1. 1 Support of Health Initiatives Support of Health Initiatives Jacqueline Brown Associate Vice President, UW Technology University of Washington Bruges, May 2008

2. 2 Outline Setting the Stage Rural Health Care Pilot Program R&E (Networks) Community in Support of Global Public Health A SARS Example APEC EINet Virtual Symposia on Pandemic Influenza Preparedness

3. 3 3 The FCC has initiated a pilot funding program to facilitate the creation of a nationwide broadband network dedicated to health care, connecting public and private non-profit health care providers in rural and urban locations Rural Health Care Pilot Program

4. 4 Recent FCC Order (Key points) The pilot program provides funding to support the cost of connecting the state or regional networks to an advanced network. By connecting to this dedicated national backbone, health care providers at the state and local levels will have the opportunity to benefit from advanced applications in continuing education and research 4

5. 5 FCC Statement of Benefits of a Dedicated Health Care Network A broadband network that connects multiple health care providers would bring the benefits of innovative telehealth and, in particular, telemedicine services to those areas of the county where the need for those benefits is most acute. Tele-health applications allow patients to access critically needed medical specialists in a variety of practices, including cardiology, pediatrics, and radiology, without leaving their homes or their communities. Linking statewide and regional networks to a nationwide backbone would connect a number of government research institutions, as well as academic, public, and private health care institutions that are repositories of medical expertise and information. Intensive care doctors and nurses can monitor critically ill patients at multiple locations around the clock. Health care providers would also benefit from advanced applications in continuing education and research. A nationwide network would enhance the health care communitys ability to provide a rapid and coordinated response in the event of a national crisis. 5

6. 6 Awards Initial Program $50-60 Million per year for 2 years Actual Awards 69 awards 42 States and 3 territories 6,000 public and non-profit providers $417 Million 3 years Connections to Internet2, NLR and Internet are pre-approved 6

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8. 8 R&E Community in Support of Global Public Health More university medical schools have or are creating departments of global health Faculty worry about coordinating efforts among countries/continents in case of a pandemic National/local governments are working on coordinating efforts, but are not normally thinking about networks/technology

9. 9 Technology in Support of Public Health: A SARS Example When: May 2003 The locale: Chinese Taipei hospitals around the city of Taipei The problem: The outbreak overwhelms the local health infrastructure Physicians are quarantined along with patients Specialists cannot travel to other hospitals to consult with colleagues

10. 10 What Is Needed A system for remote diagnosis, quick access to specialized medical expertise, and a means of sharing X-ray images, numerical instrument readings, and white board and audio/video discussions

11. 11 Implementing a Solution Hospital technical staff knew that access grid could be useful, but had no way of implementing throughout the hospital system On 15 May, the National Center for High- Performance Computing calls for help from Pacific Rim colleagues Within 12 hours, colleagues from PRC, Korea, Australia, Japan, and the U.S. respond

12. 12 Implementing a Solution (contd) 16-20 May: experts design and plan a system based on the access grid 21 May: 2 systems have been shipped, received, and tested 1 June: all greater Taipei area hospitals have received and tested systems and a dedicated network backbone is live

13. 13 Why The Concern About Pandemic Influenza Influenza pandemics are inevitable; naturally recur at more-or-less cyclical intervals Increased mobility of travelers and products: increasing challenges to Public Health response Will cause Drastic disruption of critical services Severe economic losses There will be little warning time between the onset of spread of a pandemic and its arrival in the U.S. or any country

14. 14 Copyright ©2004 by the National Academy of Sciences Hufnagel, L. et al. (2004) Proc. Natl. Acad. Sci. USA 101, 15124-15129 Fig. 1. Global aviation network- Links represent the traffic between the 500 largest airports in 100 countries in rate per day (see color code below)

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16. 16 King County (Seattle), WA 1.8 million people 1.8 million people 13 th most populous county in the US 13 th most populous county in the US 39 cities 39 cities 2 Tribal Nations 2 Tribal Nations 18 hospitals with emergency depts 18 hospitals with emergency depts 5 specialty hospitals 5 specialty hospitals 30 Community Health Clinics 30 Community Health Clinics 1,100 long term care facilities 1,100 long term care facilities

17. 17 King County Healthcare Coalition A network of healthcare organizations and providers that are committed to coordinating their emergency preparedness and response activities A network of healthcare organizations and providers that are committed to coordinating their emergency preparedness and response activities Develop and maintain a comprehensive system that assures coordination, effective communications, and optimal use of available health resources in response to emergencies and disaster for all hazards Develop and maintain a comprehensive system that assures coordination, effective communications, and optimal use of available health resources in response to emergencies and disaster for all hazards

18. 18 The Coalition More than 60 member and partner organizations More than 60 member and partner organizations Member organizations represent the continuum of care Member organizations represent the continuum of care Hospitals, Medical Groups, Safety Net Providers, Tribal Clinics, Pediatric Providers, Home Health and Home Care, Long Term Care, Mental Health, Specialty Providers – Dialysis, Blood, Poison Center Hospitals, Medical Groups, Safety Net Providers, Tribal Clinics, Pediatric Providers, Home Health and Home Care, Long Term Care, Mental Health, Specialty Providers – Dialysis, Blood, Poison Center Governed by an Executive Council Governed by an Executive Council Staffed by Public Health – Seattle & King County and experts in the community Staffed by Public Health – Seattle & King County and experts in the community Funded by local and federal resources Funded by local and federal resources

19. 19 APEC EINet APEC = Asia Pacific Economic Cooperation EINet = Emerging Infections Network

20. 20 APEC 21 Economies Main Goals Trade and Investment Liberalization Business Facilitation Economic and Technical Cooperation 28 April, 2004: First Meeting of Health Taskforce Promotes Regional Cooperation on Pandemic Disease Preparedness

21. 21 APEC EINet Founded in 1996 An APEC-approved project based at the University of Washington Dedicated to providing timely and reliable information via the Internet on issues of emerging infectious diseases in the Asia Pacific Actively promote communication, coordination, and collaboration among the 21 APEC member economies to enhance regional bio-preparedness

22. 22 APEC EINet Activities Information Sharing Certificate Program Virtual Symposia Promoting Collaborations for Biopreparedness

23. 23 Virtual Symposia Collaborative Videoconferencing in support of closer cooperation and information sharing

24. 24 First Virtual Symposium The goal was to start sharing state of preparedness in the post-SARS era Of the 21 APEC economies, 10 participated Viet Nam traveled to Thailand because of lack of technology and connectivity Scheduled for 19 Jan 2006, 02:00 – 06:30 UTC

25. 25 Results of First Symposium 10 APEC economies presented their epidemiologic situation and pandemic planning 210 minute access grid session Enough interest to consider a second symposium

26. 26 2nd Virtual Symposium ________________________ Pandemic Flu Preparedness: Partnerships and Continuity Planning for Critical Systems Goal: Describe how private and public sectors in the APEC region can cooperate and work effectively to prepare for and respond to pandemic influenza

27. 27 2nd Virtual Symposium Will bring together Public Health officials and faculty members with Business representatives Participants come mainly from the APEC Health Taskforce and from the APEC Business Advisory Council (ABAC) Participants will be hosted in universities and/or R&E institutions and networking organizations Planned for 5 hours on 29 May (Americas)/30 May (Asia) Each economy will make a 15-minute presentation + time for questions The Symposium will be led by an experienced moderator

28. 28 2nd Virtual Symposium (contd) Representatives from economies which do not have adequate bandwidth to support the application will be hosted by other economies The videoconference will use advanced R&E networks and thus avoid the congestion of the regular Internet The technology to be used will be determined by the technical staff of participating economies

29. 29 Participants in the 2nd Symposium Australia Brunei Darussalam* Canada Peoples Republic of China Indonesia* Japan Republic of Korea Malaysia* Mexico New Zealand Papua New Guinea* Peru Philippines Singapore Chinese Taipei Thailand U.S.A. Viet Nam

30. 30 Thank you. Comments? Jacqueline Brown jbrown@washington.edu