Situational Awareness February 23, 2006 Leslie Sokolow, Noel Williams, Ron McGaugh, 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 –WiFi

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?