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Health Emergency Assistance Line and Triage Hub (HEALTH) Model

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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The Rocky Mountain Regional Health Emergency Assistance Line and Triage Hub (HEALTH) model is being developed by the Denver Health Medical Information Centers (DHMIC—the Rocky Mountain Poison & Drug Center and the Denver Health NurseLine) as a partial solution to the public health communication problems that have been recognized in the aftermath of September 11, 2001.

Our goal is to determine the requirements, specifications, and resources needed for developing a public health emergency contact center that is highly integrated with public health agencies and can minimize surges in the demand for health and event information during a public health emergency. We designed a model with medical contact centers (such as poison control centers and nurse advice lines) in mind as potential implementers, and as the appropriate repositories for the creation and maintenance of readiness for providing one-on-one health communication in a public health emergency.

The model is conceived of as an expansion of DHMIC or other medical contact centers' regular functions, which includes developing and maintaining readiness for providing incident-specific information and medical triage to the public and to healthcare providers, with capacity to conduct symptom surveillance for public health agencies, if required, during an emergency. The HEALTH model is a conceptualization of a communications system. The model is designed to meet the requirements of our public health emergency preparedness goals and objectives.

This document is organized following the steps of the Systems Development Lifecycle, or SDLC. The steps of SDLC are Problem Statement, Planning, Analysis, Design, Implementation, and Testing. In addition, we added sections on Methods, Model Requirements, Limitations and Risks, and Future Tasks. The Problem Statement and Planning sections give the background of the study. The Methods, Analysis, and Model Requirements sections are analogous to Methods, Results and Conclusions. The Design section describes the specific requirements for the HEALTH model and is presented in four sections: Process, People, Technology and Exportability.

We have twice implemented a public health emergency call center in offering services to the Colorado Department of Public Health and Environment, and these experiences are described in the Implementation section and evaluated in the Testing section. The first experience came in early 2003, when we implemented the Smallpox Vaccination Program Support Service. The second opportunity came in the summer of 2003, when we implemented the West Nile virus hotline. Finally, we conclude with a brief discussion of Limitations and Risks, and Future Tasks.

As part of our analysis for the model, we conducted research into other agencies' responses to past emergency in the published literature and through interviews of agencies involved in health emergency events. We also researched best practices from the medical call center industry. From all of these components we have distilled a list of requirements for the people, processes and technology this model will need for full realization. Though these requirements are based on the foundation and infrastructure already in place at DHMIC, they can still be generalized to other medical contact centers with similar functions and capabilities.

In order to further assist other agencies in beginning to develop the capabilities and functions of our model, especially public health agencies, we created a HEALTH Contact Center Assessment Tool Set. The tool set is a Microsoft® Excel workbook that can be used by agencies to assess the potential demand they may face in a health emergency event and to determine the resources needed to address this demand:

The tool set consists of seven sections that are simple checklists or spreadsheets, including:

  • Instructions.
  • Contact Surge Calculator.
  • Staffing-Resource Calculator.
  • Capital Expense Calculator.
  • Technology Expense Calculator.
  • Surge Options Matrix.
  • Glossary.

Two ancillary reports are also included and are listed below. The reports are technical documents detailing the requirements and systems concept for the HEALTH model as it applies to the technology infrastructure at DHMIC. Although these documents are specific to the existing structure and capacity of DHMIC, they may be useful to others in developing HEALTH model capabilities after they use the tool set to determine their needs for emergency contact surge preparedness within their own organizations.

  1. Requirements Document (Appendix O).
  2. Multi-Channel Contact Center System Concept (Appendix P).

It should be emphasized that the systems described in the Multi-Channel Contact Center System Concept Plan and Report have not yet been implemented at DHMIC. The report describes future directions.

The need for realizing the HEALTH model concept has been continually reinforced by our own experiences, published reports on emergency event responses, and through conversations with other medical contact centers. In times of crisis, the public will need information resources to help guide their actions related to their health care. The HEALTH model incorporates the ability to provide one-on-one health information using the latest in technology to efficiently handle this demand through various communication modalities.

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