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Information Sharing and Collaboration
APPLICATIONS TO INTEGRATED BIOSURVEILLANCE
WORKSHOP SUMMARY
Deepali M. Patel and Steve Olson, Rapporteurs
Planning Committee on Information-Sharing Models and
Guidelines for Collaboration: Applications to an Integrated One
Health Biosurveillance Strategy
A Workshop
Board on Health Sciences Policy
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THE NATIONAL ACADEMIES PRESS • 500 Fifth Street, N.W. • Washington, DC 20001
NOTICE: The project that is the subject of this report was approved by the
Governing Board of the National Research Council, whose members are drawn
from the councils of the National Academy of Sciences, the National Academy
of Engineering, and the Institute of Medicine.
This study was supported by Contract No. HSHQDC-08-C-00111 between the
National Academy of Sciences and the Department of Homeland Security. Any
opinions, findings, conclusions, or recommendations expressed in this
publication are those of the author(s) and do not necessarily reflect the view of
the organizations or agencies that provided support for this project.
International Standard Book Number-13: 978-0-309-22403-1
International Standard Book Number-10: 0-309-22403-9
Additional copies of this report are available from the National Academies
Press, 500 Fifth Street, N.W., Lockbox 285, Washington, DC 20055; (800) 624-
6242 or (202) 334-3313 (in the Washington metropolitan area); Internet,
http://www.nap.edu.
For more information about the Institute of Medicine, visit the IOM home page
at: www.iom.edu.
Copyright 2012 by the National Academy of Sciences. All rights reserved.
Printed in the United States of America
The serpent has been a symbol of long life, healing, and knowledge among
almost all cultures and religions since the beginning of recorded history. The
serpent adopted as a logotype by the Institute of Medicine is a relief carving
from ancient Greece, now held by the Staatliche Museen in Berlin.
Suggested citation: IOM (Institute of Medicine). 2012. Information sharing and
collaboration: Applications to integrated biosurveillance: Workshop summary.
Washington, DC: The National Academies Press.
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The National Academy of Sciences is a private, nonprofit, self-perpetuating
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www.national-academies.org
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PLANNING COMMITTEE ON INFORMATION-SHARING
MODELS AND GUIDELINES FOR COLLABORATION:
APPLICATIONS TO AN INTEGRATED ONE HEALTH
BIOSURVEILLANCE STRATEGY—A WORKSHOP1
SCOTT A. MUGNO (Co-chair), Vice President, Safety and
Maintenance, FedEx Ground, Moon Township, PA
WILLIAM F. RAUB (Co-chair), Retired, Senior Advisor to the
Secretary, Department of Health and Human Services, Rockville, MD
JAMES W. BUEHLER, Director, Public Health Surveillance Program
Office, Office of Surveillance, Epidemiology and Laboratory
Services, Centers for Disease Control and Prevention, Atlanta, GA
JOSEPH KIELMAN, Chief Scientist, Infrastructure Protection and
Disaster Management Division, and Program Manager, Office of
University Programs, Department of Homeland Security Science and
Technology Directorate, Washington, DC
RICHARD C. LARSON, Mitsui Professor of Engineering Systems, and
Director, Center for Engineering Systems Fundamentals,
Massachusetts Institute of Technology, Cambridge, MA
MARK E. TEACHMAN, Director, Interagency Coordination, National
Center for Animal Health Emergency Management, Department of
Agriculture, Riverdale, MD
MICHAEL M. WAGNER, Associate Professor of Biomedical
Informatics and Intelligent Systems, Department of Biomedical
Informatics, University of Pittsburgh, Pittsburgh, PA
Study Staff
CATHARYN T. LIVERMAN, Senior Program Officer
DEEPALI M. PATEL, Program Officer
LARA STRAWBRIDGE, Research Associate
JUDY ESTEP, Program Associate
PAMELLA ATAYI, Senior Program Assistant
MEGAN PEREZ, Senior Program Assistant
VICTORIA BOWMAN, Financial Associate
1
Institute of Medicine planning committees are solely responsible for organizing the
workshop, identifying topics, and choosing speakers. The responsibility for the published
workshop summary rests with the workshop rapporteurs and the institution.
v
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Reviewers
This report has been reviewed in draft form by individuals chosen for
their diverse perspectives and technical expertise, in accordance with
procedures approved by the National Research Council’s Report Review
Committee. The purpose of this independent review is to provide candid
and critical comments that will assist the institution in making its pub-
lished report as sound as possible and to ensure that the report meets in-
stitutional standards for objectivity, evidence, and responsiveness to the
study charge. The review comments and draft manuscript remain confi-
dential to protect the integrity of the process. We wish to thank the fol-
lowing individuals for their review of this report:
James Buehler, Director, Public Health Surveillance Program Office,
Centers for Disease Control and Prevention, Department of Health
and Human Services
Joseph Gibson, Director of Epidemiology, The Marion County Public
Health Department
Amy Kircher, Associate Director, National Center for Food Protection
and Defense, University of Minnesota
Scott A. Mugno, Vice President, Safety and Maintenance, FedEx
Ground
Although the reviewers listed above have provided many construc-
tive comments and suggestions, they were not asked to endorse the final
draft of the report before its release. The review of this report was over-
seen by Claire V. Broome, Adjunct Professor, Division of Global
Health, Rollins School of Public Health, Emory University. Appointed
by the Institute of Medicine, she was responsible for making certain that
an independent examination of this report was carried out in accordance
vii
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viii REVIEWERS
with institutional procedures and that all review comments were careful-
ly considered. Responsibility for the final content of this report rests en-
tirely with the authors and the institution.
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Contents
ACRONYMS xi
1 INTRODUCTION AND OVERVIEW 1
Status of National Biosurveillance Integration, 3
Overview of the Workshop, 5
Organization of This Summary, 6
Acknowledgments, 7
2 EXPERIENCES OF FEDERAL AGENCIES 9
Responding to Epidemics at the Centers for Disease Control and
Prevention, 9
Coordinating Animal Health Actions Across the Human-Animal
Interface, 13
Integrating Complex National Missions: Lessons from the National
Counterterrorism Center’s Directorate of Strategic Operational
Planning, 16
Viewpoint of the National Security Staff, 20
3 STATE AND LOCAL EXPERIENCES 23
Biological Preparedness and Response in New York City, 23
Seeking Access to Surveillance Data in Marion County,
Indiana, 27
Information Sharing for Biosurveillance in North Carolina, 31
4 OUTSIDE PERSPECTIVES 35
Keeping Pace with Data Collections in a Rapidly Changing
Environment, 35
Information Sharing: The Israeli Experience, 37
ix
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x CONTENTS
5 DISCUSSION OF A SCENARIO 41
First Move, 42
Second Move, 45
Third Move, 49
Fourth Move, 51
Fifth Move, 55
6 CONCEPT OF OPERATIONS 57
A Focus on Performance Improvement, 57
Operational and Organizational Impacts, 61
Operational Realities, 63
A Regional Solution, 65
Discussion, 66
REFERENCES 69
APPENDIXES
A Workshop Agenda 71
B Speaker Biographies 79
C Planning Committee Biographies 93
D Standing Committee on Health Threats Resilience 99
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Acronyms
AFHSC Armed Forces Health Surveillance Center
APHIS Animal and Plant Health Inspection Service
BATR biological assessment threat response
BCU Biosurveillance Coordination Unit (renamed in 2009
as Biosurveillance Coordination Activity)
CDC Centers for Disease Control and Prevention
CONOPS concept of operations
DHS Department of Homeland Security
DOD Department of Defense
DSOP Directorate of Strategic Operational Planning
EOC emergency operation center
FBI Federal Bureau of Investigation
FDA Food and Drug Administration
FSIS Food Safety Inspection Service
GAO Government Accountability Office
HHS Department of Health and Human Services
HSPD Homeland Security Presidential Directive
IDF Israeli Defense Forces
IOM Institute of Medicine
xi
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xii ACRONYMS
MACFIO Multiple Agency Coordination Foodborne Illness
Outbreak
NBAS National Biosurveillance Advisory Subcommittee
NBIC National Biosurveillance Integration Center
NBIS National Biosurveillance Integration System
NC-DETECT North Carolina Disease Event Tracking and
Epidemiologic Collection Tool
NC DHHS North Carolina Department of Health and Human
Services
NCTC National Counterterrorism Center
NSS National Security Staff
OIG Office of Inspector General
OODA observe, orient, decide, and act
STEC Shiga toxin-producing Escherichia coli
USDA Department of Agriculture
