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Surge Capacity and Health System Preparedness

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Slide Presentation by Gregory M. Bogdan, Ph.D.

On October 26, 2204, Dr. Bogdan made a presentation in a Web conference entitled Colorado's Health Emergency Line for the Public (COHELP): Addressing Surge Capacity through Information Exchange.

This is the text version of Dr. Bogdan's slide presentation. Select to access the PowerPoint® Slides (359 KB).

Colorado's Health Emergency Line for the Public (COHELP): Addressing Surge Capacity through Information Exchange

Gregory M. Bogdan, Ph.D.
Research Director
Rocky Mountain Poison and Drug Center
Denver Health
Denver Colorado

Slide 1

Public Risk Perception

This slide contains a bar graph. The x-axis is labeled with cities and corresponding diseases: "Florida-Meningitis, Toronto-SARS, Trenton-Anthrax, NYC-WNV, Colorado-WNV." The y-axis is labeled "Hotline Contacts (percent population)" and marked at increments of "0, 5, 10, 15, 20, 25." The shaded bar above "Florida" is at 25, "Toronto" is 10, "Trenton" is 10, "NYC" is 3, and "Colorado" is 1.

Below the graph is the following text: "Event specifics (bioterrorism, child-targeted, new emerging disease) will effect the amount of public concern and numbers of people having information or others needs."

Slide 2

Challenge for Preparedness

  • 2004 Redefining Readiness Project*
    • 60 percent of public would not heed official instructions to get vaccinated during smallpox outbreak.
    • 40 percent of public would not heed official instructions to shelter in place during a dirty bomb incident.

*R. Lasker, Center for the Advancement of Collaborative Strategies in Health (www.

Slide 3

Public Needs Information on...

  • General topic/event information.
  • Public health messages:
    • Personal and family protection.
    • State/local health department guidelines.
    • Point of contact for referral agencies.
  • Health decision-support and evaluation.

Slide 4

"Natural Fits"

  • Poison control centers.
  • Nurse advice lines.
  • Drug information centers.
  • Public health agencies.

Slide 5

How a Medical Call Center Works

This slide contains a series of text boxes and arrows. On the left is the text "general public" and "health professions" with respective arrows pointing to a large arrow containing the text "voice, fax, video, email, web." The large arrow points right to a box containing the text "MCC." Directly above this box is an arrow leading to a text box labeled "hospitals & healthcare facilities" and directly below the MCC box is another arrow leading to a text box labeled "local & state public health agencies." From the right of the MCC box is another large arrow labeled "fax, email, voice, web, video." This arrow points to the right to a final text box labeled "patient surges reduced by providing information and triage through multiple paths."

Slide 6

COHELP Objectives

  • Develop a standardized and prepared response to public health events.
  • Provide consistent, accurate information.
  • Collect and maintain structured data to better characterize events and responses.
  • Develop capability and capacity to adapt to emerging public health emergencies.

Slide 7

COHELP Service Users

In the middle of this slide is a box containing the text "COHELP 877-462-2911." There are 6 text boxes with arrows pointing to this center box. Reading clockwise, the outside boxes contain the text "healthcare providers, schools, hospitals & EDs, health agencies, clinics, public."

Slide 8

Referral Procedures

In the middle of this slide is a box containing the text "COHELP." An arrow connects a text box above the center box with the text "caller." Pointing away from the center box are a series of 5 arrows each leading to its own text box. Moving from left to right the text boxes read "poison center," "nurse line," "local health agencies," CDPHE," and healthcare providers," respectively.

Slide 9

Provides one on one information

Toronto—SARS outbreak, Mar to Jun 2003.

Total Calls equals or is greater than 300,000.

  • Peak Daily Calls equals 47,567.
  • Deaths: 44.
  • Cases: 438.

COHELP—Two Outbreaks, Jul to Dec 2003

Total Calls equal 36,170.

  • West Nile Virus (WNV) Calls equal 12,555.
    • Deaths: 47.
    • Cases: 2,543.
  • Influenza/Pneumonia Calls equal 23,615.
    • Deaths: equals 809.
    • Cases: 11,427.

Slide 10

Reduces Hospital Surge

  • United States Poison Control Centers.
    • Of 2.4 million contacts about potential toxic exposures in 2003, 1.8 million (75 percent) were managed outside of health care facilities.
  • Denver Health Nurse Line.
    • Manages 40 percent of callers at home.
    • 70 percent callers changed plans.
    • 16 percent planned home care but 47 percent chose it after calling.

Slide 11

Other Benefits

  • Standardized, accurate information delivery.
  • Call center infrastructure/technology.
  • Adaptability.
  • Integrated Web sites (
  • Trained information providers.
  • Defined referral procedures.
  • Structured data collection and reporting.

Slide 12

Lessons Learned

  • Public Health events will continue to occur and will require a response.
  • Need structured, coordinated systems to respond to these events that are:
    • Cost-effective.
    • Efficient.
    • Accurate.
    • Consistent.
    • Adaptable.

Slide 13

More Lessons Learned

  • Call volume driven by event specifics and media attention.
  • Easy to adapt messages to meet evolving public health and public needs.
  • Surveillance.
    • Ongoing surveillance signals.
      • Call volumes, topics requested, collected data.
    • Sentinel event system.
      • Can identify new health concerns.

Slide 14

For More Information

  • "Health Emergency Assistance Line and Triage Hub (HEALTH) Model" report on AHRQ Web site by end of year.
  • HEALTH Contact Center Assessment Tool on HSRNET or AHRQ Web sites
    • (available now)
    • (available by end of year)

Current as of December 2004

Internet Citation:

Colorado's Health Emergency Line for the Public (COHELP): Addressing Surge Capacity through Information Exchange. Text version of a slide presentation at a Web conference. Agency for Healthcare Research and Quality, Rockville, MD.

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