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Enhanced Informatics Response to Disasters through Collaboration of Public Health Response Teams


Enhanced Informatics Response to Disasters through ... Beth Stover CDC/OWCD. Linda Karr ASTDN. Carl Kinkade CDC/NCPHI. Meeyong Park CDC/NCPHI ... – PowerPoint PPT presentation

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Title: Enhanced Informatics Response to Disasters through Collaboration of Public Health Response Teams

Enhanced Informatics Response to Disasters
through Collaboration of Public Health Response
LCDR Margaret A. Riggs, PhD, MPH, MS Career
Epidemiology Field Officer CDC / COTPER Kentucky
Dept. for Public Health
  • Disaster Surveillance
  • Exercise / Training
  • Evaluation of surveillance tool
  • Multi-state /Multi-agency collaboration
  • Recommendations

Importance of Active Surveillance During a
  • Complement to regular reporting mechanisms
  • Rapidly detect outbreaks and define health
  • Identify groups at risks for adverse health
  • Determine needs of special populations

Importance 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

Use 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.

Validating 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.

Project Objective
  • Evaluate the usefulness and acceptance of GIS/GPS
    equipped handheld computers for disaster
    surveillance through the collaboration of public
    health teams.

  • Two agencies
  • CDC
  • Association of State and Territorial Directors of
    Nursing (ASTDN)
  • Three states
  • Georgia
  • Tennessee
  • Kentucky
  • Three disciplines
  • Nurses
  • Epidemiologists
  • Environmental Health Specialists

  • 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

Training / 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.

Exercise 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

Exercise 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.
Exercise Scenario
  • On-scene police units report limited access into
    the damaged area due to large pieces of debris
    and nails littering the streets.

Exercise 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.

Exercise Scenario
  • You have been assigned to work at one of three
  • You will be interviewing patients for active
  • Enter data from the interview using the handheld
    Trimble computer
  • and the form that was
  • Developed in training.

Natural Disaster Morbidity Report Form
Patient Scenario
Handheld Computer
Evaluation 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
  • 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

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
  • felt it would facilitate collaboration and
    enhance state capability to respond to disasters.
  • Quality control assessment showed accuracy in all
    three states.

What 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
  • 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

What 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
  • 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

What 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
  • 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
  • Provide GIS training tailored specifically to
    public health relevance for public health
  • 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

  • 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

  • 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.
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