Epi-X 2008 System-Wide Notification Proficiency Test

On the recommendation of the Council of State and Territorial Epidemiologists (CSTE), CDC collaborated with partner organizations to develop The Epidemic Information Exchange (Epi-X), a system for rapid communication and notification of outbreaks and other health events as they are identified and investigated. Important features of the system are the abilities 1) to post sensitive information on the secure website, 2) to notify one, some, or all members when the information is posted, and 3) to view and discuss information posted on the secure website. Outbreaks such as monkeypox, SARS, and avian influenza underscored the need to understand the dynamics of Epi-X notification and response.In January 2004, Epi-X initiated a notification proficiency testing program to prepare users for receiving and responding to information about a public health emergency and to improve the processes and technology that support Epi-X notifications. On April 3, 2008 a system-wide test was conducted. Never before had all 5065 users been notified emergently for a single report.

On the day of the test, the test report was posted as an Epi-X Alert. Immediately upon the posting of the report, the system sent e-mail messages to each user’s work e-mail and home e-mail addresses. The system then started contacting users through their mobile devices (pager and/or cell phone), followed by their work and then their home telephones. All notifications were sent within 74 minutes.

Notifications instructed users to log on to Epi-X, view the test report, and complete a survey. Within three hours, 2454 (48%) users logged on to view the test report. A total of 3046 users completed the survey. Recurring themes from user feedback show a desire to access Epi-X on mobile devices (e.g., Blackberry), problems with digital certificates, and suggestions for improving the testing process itself. The paper will describe the results in more detail.