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

Slide Presentation by Leslie Beitsch, M.D., J.D.

On April 30, 2002, Leslie Beitsch, M.D., J.D., made a presentation in a Web-assisted teleconference at Session 2, which was entitled "Promoting Clinician Readiness."

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

Promoting Clinician Readiness

Leslie Beitsch, M.D., J.D.
Commissioner and State Health Officer
Oklahoma State Department of Health

Slide 1

Efforts by Health Departments

• Over the past 3 years, many State health departments were recipients of CDC sponsored bioterrorism (BT) grants.
• Grantees made concerted outreach efforts to clinical practitioners.
• Strengthening the Health Alert Network (HAN) included coordination with local and State medical societies.
• Establishing ties with Metropolitan Medical Response System (MMRS).

Slide 2

Clinician Needs after 9/11

• Definitive information on BT.
• Diagnostic criteria.
• Surveillance and reporting primer.
• State and local medical societies wanted greater participation in the BT planning and advisory processes.

Slide 3

Engaging Clinicians

• Have a BT event… it creates the teachable moment.
• Clinicians without further prodding will seek to enhance their competency in diagnosing BT related illnesses.
• Modest educational efforts will pay immediate dividends by raising the clinical index of suspicion.
• Reminding medical societies and individual physicians of legal duty to report diseases (e.g., anthrax, etc.).
• Reducing barriers to simplified reporting (e.g., electronic disease reporting).

Slide 4

Steps for State and Local Health Departments

• Build a systemic response to BT events.
• Provide education and training to the entire public health workforce, not only staff with day-to-day BT responsibilities.
• Enhance epidemiology, biostatistics, microbiology, and communication skills through core courses, seminars, and distance learning technologies.
• Offer graduate education for selected staff who demonstrate potential for future leadership roles.

Slide 5

Role for Clinicians

• Physicians are now engaged.
• New BT grant requires planning and advisory committees.
• Coordination with local and State medical societies requires further strengthening.
• Recruitment/involvement with MMRS.

Slide 6

Testing the System

• April 12 and 13, the Oklahoma State Department of Health (OSDH) staged largest BT exercise ever.
• Blueprint and lessons will be available for others to use across the country.
• Planning activities and exercises are the best methods to test systems responsiveness.
• Employ hackers to test security.
• IT system redundancy test.

Slide 7

Preparing for Bioterrorism

• State and local task forces in virtually every health jurisdiction.
• Involvement with Gubernatorial and Legislative task forces.
• ASTHO and NACCHO have provided tools, recommendations, and enhanced Web sites.
• CDC BT grants.
• Enhanced surveillance.

Slide 8

Public Health and Clinical Medicine

• Renewed appreciation of the importance the public health system plays in protecting our communities.
• Better understanding of the need for disease surveillance and reporting systems.
• Willing participant now in BT and other related advisory groups.

Slide 9

Model Emergency Health Powers Act

• Act is attempt to codify the various powers and authorities needed to respond to the most catastrophic public health events (BT).
• Private sector may be called upon to assist governmental public health.
• Hospitals and other facilities may be "statecized."
• Conceivably clinicians could be asked to practice in adjacent jurisdictions.

Slide 10

Coordination with Tribal Governments

• Coordination required under the terms of the new CDC grant.
• Oklahoma example: 39 federally recognized tribes.
• Short-term approach: include Bureau of Indian Health (BIH) in advisory group.
• Expand to all interested participants in the long-term planning process.

Slide 11

Available Tools

• All States recently completed a Department of Justice (DOJ) survey, with results now available.
• National Public Health Performance Standards look at broad public health systems capabilities.
• Reconcile laws in jurisdiction with Model Emergency Health Powers Act.

Slide 12

Lessons Learned

• Build close working relationships with clinical colleagues before threatened BT events.
• Use HAN resources to tie clinicians into public health network.
• Examine disease reporting and surveillance systems from perspective of the "user" and lower barriers to easy accessibility.
• Improve web sites so that clinicians seeking information can obtain it rapidly.
• Anticipate ongoing educational needs, and use CME as a carrot.

Current as of June 2002

Internet Citation

Promoting Clinician Readiness. Presentation by Leslie Beitsch at Web-Assisted Teleconference, "Bioterrorism and Health System Preparedness: Emerging Tools, Methods, and Strategies." Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/ulp/bioteleconf/session2/beitschtxt.htm

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