1. Ohio Digital Government Summit Disease Surveillance (Homeland Security session) October 5, 2004 Rana Sen Deloitte Consulting LLP

2. Copyright © 2004 Deloitte Development LLC. All rights reserved.1 Homeland Security Threats & Solutions

3. Copyright © 2004 Deloitte Development LLC. All rights reserved.2 Public Health Disease Surveillance Cornerstone for detecting epidemics and bio- terrorist events Ongoing, systematic collection of public health data Foundation for preventing and containing disease outbreaks

4. Copyright © 2004 Deloitte Development LLC. All rights reserved.3 Engaging Public Health Community First Responders Investigators Laboratories CDC Local & State Health Departments DOH Central Office Physicians Hospitals EDR App Integrated Data Collection, Management, Analysis, Transmission, and Dissemination Epi-X Rapid reporting and discussion of health events, 24/7 access to key officials and expert assistance Health Alert Network Public Health Infrastructure More Timely Intervention More Complete Patient View Privacy Centric & Secure Bio-terrorism Rapid Detection Rapid Response Point of Care Data Entry Real-time Data Collection

5. Copyright © 2004 Deloitte Development LLC. All rights reserved.4 Disease Surveillance Imperatives Increase the frequency and timeliness of disease reporting by physicians, labs, and hospitals Facilitate more timely statewide communication of disease outbreak and health alert information Provide support for more comprehensive, integrated analysis of disease data to improve intervention strategies and reduce the severity of outbreaks Safeguard the confidentiality of information and individual privacy

6. Copyright © 2004 Deloitte Development LLC. All rights reserved.5 Current Public Health Systems Stovepipe Systems Non-integrated Databases Inconsistent data standards Manual data entry Mail and Fax Delays Long processing cycle Limited Analytics Incomplete patient data Limited security Incident Diagnosis Delays Outbreak Detection Delays Limited information sharing Data reliability issues Partial patient disease views Segmented pattern analysis Patient confidentiality risk TYPICAL CHARACTERISTICS IMPACT

7. Current public health systems may not be effective to meet new challenges. 6

8. Copyright © 2004 Deloitte Development LLC. All rights reserved.7 CDC & NEDSS National Electronic Disease Surveillance System (NEDSS) established by the Center for Disease Control (CDC) Vision, standards and guidelines established by the CDC and its public health partners for next generation pubic health surveillance and information systems

9. Copyright © 2004 Deloitte Development LLC. All rights reserved.8 NEDSS Objectives Facilitate more accurate and timely reporting Electronically link and integrate a wide variety of surveillance activities Meet necessary confidentiality and security requirements Provide comprehensive and consistent data for enhanced decision-making

10. Copyright © 2004 Deloitte Development LLC. All rights reserved.9 NEDSS Features Vision for Common Data Standards –Public Health Conceptual Data Model (PHCDM) Guidelines on NEDSS Systems Architecture - Eight Core Elements of NEDSS, e.g. –Web Browser-based Data Entry –Integrated Data Repository

11. Copyright © 2004 Deloitte Development LLC. All rights reserved.10 Pennsylvania’s NEDSS Implementation Web based Provider Reporting Integrated Data Repository Cross-disease Patient History Investigator Workflow STD and TB Case Management Electronic Lab Reporting Patient de-duplication Advanced Analytics Engine Data Visualization / GIS Maps Advanced Security Health Alert Network Diseases to diagnosis mapping Point-of-care Data Entry Hospital ICPs Laboratories Physicians

12. Copyright © 2004 Deloitte Development LLC. All rights reserved.11 Homeland Security Threats & Solutions

13. Copyright © 2004 Deloitte Development LLC. All rights reserved.12 The need for communication … Notification Hub Command Staff Fire Stations Inspectors Fire Fighters Admin Support Services Fire Department Police Emergency Preparedness LAWA/ Harbor Other City Departments LADWP/ Public Works Mayor and Council Public Affairs City of Los Angeles Schools Public Telephone Directory Hospitals Utility Companies Media State, County and Other Cities Community

14. Copyright © 2004 Deloitte Development LLC. All rights reserved.13 Lessons Learned Recognize the significance of change management during implementation Address the technological challenges of mission critical high impact Web-based applications Efficiency and effectiveness is achieved from modification of business process and using technology as an enabler Remarkable results can be achieved! Remarkable achievements requires vision and coordination Address the challenges of funding and spend

15. Copyright © 2004 Deloitte Development LLC. All rights reserved.14 Benefits Faster reporting and investigation cycle Comprehensive and consistent data collection Secure and accurate communication

16. Copyright © 2004 Deloitte Development LLC. All rights reserved.15 Future Has challenges but is also promising … Comprehensive public health network Extensive and reliable communication mechanism

17. Thank you. 16