“The public health mission to protect the public’s health and prevent disease is dependent upon effective and useful logistical systems designed specifically for the purposes of the public health practitioner.”


Implementing The National Health Security Strategy

Part 2 of 5
Written by RADM Craig Vanderwagen, M.D., USPHS (Retired)

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Overview:
This essay focuses on the challenges in tracking patients before, during, and after events. This is important to resiliency because the health and well being of our population both in the immediate aftermath and in the recovery phase from an event contribute to the ability to rebound from a challenge and return to a more normal state of affairs. The significance of this element in preparedness is reflected in the National Health Security Strategy in the strategic objectives related to situational awareness and scalable health delivery systems, but also in the over arching vision of a healthy population.

Patient Tracking in Public Health - Video Transcript

So logistics is not limited to the movement of supplies and response personnel. But I think we need to understand that patient tracking before, during and after an event is a critical component to the whole business of logistics and logistics information management. One of the critical important pieces to this is registering who you're seeing, where you're seeing and what you've done to them. Some states have shown great innovative thought processes about this and are using existing demographic databases to register people. For instance, Tennessee, when people came in for their vaccine and for their TAMIFLU they would swipe their driver's license. That would allow them to know who they'd seen and their zip code, etc. This is an important set of innovations. It has to be done consistently.

If we don't know who we're caring for, when we've seen them, and where we've seen them, we aren't going to be able to manage the quality of this process. I think secondly we need to have an information exchange that links those patient registration datasets that are being generated locally into a nationally accessible one, HIPAA protected, privacy controlled, all the right stuff but accessible in a variety of locations. People in Katrina who moved from New Orleans to Houston or New Orleans to Little Rock, New Orleans to Salt Lake City and the receiving end knowing where they had been seen, what had been done to treat any medical issues that they had was not transparent at all to those on the receiving end. So that information exchange that captures and it, it's available in a protected environment for people down range.

I think the other thing that's moving now is the linkage of this patient registration data to electronic medical record data. With Medicare and Medicaid putting an, an additional amount of money now into the expansion of electronic health, health record use and development that's going to allow us to have a much better access to what the chronic diseases and medications are, the patients that we're seeing.

So if we can link that registration then to their electronic health record, we're going to be able to practice our medicine much more soundly, rationally and with continuity of care. This will take leadership in the medical and public health communities working collaboratively because they both have interest in this process and they both need to be on the same page. That's been occurring and assuring real movement forward. If we're going to make this a true national system, however, it's going to require a national approach to how we will fund the development of this in a comprehensive way.