Information Sharing and Collaboration Applications to Integrated Biosurveillance: Workshop Summary (2012) / Chapter Skim
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3 State and Local Experiences
3 State and Local Experiences
Pages 23-34
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From page 23... ...
Analysis of previous episodes and planning for possible future events are both necessary to uncover and fill gaps. BIOLOGICAL PREPAREDNESS AND RESPONSE IN NEW YORK CITY1 Under normal circumstances, within and between organizations and sectors, information sharing is considered maladaptive, said Joel Ackelsberg, Bureau of Communicable Diseases, New York City Department of Health and Mental Hygiene.
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From page 24... ...
It's heavy on people and heavy on the skills that they bring to problem solving." Before and After 9/11 The New York City Department of Health and Mental Hygiene was working on biological preparedness even before 9/11. It had instituted an internal incident management structure and had established interagency coordination with the mayor's Office of Emergency Management, law enforcement, New York City hospitals, and regional public health agen
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From page 25... ...
After the first anthrax inhalation case was identified in Florida, the department started active surveillance with intensive care units, engaged microbiology laboratories, and worked with infectious disease and infection control personnel. When anthrax cases began to occur in New York City, joint public health and law enforcement teams conducted multiple and simultaneous investigations of thousands of suspected cases.
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From page 26... ...
For example, the Department of Health has a protocol -- "well exercised, unfortunately" -- with the New York Police Department and the Federal Bureau of Investigation. "This is a good example of the way in which information needs to be shared in order for common missions and objectives to be successfully reached." It is leveraging social networks for communications and public health surveillance.
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From page 27... ...
Meanwhile, the ability to monitor diseases around the world has huge vulnerabilities, despite the potential influence on localities like New York City. SEEKING ACCESS TO SURVEILLANCE DATA IN MARION COUNTY, INDIANA2 Joseph Gibson, from the Marion County Public Health Department -- which includes the city of Indianapolis -- described his department's experiences in gaining access to three kinds of surveillance data: clinical data, school absenteeism data, and data from the state health department.
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From page 28... ...
Furthermore, state officials have worried about establishing a precedent with Marion County, which is the largest health department in the state and has greater resources, that then would apply to counties with fewer human resources and less ability to protect the confidentiality of the data. What Does Not Work Gibson described several approaches that have not worked in requesting data to protect public health at the county level.
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From page 29... ...
Hospitals also received ways to compare their information to the information for all hospitals. Along the same lines, during the H1N1 epidemic the public health department distributed swabs to clinics and then collected them every day to take to the laboratory.
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From page 30... ...
"At the local and state level, there's a lot of activity around that." Ackelsberg asked about sharing information while protecting the interests of an agency and its partners, and Gibson responded that "the more you share information, the stronger your community gets." He said that he has a sign on his wall that says, "Information is power, so spread it around." Information is not lost by sharing it -- it just builds. However, when data come from somewhere else, it is advisable to direct people to the source, "because we don't want to be sharing somebody else's data; we'd rather have it come directly from them." This is also an issue when law enforcement becomes involved, because hospitals are unlikely to keep sharing information with a public health agency if that information is then passed on to law enforcement agencies, said Gibson.
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From page 31... ...
Users have rights defined by their role, so a local person working with the hospital system could see local data, a regionally based public health professional 3 This section is based on the presentation by Jean-Marie Maillard, NC DHHS.
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From page 32... ...
Surveillance networks in North Carolina include local health departments, including communicable disease nurses, hospital-based epidemiologists, laboratory directors, and epidemiologists at the state level who can provide support remotely and on site as needed. For instance, the state has used funding received since 2002 to set up a network of hospital-based public health epidemiologists.
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From page 33... ...
An infection control program in the state has detected disease outbreaks associated with reuse of single-use products that should not be shared among patients. "It works both ways -- we tell them about the cluster of outbreaks we are informed about and investigate, and health service regulation tells us about the findings they noticed during inspections." The North Carolina Intelligence Sharing and Analysis Center provides two-way information sharing with law enforcement through public health staff with security clearances.
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From page 34... ...
34 BIOSURVEILLANCE INFORMATION SHARING AND COLLABORATION clinics as well as emergency departments, Maillard pointed to several collaborations with the agricultural sector, though funds for such activities have been diminishing. Animal surveillance generally has been at a more basic level than human surveillance, he said, but animal surveillance in North Carolina has had extensive experience with mapping and has been willing to share its mapping structure with public health agencies.
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