“To increase visibility in the fog of response, tactical data elements need to be reduced to that information most necessary to understanding the operational and strategic effects of the response efforts.”

Implementing The National Health Security Strategy
Part 4 of 5
Written by RADM Craig Vanderwagen, M.D., USPHS (Retired)
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This is the fourth essay in a series that examines the various aspects of what might be viewed as logistical support to the public health practitioner in events. In this essay, the focus will be on the challenge of providing visibility during the intense phase of response when events are fluid and information is not only changing but lacks clarity.
While the focus here is the public health practitioner, it is also about providing information to the public just when pressure and anxiety about the circumstances and trends are at their peak, and information may lack sufficient data points to see clear trends. The post-earthquake, post-tsunami, unfolding radiation events that occurred in Japan in March of 2011 will provide some examples of just how challenging this is.

Visibility in the Fog of Response - Video Transcript

Major challenge in managing an incident is working your way through the fog of response. Most of the public health practitioners have lived through that. When you've been involved in an event whether it's a hurricane event, whether it's a tornado event, you've lived through that fog of response. About all we know is what's going on in the tactical space that we live in and we don't fully understand what the larger trends are and that's been true even at the operational level because too often we've been inundated with a plethora of tactical data, data information, progress against a particular tactical target but not understanding how that is effecting the trends of progress and improvement in our capacity and response to this particular event.

Remembering that tactics subserve operations to achieve strategic outcomes, tactics are tools for doing certain things but all have to be managed in a coherent way to achieve the strategy. So we need an information system that aggregates that and eliminates the noise in the system to provide us with a clear picture of what are the operational and strategic trends and are we making progress to improving the health and well-being of the people who we're there to serve. To do this requires consensus generation among leadership and public health and medical activities. It requires consensus across jurisdictions because these should not be unique systems jurisdiction by jurisdiction.

The development of this dashboard if you will is going to be critically important in a final and comprehensive way for we must use that dashboard to clarify the status not only of the activities within the public health and medical sector, the ESF8 as any of you know it in the public health community but our dependency relationships with other sectors whether that's transportation, agriculture, public safety, etc. We need a full spectrum picture of how we're doing against the wide spectrum of sectors where we have dependency relationships.

So it's important if we're going to clear the fog of response to have an information system that allows us to understand how our tactics are achieving operational outcomes and strategic goals and how our public health and medical activity works effectively with the other elements of that response in the other sectors.

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