows area notable use case, utilized by hundreds of emergency respondersduring large-scale PH events. By analyzing this use case, CDC’sinformaticians have identified multiple opportunities for advancingPH EPRI and advance the objectives of the GHSA.MethodsPH EPRI is an interdisciplinary science, incorporating knowledgeand techniques from a multiple fields of research and practice. Theseinclude epidemiology and surveillance, gathering and distributinginformation for situational awareness (SA), technology infrastructuredevelopment, incident management, and several other disciplines.CDC’s Situational Awareness Branch used three sources for thisanalysis: direct analysis of CDC’s EOC information systems andSA activities; WHO’sFramework for a Public Health EmergencyOperations Centre2, and HHS’Public Health and Medical SituationalAwareness Strategy3. This assessment also included a comparisonof the objectives of PH EPRI to the objectives of other emergingdisciplines, such as PH informatics and emergency preparednessinformatics. This helped in avoiding overlap with other disciplinesand fixing gaps within PH EPRI.ResultsThe following information flows were identified as part of theCDC’s EOC operations: Managing and Commanding, Operations,Planning and Intelligence, Logistics, and Finance/Administration.These information flows are standard for PH EPRIs. Each informationflow is supported by an information structure that consists ofhierarchical categories. For example, the Operations information flowincludes Task Tracking, Event Investigation, and Controlling. As ofAugust, 2016, CDC’s EOC defined 41 hierarchical categories for PHEPRI data flows.CDC’s EOC harmonized different information flows by using aconsistent vocabulary to describe the hierarchical components ofeach information flow. Two hundred thirty six data elements of thisvocabulary were harmonized as of August 2016 to standardize itsEPRI systems. The hierarchy of PH EOC data flows and harmonizeddata elements were published in the CDC Vocabulary and AccessDistribution System, VADS4.Some information flows were unique to PH EPRI, and were notcovered by other emerging disciplines. Examples of these uniqueinformation flows include some incident management data, logisticsfor deployment of PH personnel and resources, and some eventmitigation data.ConclusionsCDC’s EOC has several harmonized information flows that benefitusers and CDC emergency activations. Understanding these uniquePH EPRI data flows helps improve preparedness of staff for workingwith information flows during emergency activations. Advancesin harmonization and standardization helped improve PH EPRI,optimize staff training.

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Online Journal of Public Health Informatics * ISSN 1947-2579 *