Design and Deployment of An Integrated, Standards-Based Public Health Alerting System

Public-health organizations must communicate with clinical care systems for a variety of purposes including case reporting and management, biosurveillance and situational awareness data sharing, and public-health alerting.  Traditional methods for communicating between public health and clinical healthcare entities using telephone, fax, and U.S. postal service often is cumbersome, delayed and inefficient. And although e-mail is a potential option for delivering public-health communications to clinicians, it remains unclear whether e-mails are received in a timely fashion due to several factors including unintentional e-mail filtering, invalid or outdated addresses, and a lack of a reliable mechanism for tracking receipt of such information.  To deliver public-health alerts to directly to the clinical inbox of clinicians, we developed technology that leverages an existing clinical results delivery system that currently delivers 2.8 million clinical results per month to more than 10,000 physicians.  With funding from the CDC's situational awareness initiative, and in collaboration with the Marion County Health Department in Indianapolis, Indiana, we designed, implemented, tested and deployed a public-health alerting system that was first used during the H1N1 influenza outbreak. In addition to broadcasting to all physicians within the system the system is capable of targeting customized combinations of physician specialties and geographic regions. We will describe the system design and technical overview, and will describe the routine use and features of this novel, standards-based public-health alerting system.