Use Case for Offline Version of CRA at Wyoming State Exercise: Lessons Learned

Background:
Events including the threat of pandemic influenza, SARS outbreaks, smallpox preparedness, and the anthrax attacks, have demonstrated that information systems are critical to managing the response and tracking the countermeasures administered for containing and preventing further outbreaks. Public health must be ready at all times to respond to and manage public health emergencies. During a public health emergency, there is a need to manage information about the event, check availability of countermeasures, and know who has received them. Once countermeasures are received, there is a need to monitor their effectiveness or identify resulting adverse events. Post-event, there is a need to analyze the information to help better prepare for future emergencies.  CRA has evolved as an application to support critical business needs at multiple levels of public health.

Methods:
At the federal level, CRA has been designated as the system of record for reporting pre-pandemic and pandemic vaccine doses administered during times of initial scarcity.  During CDC’s 2008 pandemic exercise, CRA was used to report progress in reaching priority groups.

 The Wyoming Department of Health (DOH) described the exercise scenario as an anthrax release by a terrorist group.  The CRA system will be used to track the dispensing of anthrax prophylaxis using the offline version.  The offline version of CRA was selected to support data collection in rural areas with limited internet connectivity, and the need for point-of-dispensing (POD) staff and those entering data to quickly acquire access to the system without having to request a Secure Data Network (SDN) digital certificate which is required for web-based CRA.

 Results:
Strengths, weaknesses and lessons learned will be shared.  Participants will be encouraged to share their uses and experiences with similar systems.

 Conclusions:
CRA has evolved significantly as an application capable of meeting the needs of all levels of public health–local, state and federal.