Emergency Preparedness

Effective prevention, detection, and rapid response to PH emergencies rely on sufficient and timely delivered information. PH EOC data flows are based on critical information requirements, addressing needs of EOC staff for timely delivered analytical products that provide situational awareness, event-specific data, event investigation tools, resource management etc1. The ability of PH EOC systems to automatically and accurately interpret meaning of the exchanged data depends on a level of semantic data interoperability and utilization of a common information exchange reference model (CIERF) that conforms to established data standards. PH EOC data interoperability requires mutual development and close collaboration with partners to develop a PH EPR CIERF, common terminology and standardized vocabulary.

Objective:

The purpose of this project is to demonstrate progress in developing functional data models and semantic definitions (content standards) for data elements and value sets comprising information categories supporting PH Emergency Preparedness and Response. (EPR) The objective is to explain the concepts and methods used to define core PH Emergency Management and Preparedness and Response functions, Information Exchange Requirements (IERs), data elements, and value sets to create a PH Emergency Operations Center (EOC) Minimum Data Set Specification. The primary focus of this presentation is to describe the value of semantic data interoperability and provide operational examples of the value and return-on-investment gained through building semantically interoperable data exchange through content standardization.

Each significant outbreak and epidemic raises questions that must be answered in order to better inform future preparedness and response efforts, such as:

• What are the systems and resources needed to characterize an outbreak?
• What systems and resources are needed to bring an outbreak to a close?

While we can anticipate these types of questions, the absence of dedicated mechanisms to record operational experiences and challenges can result in valuable, ephemeral data that are crucial for improving outbreak response not being consistently collected or analyzed. Participation in outbreaks by external experts can be instrumental in ensuring that this important operational information is documented, analyzed and shared with the broader public health community. There is a particular need for observers external to the response who can capture and analyze applied data about the operational response to outbreaks—eg, the systems and strategies involved in responding to the such events ”in order to improve our understanding of best practices for detecting and responding to these events. These can then be shared so that the entire public health community can access and incorporate lessons learned into their own preparedness and response plans. External observers can also help describe the important work performed by local responders during outbreaks and advocate for necessary preparedness and response program resources. The Outbreak Observatory is currently in a pilot phase and is looking for international and US partners who may be interested in collaborating with members of our team during their next outbreak response.

Objective:

The Outbreak Observatory (OO) aims to:

• Strengthen outbreak/epidemic preparedness and response activities through real-time, one-the-ground observations and analyses ●Identify best practices based on operational experience that are broadly applicable across outbreak response agencies
• Serve as an independent voice to advocate for policies that support preparedness and response activities based on expert assessment of the resources required to build and maintain necessary outbreak response capabilities Support local practitioners’ efforts to publish their experiences
• Sharing the firsthand experience of responders is critical for building outbreak preparedness and response capacity, and OO will serve as a dedicated mechanism to collect, analyze and disseminate this information

Syndromic surveillance is the monitoring of symptom combinations (i.e., syndromes) or other indicators within a population to inform public health actions. The Tennessee Department of Health (TDH) collects emergency department (ED) data from more than 70 hospitals across Tennessee to support statewide syndromic surveillance activities. Hospitals in Tennessee typically provide data within 48 hours of a patient encounter. While syndromic surveillance often supplements disease- or condition-specific surveillance, it can also provide general situational awareness about emergency department patients during an event or response. During Hurricanes Harvey (continental US landfall on August 25, 2017) and Irma (continental US landfall on September 10, 2017), TDH supported all hazards situational awareness using the Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) in the BioSense Platform supported by the National Syndromic Surveillance Program (NSSP). The volume of out-of-state patients in Tennessee was monitored to assess the impact on the healthcare system and any geographic- or hospital-specific clustering of out-of-state patients within Tennessee. Results were included in daily State Health Operations Center (SHOC) situation reports and shared with agency response partners such as the Tennessee Emergency Management Agency (TEMA).

Objective:

To demonstrate the use of ESSENCE in the BioSense Platform to monitor out-of-State patients seeking emergency healthcare in Tennessee during Hurricanes Harvey and Irma.