1. Helen Burstin, M.D., M.P.H. Director Center for Primary Care, Prevention, and Clinical Partnerships The Role of Community-Based Providers in Bioterrorism Preparedness

2. Role of Community Providers in Bioterrorism Preparedness Front-line clinical providers Public Health Infrastructure Public health departments Public health departments State laboratories State laboratories Emergency preparedness Emergency preparedness Patients present with symptoms Patients present with symptoms Primary care providers Primary care providers Community health centers Community health centers Emergency departments Emergency departments Hospitals Hospitals

3. Why are Linkages to Community Providers Important? Journal of Family Practice: September 2002 Chen et al (AAFP National Research Network and AHRQ researchers) Chen et al (AAFP National Research Network and AHRQ researchers) National survey of family physicians (pre-anthrax attacks) National survey of family physicians (pre-anthrax attacks) Two-thirds of family physicians feel unprepared to deal with a bioterrorist event Two-thirds of family physicians feel unprepared to deal with a bioterrorist event

4. Why Do Community Providers Need To Assist With BT Preparedness? PROBLEM #1: Patients often present to their provider with vague symptoms – may be confused with flu PROBLEM #1: Patients often present to their provider with vague symptoms – may be confused with flu POTENTIAL SOLUTIONS: POTENTIAL SOLUTIONS: – Decision support could help clinicians target the key symptoms or signs of a BT-related diagnosis – Training and point-of-care information could prepare community providers to diagnose and manage patients appropriately

5. Why Do Community Providers Need To Assist With BT Preparedness? PROBLEM #2: Community providers do not interact with the public health departments or emergency responders PROBLEM #2: Community providers do not interact with the public health departments or emergency responders POTENTIAL SOLUTIONS: POTENTIAL SOLUTIONS: – Develop ongoing relationship with the public health infrastructure (e.g., health departments, EMS) – Develop community-based data sharing systems for ongoing surveillance for BT and other public health emergencies (e.g., flu) – Develop role for community providers (and volunteer providers) for public health emergencies

6. What AHRQ Is Doing To Help Community Providers Develop training and information tools that meets the needs of community clinicians (e.g., Vanderbilt, University of Alabama website) Develop training and information tools that meets the needs of community clinicians (e.g., Vanderbilt, University of Alabama website) Support practice-based research networks of community-based providers to address important questions related to BT preparedness (e.g., Wisconsin, UNC, Cincinnati Children’s PBRNs) Support practice-based research networks of community-based providers to address important questions related to BT preparedness (e.g., Wisconsin, UNC, Cincinnati Children’s PBRNs) Enhance and reinforce linkages and IT connectivity between the health care system and the public health infrastructure (e.g., Indiana PBRN) Enhance and reinforce linkages and IT connectivity between the health care system and the public health infrastructure (e.g., Indiana PBRN)