Promoting Clinician Readiness Leslie Beitsch, M.D., J.D. Commissioner and State Health Officer Oklahoma State Department of Health
Dec 20, 2015
Promoting Clinician Readiness
Leslie Beitsch, M.D., J.D.Commissioner and State Health OfficerOklahoma State Department of Health
Efforts by Health Departments
Over the past 3 years, many State health departments were recipients of CDC sponsored bioterrorism (BT) grants
Grantees made concerted outreach efforts to clinical practitioners
Strengthening the Health Alert Network (HAN) included coordination with local and State medical societies
Establishing ties with Metropolitan Medical Response System (MMRS)
Clinician Needs after 9/11
Definitive information on BT Diagnostic criteria Surveillance and reporting primer State and local medical societies wanted
greater participation in the BT planning and advisory processes
Engaging Clinicians
Have a BT event… it creates the teachable moment Clinicians without further prodding will seek to
enhance their competency in diagnosing BT related illnesses
Modest educational efforts will pay immediate dividends by raising the clinical index of suspicion
Reminding medical societies and individual physicians of legal duty to report diseases (e.g., anthrax, etc.)
Reducing barriers to simplified reporting (e.g., electronic disease reporting)
Steps for State and Local Health Departments
Build a systemic response to BT events Provide education and training to the
entire public health workforce, not only staff with day-to-day BT responsibilities
Enhance epidemiology, biostatistics, microbiology, and communication skills through core courses, seminars, and distance learning technologies
Offer graduate education for selected staff who demonstrate potential for future leadership roles
Role for Clinicians
Physicians are now engaged New BT grant requires planning and advisory
committees Coordination with local and State medical
societies requires further strengthening Recruitment/involvement with MMRS
Testing the System
April 12 and 13, the Oklahoma State Department of Health (OSDH) staged largest BT exercise ever
Blueprint and lessons will be available for others to use across the country
Planning activities and exercises are the best methods to test systems responsiveness
Employ hackers to test security IT system redundancy test
Preparing for Bioterrorism
State and local task forces in virtually every health jurisdiction
Involvement with Gubernatorial and Legislative task forces
ASTHO and NACCHO have provided tools, recommendations, and enhanced Web sites
CDC BT grants Enhanced surveillance
Public Health and Clinical Medicine
Renewed appreciation of the importance the public health system plays in protecting our communities
Better understanding of the need for disease surveillance and reporting systems
Willing participant now in BT and other related advisory groups
Model Emergency Health Powers Act
Act is attempt to codify the various powers and authorities needed to respond to the most catastrophic public health events (BT)
Private sector may be called upon to assist governmental public health
Hospitals and other facilities may be “statecized”
Conceivably clinicians could be asked to practice in adjacent jurisdictions
Coordination with Tribal Governments
Coordination required under the terms of the new CDC grant
Oklahoma example: 39 federally recognized tribes
Short-term approach: include Bureau of Indian Health (BIH) in advisory group
Expand to all interested participants in the long-term planning process
Available Tools
All States recently completed a Department of Justice (DOJ) survey, with results now available
National Public Health Performance Standards look at broad public health systems capabilities
Reconcile laws in jurisdiction with Model Emergency Health Powers Act
Lessons Learned
Build close working relationships with clinical colleagues before threatened BT events
Use HAN resources to tie clinicians into public health network
Examine disease reporting and surveillance systems from perspective of the “user” and lower barriers to easy accessibility
Improve web sites so that clinicians seeking information can obtain it rapidly
Anticipate ongoing educational needs, and use CME as a carrot