1. Emergency Management Information: Challenges for the 21st Century Emergency Management Information: Challenges for the 21st Century ISCRAM 2008 Washington, D.C. 5th May 2008 Eric K. Noji, M.D., M.P.H., Consultant in Global Health Security Washington, D.C.

3. Good-bye!

5. Domaine de Noji Product of Prince Georges Co. USA

6. Health Information Needs in Emergency Populations Establish health care priorities Establish health care priorities Follow trends and reassess priorities Follow trends and reassess priorities Detect and respond to epidemics Detect and respond to epidemics Evaluate program effectiveness Evaluate program effectiveness Ensure targeting of resources Ensure targeting of resources Evaluate quality of health care Evaluate quality of health care

7. Disaster Epidemiology Purpose: Purpose: –Identify requirements, local capabilities, gaps –Avoid unnecessary and damaging assistance Victims Needs Available Services Data for Decision-Making

9. Hand-held Screens of Tornado Assessment Forms used last week

10. On the Hand Held - Acute Disease Survey Form

11. Forms-Handheld Process Overview Encrypted Traffic Internet Repository User Defines and Tests Questionnaire (Form) Via Web Interface 1 Handheld User Selects Forms & Downloads by direct wireless connection or via PC/cradle connection 2 Multiple Users Can Immediately Enter Data directly via Web Form 3 4 User can enter Data via Forms when Handheld is disconnected 5 Handheld Data & Forms are Synchronized the Next time device is connected

13. Investigating Person-to-Person Spread

18. Decision Making without Data Need to make decisions rapidly in the absence of data Need to make decisions rapidly in the absence of data Few genuine subject matter experts Few genuine subject matter experts No “textbook” experience to guide response No “textbook” experience to guide response Understanding of “risk” will evolve as a pandemic develops and spreads Understanding of “risk” will evolve as a pandemic develops and spreads ****Need coherent, rapid process for addressing scientific issues in midst of crisis**** ****Need coherent, rapid process for addressing scientific issues in midst of crisis****

21. Bad communication adds to crisis Mixed messages from multiple “experts” Mixed messages from multiple “experts” Late information “overcome by events” Late information “overcome by events” Over-reassuring messages Over-reassuring messages No reality check on recommendations No reality check on recommendations Myths, rumors, doomsayers not countered Myths, rumors, doomsayers not countered Poor performance by spokesperson or leader Poor performance by spokesperson or leader Public power struggles and confusion Public power struggles and confusion

22. A Typical Day at CDC Autumn 2001

24. Hand-held Screens of Tornado Assessment Forms used last week

25. On the Hand Held - Acute Disease Survey Form

28. Decision Making without Data Need to make decisions rapidly in the absence of data Need to make decisions rapidly in the absence of data Few genuine subject matter experts Few genuine subject matter experts No “textbook” experience to guide response No “textbook” experience to guide response Understanding of “risk” will evolve as an outbreak develops and spreads Understanding of “risk” will evolve as an outbreak develops and spreads ****Need coherent, rapid process for addressing scientific issues in midst of crisis**** ****Need coherent, rapid process for addressing scientific issues in midst of crisis****

29. Bad communication adds to crisis Mixed messages from multiple “experts” Mixed messages from multiple “experts” Late information “overcome by events” Late information “overcome by events” Over-reassuring messages Over-reassuring messages No reality check on recommendations No reality check on recommendations Myths, rumors, doomsayers not countered Myths, rumors, doomsayers not countered Poor performance by spokesperson or leader Poor performance by spokesperson or leader Public power struggles and confusion Public power struggles and confusion

31. A Typical Day at CDC Autumn 2001

35. Reports of Diseases

40. Forms-Handheld Process Overview Encrypted Traffic Internet Repository User Defines and Tests Questionnaire (Form) Via Web Interface 1 Handheld User Selects Forms & Downloads by direct wireless connection or via PC/cradle connection 2 Multiple Users Can Immediately Enter Data directly via Web Form 3 4 User can enter Data via Forms when Handheld is disconnected 5 Handheld Data & Forms are Synchronized the Next time device is connected