Bioterrorism and Health System Preparedness: Emerging Tools, Methods, and Strategies

Slide Presentation by Marc Overhage, M.D., Ph.D.

On April 29, 2002, Marc Overhage, M.D., Ph.D., made a presentation in a Web-assisted teleconference at Session 1, which was entitled "Enhancing Public Health, Health Care System, and Clinician Preparedness: Strategies to Promote Coordination and Communication."

This is the text version of Dr. Overhage's slide presentation. Select to access the slides or to access the streaming video of Bioterrorism and Health System Preparedness.

Enhancing Public Health, Health Care System, and Clinician Preparedness: Strategies to Promote Coordination and Communication

Marc Overhage, M.D., Ph.D.
Associate Professor of Medicine and Investigator
Regenstrief Institute for Health Care
Indiana University School of Medicine

Slide 1

This slide shows a map of Indianapolis and the locations of the different hospitals and health systems that are part of the Indiana Network for Patient Care (INPC).

Slide 2

INPC database organization

This slide shows a diagram of how the INPC is organized.

Slide 3

This slide shows an example of an electronic patient record.

Slide 4

Minimum data set

Emergency Department visits.
Hospital Discharges.
Laboratory Results.

Slide 5

Expanded data set

Minimum data set plus:

Admission notes/Discharge summaries.
Operative Reports.
Radiology Reports.
Surgical Pathology Reports.
Inpatient Medications.
Tumor Registry.

Slide 6

Electronic reporting flow

This slide shows a diagram of the electronic reporting flow. Information goes from the lab system to the interface engine. After the hospital fire wall, there is a reportable condition processor that feeds into the reportable condition database.

Slide 7

Reportable condition processor

This slide shows a diagram of the reportable condition processor. Reportable conditions flow into the Reportable Conditiosn Databases, and then out in the form of E-mail summaries and printable reports to public health and infection control.

Slide 8

Provider to Public Health Communications

Doubled reporting completeness.
Reduced reporting time lags.
Potential for syndromic surveillance.

Slide 9

Clinical Information Standards

Health Level 7 (HL7).
Digital Imaging and Communications in Medicine (DICOM).
Logical Object Identifier and Numerical Code (LONIC).

Slide 10

Public health to provider communication

Screening reminders.

Syphillis screening for high-risk patients.
Stool cultures for patients with diarrhea during outbreaks.

Outbreak alerting.

Slide 11

Barriers encountered

Obtaining cooperation.
Sustaining focus.
Inconsistency of data representation.
Modifying workflow.

Slide 12

INPC timeline

This slide shows a picture of the INPC timeline.

Early 2000: Private WAN in place to all sites.
Mid-2000: Consent forms in place.
Mid-2000: All EDs receiving printed abstract.
Early 2001: Global INQ software completed.
Mid-2001: RCT started.
Early 2002: Minimum dataset from everyone.

Slide 13

Creating cooperation

Shared vision.
Trust.
Neutral party.

Slide 14

Security/Confidentiality

Agent of State Department of Health under Memorandum of Understanding (MOU).
Private network (moving to Virtual Private Network).
Encrypted file transfer.
Controlled database access.
- Location linked IP address.
- User name/password.

Slide 15

Support

Funding from Federal agencies.
- National Library of Medicine.
- Agency for Healthcare Research and Quality.
In-kind support from hospitals.

Current as of June 2002

Internet Citation

Enhancing Public Health, Health Care System, and Clinician Preparedness: Strategies to Promote Coordination and Communication. Presentation by Marc Overhage, M.D., Ph.D., at Web-Assisted Teleconference, "Enhancing Public Health, Health Care System, and Clinician Preparedness." Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/ulp/bioteleconf/session1/overhagetxt.htm

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