Title: Enhanced Informatics Response to Disasters through Collaboration of Public Health Response Teams
1Enhanced Informatics Response to Disasters
through Collaboration of Public Health Response
Teams
LCDR Margaret A. Riggs, PhD, MPH, MS Career
Epidemiology Field Officer CDC / COTPER Kentucky
Dept. for Public Health
2Overview
- Disaster Surveillance
- Exercise / Training
- Evaluation of surveillance tool
- Multi-state /Multi-agency collaboration
- Recommendations
3Importance of Active Surveillance During a
Disaster
- Complement to regular reporting mechanisms
- Rapidly detect outbreaks and define health
problems - Identify groups at risks for adverse health
events - Determine needs of special populations
4Importance of Active Surveillance During a
Disaster (2)
- Optimize the relief response
- Monitor the effectiveness of the relief effort
- Respond to public concerns and media inquiries
- Facilitate planning for future disasters
5Use of Informatics in Disasters
- Real-time and accurate epidemiologic data is
critical to decision making - Delivery of appropriate public health services
during emergency events such as disease outbreaks
or disasters is essential. - Agencies must receive data from the field quickly
and have the ability to compare results across
jurisdictions when multiple states are affected.
6Validating systems
- A field-tested, electronic standardized system of
data collection is essential for early event
detection, emergency response, and public health
decision making. - With the rapid advancement of informatics
capabilities, it is essential to systematically
validate the methods that are most effective.
7Project Objective
- Evaluate the usefulness and acceptance of GIS/GPS
equipped handheld computers for disaster
surveillance through the collaboration of public
health teams.
8Collaboration
- Two agencies
- CDC
- Association of State and Territorial Directors of
Nursing (ASTDN) - Three states
- Georgia
- Tennessee
- Kentucky
- Three disciplines
- Nurses
- Epidemiologists
- Environmental Health Specialists
9Equipment
- Equipment purchased using funds provided by CDCs
Coordinating Office for Terrorism Preparedness
and Emergency Response. - Laptop computers
- Six Dell Precision M6300 notebooks
- Each state received two laptops.
- Software
- ESRI ArcView software
- Arc GIS
- GeoAge Field Adapted Survey Toolkit (FAST)
- SAS 9.1
- Microsoft Office Pro
- Handheld Devices
- Thirty-one Trimble Geocollector submeters
- ArcPad and Trimble GPS correct for ArcPad
10Training / Exercise
- Three-day comprehensive training exercise
- 2 days of Geographic Information System (GIS)
- ½ day of handheld computer training
- Global Positioning System (GPS)
- FAST (GeoAge) software to create a
data-collection form - Natural Disaster Morbidity Report Form template
-
- ½ day of tornado disaster exercise
- collected, imported, analyzed, mapped data.
11Exercise Scenario Setting Twisterville
- The area has been under a tornado watch since
115 p.m. Since that time, a large storm system
moving through this portion of the state has
begun moving in a direction that is taking over
portions of Tornado county, including
Twisterville.
12Exercise Scenario
Several homes have been affected. There have
been reports of a number of people being injured,
and displaced individuals are wandering around
the stricken area.
13Exercise Scenario
- On-scene police units report limited access into
the damaged area due to large pieces of debris
and nails littering the streets.
14Exercise Scenario
- Local and State health officials have been asked
to assist with setting up active surveillance at
designated shelters which have been set up for
tornado victims.
15Exercise Scenario
- You have been assigned to work at one of three
shelters. - You will be interviewing patients for active
surveillance - Enter data from the interview using the handheld
Trimble computer - and the form that was
- Developed in training.
16Natural Disaster Morbidity Report Form
17Patient Scenario
18Handheld Computer
19Evaluation Methods
- Evaluation of overall project
- a paper questionnaire
- four epidemiologists and three nursing
supervisors in the three states - Evaluation of the GIS and GPS training and
exercise - Evaluation of GIS/GPS training and exercise
consisted of four questionnaires which were
administered to training attendees in each state - 1) Pre-Training GIS
- 2) Post-Training GIS
- 3) Pre-Training GPS
- 4) Post-Training GPS and Exercise
- Attendees in Georgia and Kentucky responded to
the questionnaires via an online survey, while
those in Tennessee filled out paper
questionnaires. Responses for all attendees
were combined and entered in Excel - Quality control assessment to examine accuracy of
the data entered by participants during the
exercise
20 Evaluation Results
- 7 coordinators felt that the project enhanced the
capability of their state to facilitate emergency
response activities improved collaboration. - 78 participants for the training/exercise
- Participants were enthusiastic about conducting
this type of exercise, - gave positive feedback for use of this technology
and - felt it would facilitate collaboration and
enhance state capability to respond to disasters. - Quality control assessment showed accuracy in all
three states.
21What Worked?
- Patient cards easy to distribute controlled
test data for quantitative, retrospective
analysis of the validity of the exercise - Pre-assigning teams for the exercise based on
roles - Interactive exercises of both GIS and FAST/GPS
PDA enjoyed by the trainees - Allowing trainees to upload data from the
handheld devices into the computer (TN and KY)
to see the ease of data transfer - Demonstration of the form used in the exercise
with the Trimble PDA emulator on screen
22What didnt work?
- Format of patient scenario data was difficult to
work with. - GIS training was thought to be too compressed by
most of the trainees - Many people were frustrated with capturing GPS
coordinates. - Trimble unit screens were hard to read
- small screen
- glare from the sun
- Participants were confused about applicability to
their jurisdiction given that there was a limited
amount of hardware and software that was granted
through the project funds - Participants needed more detailed explanation of
did not adequately grasp the Natural Disaster
Morbidity Report Form found many gaps and
limitations
23What should we do differently in the future why?
- Task participants to bring a form often used in
the field which they can use to build a FAST
survey - Allow an extra day for the full GIS training
the training was too rushed and complicated for
most 3 days is the original length of the GIS
training - Provide GIS training tailored specifically to
public health relevance for public health
audience - Demonstrate using data gathered in FAST in other
analytical software, say with a pre-fabricated
SAS program to demonstrate usefulness of
application and technology - Integrate other technologies already in use in
the public health arena (i.e., software OMS,
hardware barcode readers, etc.) to further
enrich training
24Recommendations
- Implement GIS/GPS equipped handheld computers can
expand collaboration among public health
officials within states, between states, and with
federal partners. - Enhance the capacity of state and local health
departments to meet public health preparedness
goals and capture data in a more rapid format. - Train staff and practice using equipment on a
regular basis
25Acknowledgements
- Douglas Thoroughman CDC/COTPER (Kentucky)
- Araceli Rey CDC/NCPHI
- David Kim CDC/COTPER (Georgia)
- John Dunn - Tennessee
- Pat Drehobl CDC/OWCD
- Beth Stover CDC/OWCD
- Linda Karr ASTDN
- Carl Kinkade CDC/NCPHI
- Meeyong Park CDC/NCPHI
Disclaimer The findings and conclusions in this
report are those of the authors and do not
necessarily represent the official position of
the Centers for Disease Control and Prevention.
26QUESTIONS????