Public Health Emergency Preparedness
This resource was part of AHRQ's Public Health Emergency Preparedness program, which was discontinued on June 30, 2011, in a realignment of Federal efforts.
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Chapter 1. Final Products
This report describes the development, testing, and implementation of the
Health Emergency Line for the Pubic (HELP)—a model to enable community health
call centers, such as poison control centers, nurse advice lines, and other
hotlines, to support home-management and shelter-in-place approaches in certain
mass casualty or health emergency events.
The report presents four products, introduced here, to help community health
call centers and public health and public safety agency planners adapt their
call centers for surge response during a public health emergency. Following
chapters provide the background, methodology, and results of the project
as well as some recommendations.
1. National Planning Scenarios Analysis
We reviewed the Department of Homeland Security (DHS) National Planning
Scenarios and developed a matrix that summarizes the 15 scenarios for which
emergency planners should develop response capabilities. Using the same set
of scenarios will allow for a common language of response planning and capabilities
development, so that best practices can be shared and adapted between agencies
and localities. After summarizing each scenario, the matrix shows the six
response capabilities that community health call centers can provide. The
National Planning Scenarios Analysis
Matrix (Appendix 1) lists each
scenario and indicates which health call center capabilities correspond to the expected
response needs of communities.
Call centers can use the matrix to determine whether they are prepared to
provide response capabilities for the scenarios most likely to occur in the
communities they serve. The matrix can help frame discussions among public
health and public safety agency planners so that community health call centers
can be integrated into planning and responses, both as a resource and as
2. Potential Health Call Center Capabilities
for Four National Planning Scenarios
We determined four National Planning Scenarios for which we determined that
call centers had the best capabilities and developed a detailed list of all
the applicable capabilities (Appendix
2). This document can assist call centers
and public health agencies in determining the expected health needs for each
scenario and selecting those for which they may want to plan.
3. Suggested Elements for Public Health Information
and Decision Support Hotlines: the Health Emergency Line for the Public (HELP)
Appendix 3 describes many
of the essential components of the HELP model.
The HELP program serves as Denver Health's operational platform for
disseminating and collecting consistent, accurate, and up-to-date information,
in partnership with public health agencies, during bioterrorism and other
public health emergencies. The goal is to provide self-service information
to the public so that they can make informed decisions about their health
concerns. The structure and adaptability of the HELP model have allowed Denver
Health to effectively respond to major health events, such as West Nile Virus
(WNV) and influenza outbreaks. Community health call centers can use Appendix
3 begin to develop similar capabilities within their existing infrastructure.
A more complete discussion of the requirements for general call center infrastructure
(people, processes, and technology) can be found in the Health Emergency
Assistance Line and Triage Hub (HEALTH) Model. The HEALTH model is discussed
in Chapter 2
and Chapter 3,
and the full report is available
We strongly urge any call center attempting to provide these community services
to do so in cooperation with the appropriate public health authority. That
is, the authority that, by statute, is responsible for coordinating health
and medical services following a major disaster or emergency or during a
developing potential medical situation. Coordination with the health authority
will help ensure overall consistency with other response measures in the
4. Interactive Response (IR) Applications
Appendix 4 provides the
blueprint for other call centers to develop similar capabilities within their
own infrastructure and using their own equipment. It includes full details of
the planning, analysis, design, implementation, and evaluation of the four IR
applications that we developed:
- Quarantine/Isolation (QI) Monitoring (outbound application).
- Drug Identification (DI) (inbound application).
- Point of Dispensing (POD) (inbound application).
- Frequently Asked Question (FAQ) Library (inbound application).
An IR system with applications such as these allows callers to use their touch-tone
phones to automatically retrieve information during a public health emergency.
Since we had previously purchased an IR system, we designed the IR applications
to use the available features of our equipment. We contracted with an IR
consultant and developer to oversee the development of the applications in
accordance with our business requirements and specifications. The IR consultant
developed the applications, provided administration and maintenance training
for our internal technology staff, and assisted with modifications to the
applications after testing in two exercises. Our internal technology staff
made the appropriate programming changes to our telephone switch to support
the IR applications. Through this process, our technology staff acquired
some training on IR programming and can make certain modifications to the
applications without requiring an IR consultant.
Call centers that have an IR system can contract with an IR consultant
or use internal technology staff to program similar tools. Planners can review
the Appendix 4 with internal
technology staff to determine how best to develop the desired capabilities
with available resources. Call centers that want to purchase an IR system can
use the information in this appendix to help select equipment to meet their
business needs and specifications. Call centers that cannot invest in such
technology can still use the appendix to develop call handling procedures
that their staff can use to provide the same capabilities to the public.
These four products were developed for the four specific planning scenarios
but can be adapted to others as appropriate. Together, they cover the full
range of capabilities that community health call centers can provide.
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