Creating a Common Operating Picture

1. Creating a Common Operating Picture Eddie Oldfield, BA, Candidate M.Phil (policy) Director, NB Climate Change Hub and Environmental Health Mapping, New Brunswick Lung Association May 2010

3. Public Health Applications The “Learning from SARS” report, by the National Advisory Committee on SARS and Public Health, identified many systemic deficiencies in responding to SARS in Canada. Among these were: absence of protocols for sharing data, poor coordination among health authorities at national, provincial, and local levels, delays in identification of unknown virus, poor understanding of disease etiology and transmission vectors.

4. GIS for Public Health in Canada • Nearly a decade has passed since the first call to integrate GIS technology into the Canadian health-care planning process. • Conversely, GIS applications have become a staple in European health policy evaluation tools: • a national public health atlas in The Netherlands, • healthcare planning tools in Switzerland, and • modular GIS applications in the United Kingdom. • The expansion of the Canadian Geospatial Data Infrastructure into the public health discipline is deemed critical for addressing shortcomings in population health monitoring, developing effective intervention strategies for chronic and infectious disease, improving healthcare services, and responding to health and safety emergencies. NB Lung carried out analysis for GeoConnections on gaps/opportunities for the CGDI in support of public health decision-making.

5. GIS Applications in support of Public Health • Monitor epidemic outbreaks (influenza), communicable disease clusters, and disease vectors (e.g. migratory bird routes, zoonotic vectors) • Syndromic/surveillance/outbreak/adverse event detection • Aboriginal health status (Tuberculosis, Diabetes etc) • Monitor chronic diseases (including obesity) • Monitor water (including well-water) and food quality • Cross-disciplinary research (such as linking air quality, climate change and human health) • Population demographics (for assessing population vulnerabilities) • Joint health and safety emergency management • Highway safety / Weather-related incidents • Public Health Infrastructure / facilities • Ambulance vehicle routing • All respiratory diseases • Global Warming – health impacts modeling (past, current, future scenarios) • Flood zones and Sea-Level Rise / Coastal Erosion • Emergency equipment locations • Enhance upon health data standards • Build on-line health repositories (for public education)

6. Gaps in GIS for Public Health ·        Cost – equipment, software, data, staff, etc ·        Concerns over data privacy ·        Lack of knowledge / training / competencies in GIS ·        Continuous need to educate decision-makers ·        Uneven capacity among health authorities ·        Barriers to integration of health data within CGDI (e.g. health data standards / inconsistencies across borders) ·        Patchwork of applications, systems, standards ·        Patchwork research agenda (national)

7. Kilometers 0 25 50 100 0 0.1 - 7.1 7.1 - 9.7 9.7 - 15.7 15.7 - 110.3 Mapping Public Health Data Community Health Maps Kilometers 0 25 50 100 Access to Health Care This project deals primarily with seamless integration of public health data, as discussed in the next slide. Asthma Admission / 10,000 Population – 2001 Admission / 10,000 Population Mapping Influenza Cases 0 0.1 - 7.1 7.1 - 9.7 9.7 - 15.7 15.7 - 110.3

8. From Data to Maps • Data Licenses Obtained (Maine, NB, Canada) • Data privacy is maintained at all times • Application is Permission Based • Historical Influenza Maps • Simulated Pandemic Influenza Maps Incidence Frequency and Sum, 4 Health Outcomes, by 5 Age Groups, by Gender, by Day (550,000 reported cases) • Multiple Geographic Scales: Dissemination Area, Census Area, Health Region, Province / State • Infrastructure Data: Hospitals/Clinics, Schools, Roads, Administrative Boundaries, Exercise Operation Facility Locations • Food and Fuel Supply • School Absenteeism / Surveillance Data • Medicine Supply / End-to-End Tracking

9. Mapping Methods • Cell distribution • Frequency, cumulative, Normative distribution methods • Four geolayers: Province, Health Region, County, Dissemination Area

10. Mapping Methods • Contour distribution • Inverse Distance Weighting method • One geolayer: Province/State; with 4 boundary overlays (Health Region, County, Metropolitan, and DAUID levels)

11. Mapping Across Borders Visualization of Indicators in Space and Time

12. Creating a COP in Public Health Examples of COMMON OPERATING PICTURES in Public Health: WHO Protocol – Early Action Measures for Disease Containment Contact Tracing – cluster outbreaks Continuity of Operations Protection of Critical Infrastructure (food, fuel, electricity, transport, industry, public security) through EAC Public Health Resource Management Reducing Public Exposure to Health Threats, natural and man-made disasters Vaccine/Resource Distribution Cancer, Respiratory, Heart/Stroke, and population health Research

13. Sharing Map Views / POIs Surveillance AlertsFeedsGroups Reports - Phase 4 Alert – H1N1 activity in NB.- H1N1 Activity High in North East NB.- Fredericton School District reports high absenteeism / nurse visits.- Border restrictions activated at St-Stephen-Calais crossing…

14. Wireless and Remote Applications Porting an existing desktop web application Layered windows Prototype Thin Client in Action Map View Data Entry

15. Chief Medical Officer Physician / Nurse / RT Data Technician Notification Lab Verification of Suspected Cases Must be easy to use Public Access Ambulatory Response

16. 2007