Colorado’s Health Emergency Line for the Public (COHELP): Addressing Surge Capacity through Information Exchange Gregory M. Bogdan, Ph.D. Research Director Rocky Mountain Poison and Drug Center Denver Health Denver, CO

Public Risk Perception Hotline Contacts (% population) Event specifics (bioterrorism, child-targeted, new emerging disease) will effect the amount of public concern and numbers of people having information or others needs.

Challenge for Preparedness 2004 Redefining Readiness Project* 60% of public would not heed official instructions to get vaccinated during smallpox outbreak 40% of public would not heed official instructions to shelter in place during a dirty bomb incident * R. Lasker, Center for the Advancement of Collaborative Strategies in Health (www. cacsh.org)

Public Needs Information on….. General topic/event information Public health messages Personal and family protection State/local health dept guidelines Points of contact for referral agencies Health decision-support and evaluation

“Natural Fits” Poison control centers Nurse advice lines Drug information centers Public health agencies

How a Medical Call Center Works Hospitals & Healthcare Facilities M C General Public Voice Fax Video Email Web Fax Email Voice Web Video patient surges reduced by providing information and triage through multiple paths Health Professionals Local & State Public Health Agencies

COHELP Objectives Develop a standardized and prepared response to public health events Provide consistent, accurate information Collect and maintain structured data to better characterize events and responses Develop capability and capacity to adapt to emerging public health emergencies

COHELP Service Users Public Healthcare Providers COHELP 877-462-2911 Clinics Schools Health Agencies Hospitals & EDs

Referral Procedures Caller COHELP Poison Center Nurse Line Local Health Agencies CDPHE Healthcare Providers

Provides 1-on-1 Information Toronto – SARS outbreak, Mar to Jun 2003 Total Calls = >300,000 Peak Daily Calls = 47,567 Deaths: 44 Cases: 438 COHELP – Two Outbreaks, Jul to Dec 2003 Total Calls = 36,170 West Nile Virus (WNV) Calls = 12,555 Deaths: 47 Cases: 2,543 Influenza/Pneumonia Calls = 23,615 Deaths: 809 Cases: 11,427

Reduces Hospital Surge United States Poison Control Centers Of 2.4 million contacts about potential toxic exposures, 1.8 million (75%) were managed outside of health care facilities Denver Health Nurse Line Manages 40% of callers at home 70% callers changed plans 16% planned home care but 47% chose it after calling

Other Benefits Standardized, accurate information delivery Call center infrastructure/technology Adaptability Integrated Web sites (www.cohelp.us) Trained information providers Defined referral procedures Structured data collection and reporting

Lessons Learned Public health events will continue to occur and will require a response Need structured, coordinated systems to respond to these events that are: Cost-effective Efficient Accurate Consistent Adaptable

More Lessons Learned Call volume driven by event specifics and media attention Easy to adapt messages to meet evolving public health and public needs Surveillance Ongoing surveillance signals call volumes, topics requested, collected data Sentinel event system can identify new health concerns

For More Information “Health Emergency Assistance Line and Triage Hub (HEALTH) Model” report on AHRQ Web site by end of year www.ahrq.gov HEALTH Contact Center Assessment Tool on HSRNET or AHRQ Web sites www.hsrnet.net/ahrq/surgecapacity/event3/resource.htm (available now) www.ahrq.gov (available by end of year)