Situational Awareness February 23 2006 Leslie Sokolow Noel

Situational Awareness February 23, 2006 Leslie Sokolow, Noel Williams, Ron Mc. Gaugh, Carla Rodriguez, Tom Reynolds, Regina Tan, Julia Gunn

Components of Situational Awareness • Information gathering • Information sharing • Reactive process

Information gathering: Data Types – Health • • • ED visits 911 calls Poison control Death certificates Veterinarian data Laboratory results Epi studies Drop-in surveillance for special events (ie Katrina shelters) I&Q – contact tracing – Environmental • • Weather Pollen Air quality Water quality measures – Other • • • Population profiles Organization characteristics Transportation (Cars, Rail, Air: Volume & Routing) Infrastructure Data (Fire/Police Departments, Schools, Hospitals, Hotels, Laboratories) Passenger Tracking

Information gathering: Data Sources – Does another agency collect the information? – Can we partner? – Communication across data silos – What can we prepare pre-event – templates, MOUs, development of portals • Roles and responsibilities – What are the holes – what is missing and who has responsibility for developing solutions – Don’t waste time creating what already exits.

Information sharing • With whom – Government • Public health, emergency management, law enforcement, military – Local – State – Federal – Others • Red Cross • THE MEDIA • At what level of detail – – – Aggregate data Line listings Pictures Analytics Dynamic mapping Exportable data/results

Reactive Process • Monitor the evolution of an “event” • Resource – Allocation – Redistribution • Planning (Before - During – After) • Control measures & process measures – Vaccination rate, shelter/hospital occupancy, medical deployment, evacuation plans • Inform decision makers – Everyone using the same information – Levels the playing field • Varies with agency roles and responsibilities

Scenarios: Mass Casualty Incident • Disasters – Accidents: Plane crash, fires – Hurricanes, floods, earthquakes – Explosions • Radiation – Dirty Bomb • Chemical - Spills • Biological – BT, Influenza, Emerging Infectious Diseases • Defining MCI and levels of situational awareness – Public health vs emergency management vs others

Electronic Communication • Interoperability – – • • Open architecture Data standards Templates Secure Plug & play Modular ie food history Equipment – PDA’s, GPS Backup systems – Number and location (off-site, extraregional) – System of last resort – paper and pencils • Real time? Issues related to data lags

Communication • Common language – Data definitions • What does dead mean? Confirmed vs reported – Standard chief complaint/diagnosis • Who decides? • What is lost is translation? • Telecommunication infrastructure: – Phones: • Land, cell, satellite – Radios – Blackberries, pager, etc – Wi. Fi

Coordination • Federal State Local • Emergency management services – Information systems • Patient tracking: Bar coding; RFID • WEBEOC – Field health care sites ie DMAT • Dueling algorithms – Information requests to local/state public health first responders

Time & Resource Constraints • IT Capacity • Epidemiology and Statistical – Analysis • Adjust baseline with population and health care utilization shift during an event – Proxy data? Is it valid? Other information? – Short baseline – Are there gaps – and who can help • Rural areas – Are their special needs? Funding • Culture of information sharing – Standard operating procedures • Short term vs Long term – What are issues? What needs more planning – What needs to be set up immediately for Panflu?

Virtual social network • Forum for sharing lessons learned – “Lessons Learned Information Sharing (LLIS. gov) is the national network of Lessons Learned and Best Practices for emergency response providers and homeland security officials. ” • Web clearinghouse for database, GIS, map layers, web resources • Sharing table top experience

Gap Analysis • IT/Informatics/Surveillance table top – – – Local State Federal Health sites – Can we leverage their IT/IS capacity Others – Banking, Finance, Military, Law, EMS • National CIO – Advocating for national data standards across disciplines and jurisdictions • Public health responder training • Flexibility and expandable - BT to hurricane related injuries – Are we ready for mental health surveillance? – Are we ready for the unforeseeable?

• Can situational awareness compromise public trust ? • If yes – what are the safe guards?

Will it happen?