Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-10T20:10:44.457Z Has data issue: false hasContentIssue false

Information Technology Systems for Critical Care Triage and Medical Response During an Influenza Pandemic: A Review of Current Systems

Published online by Cambridge University Press:  15 August 2013

Kristofer Bandayrel*
Affiliation:
Mount Sinai Hospital, University of Toronto, and the School of Nutrition, Ryerson University
Stephen Lapinsky
Affiliation:
Mount Sinai Hospital, University of Toronto
Michael Christian
Affiliation:
Mount Sinai Hospital, University of Toronto
*
Address correspondence and reprint requests to Kristofer Bandayrel, BASc (Hons), School of Nutrition, Ryerson University, 350 Victoria St, Toronto, ON M5B 2K3, Canada (e-mail kbandayr@ryerson.ca).

Abstract

Objectives

To assess local, state, federal, and global pandemic influenza preparedness by identifying pandemic plans at the local, state, federal, and global levels, and to identify any information technology (IT) systems in these plans to support critical care triage during an influenza pandemic in the Canadian province of Ontario.

Methods

The authors used advanced MEDLINE and Google search strategies and conducted a comprehensive review of key pandemic influenza Web sites. Descriptive data extraction and analysis for IT systems were conducted on all of the included pandemic plans.

Results

A total of 155 pandemic influenza plans were reviewed: 29 local, 62 state, 63 federal, and 1 global. We found 70 plans that examined IT systems (10 local, 33 state, 26 federal, 1 global), and 85 that did not (19 local, 29 state, 37 federal). Of the 70 plans, 64 described surveillance systems (10 local, 32 state, 21 federal, 1 global), 2 described patient data collection systems (1 state, 1 federal); 4 described other types of IT systems (4 federal), and none were intended for triage.

Conclusions

Although several pandemic plans have been drafted, the majority are high-level general documents that do not describe IT systems. The plans that discuss IT systems focus strongly on surveillance, which fails to recognize the needs of a health care system responding to an influenza pandemic. The best examples of the types of IT systems to guide decision making during a pandemic were found in the Kansas and the Czech Republic pandemic plans, because these systems were designed to collect both patient and surveillance data. Although Ontario has yet to develop such an IT system, several IT systems are in place that could be leveraged to support critical care triage and medical response during an influenza pandemic. (Disaster Med Public Health Preparedness. 2013;7:287-291)

Type
Original Research
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Whitley, RJ, Monto, AS. Seasonal and pandemic influenza preparedness: a global threat. J Infect Dis. 2006;194(Suppl 2):S65-S69.CrossRefGoogle ScholarPubMed
2.Osterholm, MT. Preparing for the next pandemic. N Engl J Med. 2005;35:1839-1842.CrossRefGoogle Scholar
3.Ungchusak, K, Auewarakul, P, Dowell, SF, etal. Probable person-to-person transmission of avian influenza A (H5N1). N Engl J Med. 2005;352(4):333-340.CrossRefGoogle ScholarPubMed
4.Taubenberger, JK, Morens, DM, Fauci, AS. The next influenza pandemic: can it be predicted? JAMA. 2007;297(18):2025-2027.Google Scholar
5.Gross, PA. Preparing for the next influenza pandemic: a reemerging infection. Ann Intern Med. 1996;124(7):682-685.Google Scholar
6.Blaser, MJ. Pandemics and preparations. J Infect Dis. 2006;194(Suppl 2):S70-S72.CrossRefGoogle ScholarPubMed
7.Oxford, JS. Preparing for the first influenza pandemic of the 21st century. Lancet Infect Dis. 2005;5(3):129-131.CrossRefGoogle Scholar
8.Fauci, AS. Pandemic influenza threat and preparedness. Emerg Infect Dis. 2006;12(1):73-77.CrossRefGoogle ScholarPubMed
9.Hampton, T. Government drafts flu preparedness plan: concerns about serious pandemic spur effort. JAMA. 2004;292(14):1671-1672.Google ScholarPubMed
10.Mitka, M. National plan for pandemic flu unveiled. JAMA. 2006;295(23):2707-2708.CrossRefGoogle ScholarPubMed
11.Chowell, G, Bertozzi, SM, Colchero, MA, et al. Severe respiratory disease concurrent with the circulation of H1N1 influenza. N Engl J Med. 2009;361(7):674-679.CrossRefGoogle ScholarPubMed
12.Dawood, FS, Jain, S, Finelli, L, etal. Novel Swine-Origin Influenza A (H1N1) Virus Investigation Team. Emergence of a novel swine-origin influenza A (H1N1) virus in humans. N Engl J Med. 2009;360(25):2605-2615.Google Scholar
13.Perez-Padilla, R, de la Rosa-Zamboni, D, Ponce de Leon, S, etal; INER Working Group on Influenza. Pneumonia and respiratory failure from swine-origin influenza A (H1N1) in Mexico. N Engl J Med. 2009;361(7):680-689.Google Scholar
14.Cohen, J, Enserink, M. Swine flu. After delays, WHO agrees: the 2009 pandemic has begun. Science. 2009;324(5934):1496-1497.Google Scholar
15.Harrison, JP, Harrison, RA. Role of information technology in disaster medical response. Health Care Manag. 2008;27:304-313.CrossRefGoogle ScholarPubMed
16.Chan, TC, Killeen, J, Griswold, W, Lenert, L. Information technology and emergency medical care during disasters. Acad Emerg Med. 2004;11(11):1229-1236.CrossRefGoogle ScholarPubMed
17.Barillo, DJ, Jordan, MH, Jocz, RJ, Nye, D, Cancio, LC, Holcomb, JB. Tracking the daily availability of burn beds for national emergencies. J Burn Care Rehabil. 2005;26(2):174-182.Google Scholar
18.Urquhart, GA, Williams, W, Tobias, J, Welch, FJ. Immunization information systems use during a public health emergency in the United States. J Public Health Manag Pract. 2007;13(5):481-485.CrossRefGoogle ScholarPubMed
19.Christian, MD, Hawryluck, L, Wax, RS, etal. Development of a triage protocol for critical care during an influenza pandemic. CMAJ. 2006;175(11):1377-1381.Google Scholar
20.Milstein, S, Biersdorfer, JD, MacDonald, M. Google: The Missing Manual. 2nd ed.Sebastopol, CA: O'Reilly Media; 2006.Google Scholar
21. Kansas Department of Health and Environment. Kansas pandemic influenza preparedness and response plan. Kansas response plan, biological incident annex, attachment 1. http://www.kdheks.gov/flu/download/KS_Pan_flu_10_05.pdf. Accessed June 6, 2008.Google Scholar
22. World Health Organization. Pandemic planning. Pandemic plans on the Internet. Plan of measures for the case of an influenza pandemic caused by a new strain of the influenza virus: pandemic plan of the Czech Republic. http://www.euroflu.org/html/pandemic_plans.html. Accessed August 15, 2008.Google Scholar
23. Santa Barbara County Public Health Department. Pandemic H1N1 flu (swine flu). http://www.countyofsb.org/uploadedFiles/pandemic/Santa%20Barbara%20County%20Pandemic%20Influenza%20Response%20Plan.pdf. Accessed June 22, 2011.Google Scholar
24. US Department of Homeland Security. Pandemic influenza: preparedness, response, and recovery. Guide for critical infrastructure and key resources. http://www.flu.gov/professional/pdf/cikrpandemicinfluenzaguide.pdf. Published September 19, 2006. Accessed June 4, 2008.Google Scholar
25. World Health Organization. Detailed plan of measures in case of an influenza pandemic in the Slovak Republic. http://www.who.int/csr/disease/influenza/Pand_Plan_SR_AJ.pdf. Accessed June 4, 2008.Google Scholar
26. Ministry for Social Policy, Health, the Elderly and Community Care The Health Division influenza pandemic contingency plan for the Maltese Islands. http://www.sahha.gov.mt/showdoc.aspx?id=622&filesource=4&file=Health%20Division%20Influenza%20Pandemic%20Contingency%20Plan.pdf. Published January 28, 2007. Accessed August 15, 2008.Google Scholar
27.Devereaux, AV, Dichter, JR, Christian, MD, etal; Task Force for Mass Critical Care. Definitive care for the critically ill during a disaster: a framework for allocation of scarce resources in mass critical care: from a Task Force for Mass Critical Care summit meeting, January 26-27, 2007, Chicago, IL. Chest. 2008;133(5 (Suppl) 51S-66S.Google Scholar
28.Frykberg, ER. Medical management of disasters and mass casualties from terrorist bombings: how can we cope? J Trauma. 2002;53(2):201-212.CrossRefGoogle ScholarPubMed
29.Lising, M, Kennedy, C. A multimethod approach to evaluating critical care information systems. Comput Inform Nurs. 2005;23(1):27-37.Google Scholar
30.Singer, PA, Benatar, SR, Bernstein, M, etal. Ethics and SARS: lessons from Toronto. BMJ. 2003;327(7427):1342-1344.Google Scholar
31.Naylor, CD, Chantler, C, Griffiths, S. Learning from SARS in Hong Kong and Toronto. JAMA. 2004;291(20):2483-2487.Google Scholar
32.Wilson, K, McDougall, C, Upshur, R. Joint Centre for Bioethics SARS Global Health Ethics Research Group. The new International Health Regulations and the federalism dilemma. PLoS Med. 2006;3(1):e1.Google Scholar