@article{Lipskiy_Tyson_2017, title={Advancing PH Emergency Preparedness Informatics to Support Emergency Responses}, volume={9}, url={https://ojphi.org/ojs/index.php/ojphi/article/view/7637}, DOI={10.5210/ojphi.v9i1.7637}, abstractNote={<div style="left: 89.1818px; top: 332.706px; font-size: 14.0379px; font-family: sans-serif; transform: scaleX(1.08186);" data-canvas-width="63.1985303030303">Objective</div><div style="left: 104.045px; top: 347.521px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.973351);" data-canvas-width="374.6429090909089">The purpose of this project is to demonstrate progress in developing</div><div style="left: 89.1818px; top: 364.036px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.01164);" data-canvas-width="390.25864545454556">a scientific and practical approach for public health (PH) emergency</div><div style="left: 89.1818px; top: 380.551px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.01253);" data-canvas-width="392.5243590909091">preparedness and response informatics (EPRI) that supports the</div><div style="left: 89.1818px; top: 397.066px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.04215);" data-canvas-width="393.445243939394">National Health Security Strategy and Global Health Security</div><div style="left: 89.1818px; top: 413.582px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.98859);" data-canvas-width="389.55394393939395">Agenda (GHSA) objectives. PH emergency operations centers (EOC)</div><div style="left: 89.1818px; top: 430.097px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.03113);" data-canvas-width="390.6418795454547">contribute to health security objectives because they operationalize</div><div style="left: 89.1818px; top: 446.612px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.01232);" data-canvas-width="392.7644068181817">response, recovery and mitigation activities during national and</div><div style="left: 89.1818px; top: 463.127px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.01784);" data-canvas-width="390.5436143939393">international PH events. The primary focus of this presentation is to</div><div style="left: 89.1818px; top: 479.642px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.987655);" data-canvas-width="389.5146378787878">describe the results of an analysis of CDC’s EOC, and other EOCs, in</div><div style="left: 89.1818px; top: 496.157px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.00241);" data-canvas-width="180.93421969696976">building their EPRI capabilities.</div><div style="left: 89.1818px; top: 527.584px; font-size: 14.0379px; font-family: sans-serif; transform: scaleX(1.11811);" data-canvas-width="81.88294696969696">Introduction</div><div style="left: 104.045px; top: 542.4px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.04129);" data-canvas-width="376.32043560606013">Global travel and human migration patterns facilitate the spread</div><div style="left: 89.1818px; top: 558.915px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.03908);" data-canvas-width="391.0391515151516">of diseases such as influenza A/H1N1, Ebola, and Zika, increasing</div><div style="left: 89.1818px; top: 575.43px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.961358);" data-canvas-width="391.41677045454577">pressure to PH systems to protect their constituents against global</div><div style="left: 89.1818px; top: 591.945px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.01464);" data-canvas-width="390.48465530303025">health threats. Effective prevention, detection, and rapid response to</div><div style="left: 89.1818px; top: 608.46px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.03737);" data-canvas-width="390.70645378787873">threats rely heavily on adequate information sharing. This requires</div><div style="left: 89.1818px; top: 624.976px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.991855);" data-canvas-width="391.9810931818182">effective information management through PH EPRI applications</div><div style="left: 89.1818px; top: 641.491px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.00223);" data-canvas-width="392.4724189393939">such as information systems and tools, knowledge management,</div><div style="left: 89.1818px; top: 658.006px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.991166);" data-canvas-width="392.2042954545453">and a continuous cycle improvement to maintain system quality.</div><div style="left: 89.1818px; top: 674.521px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.02695);" data-canvas-width="393.32030681818173">Enhancement of PH EPRI capabilities contributes to improved</div><div style="left: 89.1818px; top: 691.036px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.999777);" data-canvas-width="216.0850681818182">decision making during emergencies</div><div style="left: 305.153px; top: 691.407px; font-size: 8.42273px; font-family: serif;">1</div><div style="left: 309.446px; top: 691.036px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.973007);" data-canvas-width="171.60604924242423">. It transforms public health</div><div style="left: 89.1818px; top: 707.551px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.03053);" data-canvas-width="390.89877272727296">practice and improves health outcomes through better surveillance,</div><div style="left: 89.1818px; top: 724.066px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.02855);" data-canvas-width="390.9338674242423">epidemiology, integrated delivery of services, and other emergency</div><div style="left: 89.1818px; top: 740.582px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.00223);" data-canvas-width="207.39562121212126">preparedness and response activities.</div><div style="left: 104.045px; top: 757.097px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.03063);" data-canvas-width="376.17865303030294">EPRI activities depend on both technical systems and the people</div><div style="left: 89.1818px; top: 773.612px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.04098);" data-canvas-width="390.7148765151515">who use them. Without adequate training, these systems cannot be</div><div style="left: 89.1818px; top: 790.127px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.02121);" data-canvas-width="390.526768939394">effective. CDC’s PH EOC information processes and data flows are</div><div style="left: 89.1818px; top: 806.642px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.966978);" data-canvas-width="391.65822196969685">a notable use case, utilized by hundreds of emergency responders</div><div style="left: 89.1818px; top: 823.157px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.979863);" data-canvas-width="391.961440151515">during large-scale PH events. By analyzing this use case, CDC’s</div><div style="left: 89.1818px; top: 839.672px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.0305);" data-canvas-width="390.8847348484851">informaticians have identified multiple opportunities for advancing</div><div style="left: 89.1818px; top: 856.188px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.00142);" data-canvas-width="287.341340909091">PH EPRI and advance the objectives of the GHSA.</div><div style="left: 89.1818px; top: 887.615px; font-size: 14.0379px; font-family: sans-serif; transform: scaleX(1.07334);" data-canvas-width="57.70971969696969">Methods</div><div style="left: 104.045px; top: 902.43px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.00812);" data-canvas-width="375.4079734848484">PH EPRI is an interdisciplinary science, incorporating knowledge</div><div style="left: 89.1818px; top: 918.945px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.00219);" data-canvas-width="389.9371780303031">and techniques from a multiple fields of research and practice. These</div><div style="left: 89.1818px; top: 935.46px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.98821);" data-canvas-width="391.82527272727265">include epidemiology and surveillance, gathering and distributing</div><div style="left: 89.1818px; top: 951.976px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.995565);" data-canvas-width="389.6143068181818">information for situational awareness (SA), technology infrastructure</div><div style="left: 89.1818px; top: 968.491px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.00216);" data-canvas-width="369.996371212121">development, incident management, and several other disciplines.</div><div style="left: 104.045px; top: 985.006px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.0343);" data-canvas-width="375.81226439393953">CDC’s Situational Awareness Branch used three sources for this</div><div style="left: 89.1818px; top: 1001.52px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.984933);" data-canvas-width="391.9375757575759">analysis: direct analysis of CDC’s EOC information systems and</div><div style="left: 89.1818px; top: 1018.04px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.971544);" data-canvas-width="132.40527272727272">SA activities; WHO’s</div><div style="left: 221.525px; top: 1018.04px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.973645);" data-canvas-width="259.03816969696976">Framework for a Public Health Emergency</div><div style="left: 89.1818px; top: 1034.55px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.0124);" data-canvas-width="103.60235303030302">Operations Centre</div><div style="left: 192.74px; top: 1034.92px; font-size: 8.42273px; font-family: serif;">2</div><div style="left: 196.923px; top: 1034.55px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.969734);" data-canvas-width="64.98835984848483">, and HHS’</div><div style="left: 261.888px; top: 1034.55px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.996745);" data-canvas-width="216.75888636363635">Public Health and Medical Situational</div><div style="left: 89.1818px; top: 1051.07px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.00572);" data-canvas-width="114.53505303030305">Awareness Strategy</div><div style="left: 203.684px; top: 1051.44px; font-size: 8.42273px; font-family: serif;">3</div><div style="left: 207.962px; top: 1051.07px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.966463);" data-canvas-width="272.7840606060605">. This assessment also included a comparison</div><div style="left: 89.1818px; top: 1067.58px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.959649);" data-canvas-width="391.392906060606">of the objectives of PH EPRI to the objectives of other emerging</div><div style="left: 89.1818px; top: 1084.1px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.997284);" data-canvas-width="392.19868030303013">disciplines, such as PH informatics and emergency preparedness</div><div style="left: 89.1818px; top: 1100.61px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.03734);" data-canvas-width="390.7317219696972">informatics. This helped in avoiding overlap with other disciplines</div><div style="left: 89.1818px; top: 1117.13px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.00573);" data-canvas-width="184.83675">and fixing gaps within PH EPRI.</div><div style="left: 89.1818px; top: 1148.55px; font-size: 14.0379px; font-family: sans-serif; transform: scaleX(1.08498);" data-canvas-width="50.70481818181818">Results</div><div style="left: 104.045px; top: 1163.37px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.977228);" data-canvas-width="376.70507348484847">The following information flows were identified as part of the</div><div style="left: 89.1818px; top: 1179.88px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.979266);" data-canvas-width="391.15145454545444">CDC’s EOC operations: Managing and Commanding, Operations,</div><div style="left: 89.1818px; top: 1196.4px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.995975);" data-canvas-width="391.8000045454543">Planning and Intelligence, Logistics, and Finance/Administration.</div><div style="left: 505.364px; top: 331.006px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.979971);" data-canvas-width="389.48936969696956">These information flows are standard for PH EPRIs. Each information</div><div style="left: 505.364px; top: 347.521px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.03697);" data-canvas-width="393.2711742424242">flow is supported by an information structure that consists of</div><div style="left: 505.364px; top: 364.036px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.987055);" data-canvas-width="389.42619924242405">hierarchical categories. For example, the Operations information flow</div><div style="left: 505.364px; top: 380.551px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.01976);" data-canvas-width="390.5688825757575">includes Task Tracking, Event Investigation, and Controlling. As of</div><div style="left: 505.364px; top: 397.066px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.00123);" data-canvas-width="389.82768257575754">August, 2016, CDC’s EOC defined 41 hierarchical categories for PH</div><div style="left: 505.364px; top: 413.582px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.00945);" data-canvas-width="95.52776515151515">EPRI data flows.</div><div style="left: 520.227px; top: 430.097px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.96258);" data-canvas-width="376.1281166666665">CDC’s EOC harmonized different information flows by using a</div><div style="left: 505.364px; top: 446.612px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.994029);" data-canvas-width="392.26044696969694">consistent vocabulary to describe the hierarchical components of</div><div style="left: 505.364px; top: 463.127px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.0271);" data-canvas-width="390.58993939393946">each information flow. Two hundred thirty six data elements of this</div><div style="left: 505.364px; top: 479.642px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.96529);" data-canvas-width="391.6020704545453">vocabulary were harmonized as of August 2016 to standardize its</div><div style="left: 505.364px; top: 496.157px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.0014);" data-canvas-width="389.8964681818182">EPRI systems. The hierarchy of PH EOC data flows and harmonized</div><div style="left: 505.364px; top: 512.672px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.964921);" data-canvas-width="391.19497196969706">data elements were published in the CDC Vocabulary and Access</div><div style="left: 505.364px; top: 529.188px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.01341);" data-canvas-width="157.9401742424242">Distribution System, VADS</div><div style="left: 663.303px; top: 529.559px; font-size: 8.42273px; font-family: serif;">4</div><div style="left: 667.515px; top: 529.188px; font-size: 14.0379px; font-family: serif;">.</div><div style="left: 520.227px; top: 545.703px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.04281);" data-canvas-width="376.0017757575759">Some information flows were unique to PH EPRI, and were not</div><div style="left: 505.364px; top: 562.218px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.97846);" data-canvas-width="391.71016212121197">covered by other emerging disciplines. Examples of these unique</div><div style="left: 505.364px; top: 578.733px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.0125);" data-canvas-width="390.38639015151506">information flows include some incident management data, logistics</div><div style="left: 505.364px; top: 595.248px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.99704);" data-canvas-width="392.4682075757579">for deployment of PH personnel and resources, and some event</div><div style="left: 505.364px; top: 611.763px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.0028);" data-canvas-width="88.12980303030302">mitigation data.</div><div style="left: 505.364px; top: 643.191px; font-size: 14.0379px; font-family: sans-serif; transform: scaleX(1.10288);" data-canvas-width="84.24131060606061">Conclusions</div><div style="left: 520.227px; top: 658.006px; font-size: 14.0379px; font-family: serif; transform: scaleX(0.990666);" data-canvas-width="374.4716469696969">CDC’s EOC has several harmonized information flows that benefit</div><div style="left: 505.364px; top: 674.521px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.02677);" data-canvas-width="390.9100030303023">users and CDC emergency activations. Understanding these unique</div><div style="left: 505.364px; top: 691.036px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.001);" data-canvas-width="389.8234712121212">PH EPRI data flows helps improve preparedness of staff for working</div><div style="left: 505.364px; top: 707.551px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.01171);" data-canvas-width="392.37555757575785">with information flows during emergency activations. Advances</div><div style="left: 505.364px; top: 724.066px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.00736);" data-canvas-width="392.5004946969693">in harmonization and standardization helped improve PH EPRI,</div><div style="left: 505.364px; top: 740.582px; font-size: 14.0379px; font-family: serif; transform: scaleX(1.0044);" data-canvas-width="128.27813636363635">optimize staff training.</div>}, number={1}, journal={Online Journal of Public Health Informatics}, author={Lipskiy, Nikolay and Tyson, James}, year={2017}, month={May} }