scholarly journals Progress in the Development of the Standardized Public Health Emergency Preparedness Terminology

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Nikolay Lipskiy ◽  
James Tyson ◽  
Shauna Mettee Zarecki ◽  
Jacqueline Burkholder
Keyword(s):  
Public Health ◽  
Emergency Management ◽  
Emergency Preparedness ◽  
Data Exchange ◽  
Semantic Interoperability ◽  
Incident Management ◽  
Data Set ◽  
Emergency Operations ◽  
Support Organizations ◽  
Emergency Preparedness And Response

ObjectiveThe purpose of this project is to demonstrate the progress in development of a standardized public health (PH) emergency preparedness and response data ontology (terminology) through collaboration between the Centers for Disease Control and Prevention (CDC), Division of Emergency Operations (DEO), and the Logical Observation Identifiers Names and Codes (LOINC) system.IntroductionThe U.S. Department of Homeland Security National Incident Management System (NIMS) establishes a common framework and common terminology that allows diverse incident management and support organizations to work together across a wide variety of functions and hazard scenarios1. Using common terminology helps avoid confusion and enhances interoperability, particularly in fast-moving public health (PH) emergency responses. In addition, common terminology allows diverse incident management and support organizations to work together across a wide variety of functions and scenarios1. LOINC is one of a suite of designated standards for the electronic exchange of public health and clinical information. Implementation of LOINC facilitates improvement of semantic interoperability, including unified terminology2. More than 68,100 registered users from 172 countries use LOINC to move interoperable data seamlessly between systems3. The CDC Division of Emergency Operations (DEO) leads development of standardized PH emergency preparedness and response terminology to improve effective and interoperable communications between national and international partners. Realizing the scale of LOINC support and implementation across the global public health arena, CDC DEO collaborates with LOINC to further enhance and harmonize the current PH emergency response terminology and to attain critical PH emergency management and preparedness and response requirements.MethodsDEO analyzed 87,863 LOINC terms that were included in LOINC version 2.64, released on 06/15/20183. Access to this LOINC version was obtained through the Regenstrief LOINC Mapping Assistant (RELMA). RELMA is a Windows-based LOINC utility developed by the Regenstrief Institute (Indiapolis, USA) for searching the LOINC database and mapping local codes to LOINC codes4. The relevance of LOINC terminology to PH emergency preparedness and response was assessed through evaluating existing LOINC terminology against terminology specified by the World Health Organization PH Emergency Operation Centers (EOC). The following functions were evaluated: 1) Managing and Commanding; 2) Operating; 3) Planning/Intelligence; 4) Logistics and 5) Finance/Administration5. LOINC terminology was also evaluated against the CDC PH EOC Minimum Data Set (MDS)6 that contains 315 standardized terms. Analysis of fully specified LOINC terms was conducted through assessment of such LOINC term parts (attributes) as the code, name (component), system, method and class. Recommendations of gaps and enhancements were coordinated with LOINC management for inclusion of the new terminology in the release of version 2.65 .ResultsA new LOINC method, “CDC.EOC”, is under development. Currently, the “emergency management incident” terminology presented by LOINC is limited by such characteristics as event type, event location and event name and requires amplification regarding to PH operations (i.e., communication, logistics etc.).As a result of this investigation, emergency management terms are now being classified according to the type of incident or event (i.e., hurricane, outbreak, etc.) under LOINC code 80394-0. Similarly laboratory and clinical terms are being classified under a provisional LOINC code (89724-9). Two panels were created: 1) The emergency medical systems from the National Emergency Medical Services Information System (NEMSIS) was added under the NEMSIS.Panel (n= 177 terms) and 2) the Data Elements for Emergency Departments Systems (DEEDS) panel (n = 152 terms) was added with two subpanels: Attach.ED and Panel.ED.Assessing existing LOINC taxonomy and codification, DEO is working with the LOINC management team on evaluating additional options for reconciliation the PH emergency preparedness and response common information exchange reference model and LOINC standard. This process aims to further improve semantic interoperability of PH emergency preparedness and response information.ConclusionsThe LOINC terminology standardization is essential for improving PH preparedness and response data exchange and semantic interoperability. Collaboration with the Regenstrief Institute (LOINC) allows CDC to meet the terminology needs of PH emergency management and defines new opportunities for reconciliation data exchange between NIMS partners. This collaborative effort incorporates critically needed PH emergency and preparedness terminology and hierarchical structure in the LOINC standard.References1.FEMA National Incident Management System. Third Edition, October 2017. At: https://www.fema.gov/media-library-data/1508151197225-ced8c60378c3936adb92c1a3ee6f6564/FINAL_NIMS_2017.pdf2. US National Library of Medicine. Logical Observation Identifiers Names and Codes (LOINC). At: https://www.nlm.nih.gov/research/umls/loinc_main.html3. LOINC. The international standard for identifying health measurements, observations, and documents. At: https://loinc.org/4. RELMA-the Reginstrief Institute LOINC Mapping Assistant. At: https://loinc.org/relma/5.WHO. Framework for a Public Health Emergency Operations Centre. Interim document. November, 2015. At: http://www.who.int/ihr/publications/9789241565134_eng/en/6. CDC. Public Health Information Network Vocabulary Access and Distribution System (PHIN VADS). Minimum Data Set for PH Emergency Operations Center. At: https://phinvads.cdc.gov/vads/SearchVocab.action 

scholarly journals Development Semantically Interoperable PH Emergency Preparedness Data Exchange

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Nikolay Lipskiy ◽  
James Tyson ◽  
Jaqueline Burkholder
Keyword(s):  
Emergency Management ◽  
Emergency Preparedness ◽  
Information Exchange ◽  
Data Exchange ◽  
Situational Awareness ◽  
Content Standards ◽  
Data Interoperability ◽  
Data Set ◽  
Emergency Operations ◽  
Data Elements

Objective:The purpose of this project is to demonstrate progress in developing functional data models and semantic definitions (content standards) for data elements and value sets comprising information categories supporting PH Emergency Preparedness and Response. (EPR) The objective is to explain the concepts and methods used to define core PH Emergency Management and Preparedness and Response functions, Information Exchange Requirements (IERs), data elements, and value sets to create a PH Emergency Operations Center (EOC) Minimum Data Set Specification. The primary focus of this presentation is to describe the value of semantic data interoperability and provide operational examples of the value and return-on-investment gained through building semantically interoperable data exchange through content standardization. Introduction:Effective prevention, detection, and rapid response to PH emergencies rely on sufficient and timely delivered information. PH EOC data flows are based on critical information requirements, addressing needs of EOC staff for timely delivered analytical products that provide situational awareness, event-specific data, event investigation tools, resource management etc1. The ability of PH EOC systems to automatically and accurately interpret meaning of the exchanged data depends on a level of semantic data interoperability and utilization of a common information exchange reference model (CIERF) that conforms to established data standards. PH EOC data interoperability requires mutual development and close collaboration with partners to develop a PH EPR CIERF, common terminology and standardized vocabulary.Methods: The CDC’s Situational Awareness Branch (SAB) facilitates national activities on development PH EOC informatics through participation in the WHO EOC Network (EOC-NET) 2, and collaboration with national organizations and CDC partners on content standardization. The following sources were used for this analysis: 1) 26 content standards developed by national and international standard development organization, 2) WHO’s Framework for a Public Health Emergency Operations Centre2, and 3) PH EOC data requirements3 that were published by CDC’s SAB . These data requirements were included into the CDC Vocabulary and Access Distribution System (VADS) 4, which serves as the primary vocabulary content browser for PH EPR informatics.Results: In analyzing the PH EPR content standards, the CDC’s SAB arrived at the following results. The CDC EOC’s process of development and implementation content standards is based on the PH EOC critical information requirements. These requirement became business rules for the PH EPR CIERF.The current, version 2, of the PH EPR CIERF consists of 12 information modules including PH EOC minimum data set (MDS), patient clinical observations, emergency medical systems (EMS), data elements for emergency departments (DEEDS), WHO MDS for Health Workforce Registry, Resource Utilization Message Component (vocabulary for hospital resources), vocabulary for the national trauma standard. These PH EPR CIERF modules are interoperable and built on existing data standards. These modules were codified by VADS and ready for utilization by international and national PH EOC partners. At the stage of this analysis the PH EPR CIERF codification schema was prepared for adding it into the Logical Observation Identifiers Names and Codes (LOINC) content standard.The current PH EOC MDS version was released in September 2017. The common terminology and vocabulary that were included into this version are conformant with existing national and international content standards and specifications. Comparatively to the previous version 1, the current PH EOC MDS contains more than 60% new and updated terminology and value sets.Added to the PH EOC MDS version 2 new features are the Situational Analysis concept model, that also incorporates a nomenclature and structure for the Public Health EOC Situational Report (SITREP). Also, the Managing and Commanding conceptual model was updated by adding concepts and vocabulary for the agency internal communication, including standardized knowledge repository for managing standard operating procedures (SOP) and reports for leadership.The CDC’s SAB directly supports the CDC Surveillance Data Platform (SDP) and national organizations on development of electronic forms and form builders. These efforts will provide additional capabilities for collecting and electronically sharing standardized SA information utilizing web-enabled Services and mobile capabilities.Conclusions: CDC’s EOC and Division of Emergency Operations Staff is improving the application of emergency management and PH practice in preparing and responding to emergencies through partnerships and coordinated work with Standard Development Organizations (SDOs) to add critical EPR vocabularies to national and international standards. This work supports National Emergency Management Organizations and is a reference source for the WHO EOC-NET guiding documents supporting international efforts to strengthen Global Health Security.

Designing an Emergency Management Simulation Testbed to Investigate Incident Management Team Performance

2020 ◽  
Vol 64 (1) ◽  
pp. 1881-1885
Author(s):  
Changwon Son ◽  
Farzan Sasangohar ◽  
S. Camille Peres ◽  
Jukrin Moon
Keyword(s):  
Emergency Management ◽  
Team Performance ◽  
Real Life ◽  
Management Team ◽  
Future Research ◽  
Incident Management ◽  
Emergency Operations ◽  
Management Domain ◽  
Qualitative Approaches ◽  
Complex Phenomena

Investigating real-life disasters and crises has been challenging due to accompanying difficulties and risks posed by these complex phenomena. Previous research in the emergency management domain has largely relied on qualitative approaches to describe the event after it occurred. To facilitate investigations for more generalizable findings, this paper documents ongoing efforts to design an emergency management simulation testbed called Team Emergency Operations Simulation (TEOS) in which an incident management team (IMT) is situated. First, we describe the design process based on our previous work. Next, we present the overall description of TEOS including representative roles, tasks, and team environments. We also propose measures of team performance of the IMT and propose future research that can be realized through TEOS.

scholarly journals 18.H. Workshop: Bringing evidence during public health emergencies: addressing the challenge through HTA

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Emergency Preparedness ◽  
Public Health Emergency ◽  
Decision Makers ◽  
Evidence Based ◽  
Public Health Emergencies ◽  
Response Planning ◽  
Emergency Preparedness And Response ◽  
Public Health Emergency Preparedness

Abstract Evidence-based decision-making is central to public health. Implementing evidence-informed actions is most challenging during a public health emergency as in an epidemic, when time is limited, scientific uncertainties and political pressures tend to be high, and irrefutable evidence may be lacking. The process of including evidence in public health decision-making and for evidence-informed policy, in preparation, and during public health emergencies, is not systematic and is complicated by many barriers as the absences of shared tools and approaches for evidence-based preparedness and response planning. Many of today's public health crises are also cross-border, and countries need to collaborate in a systematic and standardized way in order to enhance interoperability and to implement coordinated evidence-based response plans. To strengthen the impact of scientific evidence on decision-making for public health emergency preparedness and response, it is necessary to better define mechanisms through which interdisciplinary evidence feeds into decision-making processes during public health emergencies and the context in which these mechanisms operate. As a multidisciplinary, standardized and evidence-based decision-making tool, Health Technology Assessment (HTA) represents and approach that can inform public health emergency preparedness and response planning processes; it can also provide meaningful insights on existing preparedness structures, working as bridge between scientists and decision-makers, easing knowledge transition and translation to ensure that evidence is effectively integrated into decision-making contexts. HTA can address the link between scientific evidence and decision-making in public health emergencies, and overcome the key challenges faced by public health experts when advising decision makers, including strengthening and accelerating knowledge transfer through rapid HTA, improving networking between actors and disciplines. It may allow a 360° perspective, providing a comprehensive view to decision-making in preparation and during public health emergencies. The objective of the workshop is to explore and present how HTA can be used as a shared and systematic evidence-based tool for Public Health Emergency Preparedness and Response, in order to enable stakeholders and decision makers taking actions based on the best available evidence through a process which is systematic and transparent. Key messages There are many barriers and no shared mechanisms to bring evidence in decision-making during public health emergencies. HTA can represent the tool to bring evidence-informed actions in public health emergency preparedness and response.

A Consensus Process on the Use of Exercises and After Action Reports to Assess and Improve Public Health Emergency Preparedness and Response

2013 ◽  
Vol 28 (3) ◽  
pp. 305-308 ◽  
Author(s):  
Elena Savoia ◽  
Jessica Preston ◽  
Paul D. Biddinger
Keyword(s):  
Public Health ◽  
Emergency Preparedness ◽  
Disaster Preparedness ◽  
Public Health Emergency ◽  
Nominal Group ◽  
Evaluation Methodology ◽  
Consensus Process ◽  
Disaster Victims ◽  
Emergency Preparedness And Response ◽  
Public Health Emergency Preparedness

AbstractIntroductionThe objective of disaster preparedness is to ensure that appropriate systems, procedures, and resources are in place to provide prompt, effective assistance to disaster victims, thus facilitating relief measures and rehabilitation of services. Disaster preparedness efforts include the identification of possible health scenarios based on the probability of hazards and vulnerability of the population as a basis for creating a disaster plan. Exercises that simulate emergency response, involving the health and other sectors, have been suggested as useful tools to test the plans on a regular basis and measure preparedness efforts; the absence of actual testing is likely to negate even the best of abstract plans.ProblemExercises and after action reports (AARs) are used to document preparedness activities. However, to date, limited analysis has been performed on what makes an exercise an effective tool to assess public health emergency preparedness (PHEP), and how AARs can be developed and used to support PHEP improvement efforts. The scope of this project was to achieve consensus on: (1) what makes an exercise an effective tool to assess PHEP; and (2) what makes an AAR an effective tool to guide PHEP improvement efforts.MethodsSixty-one PHEP experts were convened by the use of Nominal Group Techniques to achieve consensus on a series of characteristics that exercises should have when designed to assess PHEP and on the recommendations for developing high-quality AARs.ResultsThe panelists achieved consensus on a list of recommendations to improve the use of exercises and AARs in PHEP improvement efforts. Such recommendations ranged from the characteristics of the exercise audience to the evaluation methodology being used and the characteristics of the produced AAR such as its structure and content.ConclusionsThe characteristics of the exercise audience, scenario and scope are among the most important attributes to the effectiveness of an exercise conducted for PHEP evaluation purposes. The evaluation instruments used to gather observations need an appropriate matching between exercise objectives and the response capabilities tested during the exercise, to build the base for the production of a good AAR. Improvements in the design and creation of exercises and AARs could facilitate better reporting and measurement of preparedness outcomes.SavoiaE, PrestonJ, BiddingerPD. A consensus process on the use of exercises and after action reports to assess and improve public health emergency preparedness and response. Prehosp Disaster Med. 2013;28(3):1-4.

scholarly journals Transparency and stakeholder engagement in nuclear or radiological emergency management

2020 ◽  
Vol 55 ◽  
pp. S243-S248 ◽  
Author(s):  
T. Perko ◽  
M. Martell ◽  
C. Turcanu
Keyword(s):  
Emergency Management ◽  
Emergency Preparedness ◽  
Stakeholder Engagement ◽  
Stakeholder Involvement ◽  
Lessons Learned ◽  
Full Potential ◽  
Radiological Emergency ◽  
The Public ◽  
Environmental Decision Making ◽  
Emergency Preparedness And Response

Stakeholder involvement and transparency are strongly interrelated. Stakeholder involvement is key to strengthening transparency, while transparency is necessary for effective stakeholder involvement. International and European legal requirements in environmental decision-making, radiation protection, nuclear safety and emergency preparedness and response call for increasing levels of transparency and stakeholder engagement. However, recent nuclear or radiological events demonstrate that transparency and engagement in practice are perceived differently by authorities, media and the public. Research conducted in this study by means of a questionnaire sent to authorities responsible for nuclear/radiological emergency management shows a range of challenges related to transparency during a nuclear or radiological emergency, e.g. fear of panic or timely and proper information. Few countries use the full potential of tools and methods for stakeholder engagement in emergency preparedness, although these may also contribute to improved transparency. Despite lessons learned to enhance transparency and stakeholder engagement in nuclear or radiological emergency management, there is room for improvement at a practical level and for finding a common understanding among stakeholders.

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