1 Support of Health Initiatives Support of Health Initiatives Jacqueline Brown Associate Vice President, UW Technology University of Washington Bruges,

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Support of Health Support of Health Initiatives Initiatives

Jacqueline BrownJacqueline Brown

Associate Vice President, UW Associate Vice President, UW TechnologyTechnology

University of WashingtonUniversity of Washington

Bruges, May 2008Bruges, May 2008

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Outline

Setting the Stage Rural Health Care Pilot Program R&E (Networks) Community in

Support of Global Public Health A SARS Example APEC EINet Virtual Symposia on

Pandemic Influenza Preparedness

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The FCC has initiated a pilot funding program to facilitate the creation of a nationwide broadband network dedicated to health care, connecting public and private non-profit health care providers in rural and urban locations

Rural Health Care Pilot Program

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Recent FCC Order (Key points)

The pilot program provides funding to support the cost of connecting the state or regional networks to an advanced network.

By connecting to this dedicated national backbone, health care providers at the state and local levels will have the opportunity to benefit from advanced applications in continuing education and research

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FCC Statement of Benefits of a Dedicated Health Care

Network A broadband network that connects multiple health care providers would bring the benefits of innovative telehealth and, in particular, telemedicine services to those areas of the county where the need for those benefits is most acute.

Tele-health applications allow patients to access critically needed medical specialists in a variety of practices, including cardiology, pediatrics, and radiology, without leaving their homes or their communities.

Linking statewide and regional networks to a nationwide backbone would connect a number of government research institutions, as well as academic, public, and private health care institutions that are repositories of medical expertise and information.

Intensive care doctors and nurses can monitor critically ill patients at multiple locations around the clock.

Health care providers would also benefit from advanced applications in continuing education and research.

A nationwide network would enhance the health care community’s ability to provide a rapid and coordinated response in the event of a national crisis.

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AwardsInitial Program

$50-60 Million per year for 2 yearsActual Awards

69 awards 42 States and 3 territories 6,000 public and non-profit providers $417 Million 3 years Connections to Internet2, NLR and Internet are

pre-approved

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R&E Community in Support of Global Public

Health

More university medical schools have or are creating departments of global health

Faculty worry about coordinating efforts among countries/continents in case of a pandemic

National/local governments are working on coordinating efforts, but are not normally thinking about networks/technology

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Technology in Support of Public Health: A SARS

Example When: May 2003 The locale: Chinese Taipei hospitals

around the city of Taipei The problem:

The outbreak overwhelms the local health infrastructure

Physicians are quarantined along with patients

Specialists cannot travel to other hospitals to consult with colleagues

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What Is Needed

A system for remote diagnosis, quick access to specialized medical expertise, and a means of sharing X-ray images, numerical instrument readings, and white board and audio/video discussions

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Implementing a Solution Hospital technical staff knew that access

grid could be useful, but had no way of implementing throughout the hospital system

On 15 May, the National Center for High-Performance Computing calls for help from Pacific Rim colleagues

Within 12 hours, colleagues from PRC, Korea, Australia, Japan, and the U.S. respond

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Implementing a Solution (cont’d)

16-20 May: experts design and plan a system based on the access grid

21 May: 2 systems have been shipped, received, and tested

1 June: all greater Taipei area hospitals have received and tested systems and a dedicated network backbone is live

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Why The Concern About Pandemic Influenza

Influenza pandemics are inevitable; naturally recur at more-or-less cyclical intervals

Increased mobility of travelers and products: increasing challenges to Public Health response

Will cause Drastic disruption of critical services Severe economic losses

There will be little warning time between the onset of spread of a pandemic and its arrival in the U.S. or any country

14Copyright ©2004 by the National Academy of Sciences

Hufnagel, L. et al. (2004) Proc. Natl. Acad. Sci. USA 101, 15124-15129

Fig. 1. Global aviation network- Links represent the traffic between the 500 largest airports in 100 countries in rate per day (see color code below)

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King County (Seattle), King County (Seattle), WAWA

1.8 million people1.8 million people 1313thth most populous county in the most populous county in the

USUS 39 cities39 cities 2 Tribal Nations2 Tribal Nations 18 hospitals with emergency depts18 hospitals with emergency depts 5 specialty hospitals5 specialty hospitals 30 Community Health Clinics30 Community Health Clinics 1,100 long term care facilities1,100 long term care facilities

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King County Healthcare King County Healthcare CoalitionCoalition

A network of healthcare organizations and A network of healthcare organizations and providers that are committed to providers that are committed to coordinating their emergency coordinating their emergency preparedness and response activitiespreparedness and response activities

Develop and maintain a comprehensive Develop and maintain a comprehensive system that assures coordination, effective system that assures coordination, effective communications, and optimal use of communications, and optimal use of available health resources in response to available health resources in response to emergencies and disaster for all hazardsemergencies and disaster for all hazards

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The CoalitionThe Coalition

More than 60 member and partner More than 60 member and partner organizationsorganizations

Member organizations represent the Member organizations represent the continuum of carecontinuum of care Hospitals, Medical Groups , Safety Net Providers, Hospitals, Medical Groups , Safety Net Providers,

Tribal Clinics, Pediatric Providers, Home Health Tribal Clinics, Pediatric Providers, Home Health and Home Care, Long Term Care, Mental Health, and Home Care, Long Term Care, Mental Health, Specialty Providers – Dialysis, Blood, Poison Specialty Providers – Dialysis, Blood, Poison CenterCenter

Governed by an Executive CouncilGoverned by an Executive Council Staffed by Public Health – Seattle & King Staffed by Public Health – Seattle & King

County and experts in the communityCounty and experts in the community Funded by local and federal resourcesFunded by local and federal resources

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APEC EINet

APEC = Asia Pacific Economic Cooperation

EINet = Emerging Infections Network

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APEC 21 Economies Main Goals

Trade and Investment Liberalization Business Facilitation Economic and Technical Cooperation

28 April, 2004: First Meeting of Health Taskforce

Promotes Regional Cooperation on Pandemic Disease Preparedness

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APEC EINet Founded in 1996 An APEC-approved project based at the

University of Washington Dedicated to providing timely and

reliable information via the Internet on issues of emerging infectious diseases in the Asia Pacific

Actively promote communication, coordination, and collaboration among the 21 APEC member economies to enhance regional bio-preparedness

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APEC EINet Activities

Information Sharing Certificate Program Virtual Symposia Promoting

Collaborations for Biopreparedness

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Virtual Symposia

Collaborative Videoconferencing in support of closer cooperation and information sharing

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First Virtual Symposium

The goal was to start sharing state of preparedness in the post-SARS era

Of the 21 APEC economies, 10 participated

Viet Nam traveled to Thailand because of lack of technology and connectivity

Scheduled for 19 Jan 2006 , 02:00 – 06:30 UTC

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Results of First Symposium

10 APEC economies presented their epidemiologic situation and pandemic planning

210 minute access grid session Enough interest to consider a

second symposium

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2nd Virtual Symposium________________________

Pandemic Flu Preparedness:

Partnerships and Continuity Planning for

Critical Systems Goal: Describe how private and public sectors in the APEC region can cooperate and work effectively to prepare for and respond to pandemic influenza

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2nd Virtual Symposium

Will bring together Public Health officials and faculty members with Business representatives

Participants come mainly from the APEC Health Taskforce and from the APEC Business Advisory Council (ABAC)

Participants will be hosted in universities and/or R&E institutions and networking organizations

Planned for 5 hours on 29 May (Americas)/30 May (Asia)

Each economy will make a 15-minute presentation + time for questions

The Symposium will be led by an experienced moderator

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2nd Virtual Symposium (cont’d)

Representatives from economies which do not have adequate bandwidth to support the application will be hosted by other economies

The videoconference will use advanced R&E networks and thus avoid the congestion of the regular Internet

The technology to be used will be determined by the technical staff of participating economies

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Participants in the 2nd Symposium

Australia Brunei Darussalam* Canada People’s Republic of

China Indonesia* Japan Republic of Korea Malaysia* Mexico

New Zealand Papua New

Guinea* Peru Philippines Singapore Chinese Taipei Thailand U.S.A. Viet Nam

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Thank you.Comments?

Jacqueline [email protected]

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