Colorado’s Health Emergency Line for the Public (COHELP): Addressing Surge Capacity through Information Exchange Gregory M. Bogdan, Ph.D. Research Director Rocky Mountain Poison and Drug Center Denver Health Denver, CO

Hotline Contacts (% population) Public Risk Perception Event specifics (bioterrorism, child-targeted, new emerging disease) will effect the amount of public concern and numbers of people having information or others needs.

Challenge for Preparedness  2004 Redefining Readiness Project*  60% of public would not heed official instructions to get vaccinated during smallpox outbreak  40% of public would not heed official instructions to shelter in place during a dirty bomb incident *R. Lasker, Center for the Advancement of Collaborative Strategies in Health (www. cacsh.org)

Public Needs Information on…..  General topic/event information  Public health messages  Personal and family protection  State/local health dept guidelines  Points of contact for referral agencies  Health decision-support and evaluation

“Natural Fits”  Poison control centers  Nurse advice lines  Drug information centers  Public health agencies

Hospitals & Healthcare Facilities MCCMCC General Public Health Professionals Local & State Public Health Agencies Voice Fax Video Web patient surges reduced by providing information and triage through multiple paths How a Medical Call Center Works Fax Voice Web Video

COHELP Objectives  Develop a standardized and prepared response to public health events  Provide consistent, accurate information  Collect and maintain structured data to better characterize events and responses  Develop capability and capacity to adapt to emerging public health emergencies

COHELP Service Users COHELP Health Agencies Public Hospitals & EDs Healthcare Providers ClinicsSchools

Referral Procedures COHELP Local Health Agencies Caller Poison Center Healthcare Providers CDPHE Nurse Line

Provides 1-on-1 Information Toronto – SARS outbreak, Mar to Jun 2003 Total Calls = >300,000 Peak Daily Calls = 47,567 Deaths: 44Cases: 438 COHELP – Two Outbreaks, Jul to Dec 2003 Total Calls = 36,170 West Nile Virus (WNV) Calls = 12,555 Deaths: 47Cases: 2,543 Influenza/Pneumonia Calls = 23,615 Deaths: 809Cases: 11,427

Reduces Hospital Surge  United States Poison Control Centers  Of 2.4 million contacts about potential toxic exposures, 1.8 million (75%) were managed outside of health care facilities  Denver Health Nurse Line  Manages 40% of callers at home  70% callers changed plans  16% planned home care but 47% chose it after calling

Other Benefits  Standardized, accurate information delivery  Call center infrastructure/technology  Adaptability  Integrated Web sites (  Trained information providers  Defined referral procedures  Structured data collection and reporting

Lessons Learned  Public health events will continue to occur and will require a response  Need structured, coordinated systems to respond to these events that are:  Cost-effective  Efficient  Accurate  Consistent  Adaptable

More Lessons Learned  Call volume driven by event specifics and media attention  Easy to adapt messages to meet evolving public health and public needs  Surveillance  Ongoing surveillance signals  call volumes, topics requested, collected data  Sentinel event system  can identify new health concerns

For More Information  “Health Emergency Assistance Line and Triage Hub (HEALTH) Model” report on AHRQ Web site by end of year   HEALTH Contact Center Assessment Tool on HSRNET or AHRQ Web sites  rce.htm (available now)  (available by end of year)