Pandemic Flu Health Information and Work Flow Project - Sunil Nair Health Informatics Dalhousie University

March 20, 2008March 20, 2008

NOVA SCOTIA HEALTH SYSTEMNOVA SCOTIA HEALTH SYSTEM

PANDEMIC INFLUENZA PLANPANDEMIC INFLUENZA PLAN

Health Information FlowHealth Information FlowByBy

Sunil NairSunil NairAbel Medhanie Geb Abel Medhanie Geb

2212/01/0912/01/09 HINF6102-FlowProject-Sunil-AbelHINF6102-FlowProject-Sunil-Abel

AgendaAgenda

Pandemic InfluenzaPandemic Influenza

Avian Flu – Threat? Avian Flu – Threat?

NS Pandemic Influenza PlanNS Pandemic Influenza Plan

Key PlayersKey Players

Flow of InformationFlow of Information

Problems / SolutionsProblems / Solutions

??


AcknowledgementsAcknowledgements

Ms. Susan Baikie, RN/BN Ms. Susan Baikie, RN/BN Public Health Informatician, NS Health Public Health Informatician, NS Health

Promotion and Protection Promotion and Protection

Ms. Gertrude Oliver, RN Ms. Gertrude Oliver, RN Communicable Disease Nurse ConsultantCommunicable Disease Nurse Consultant

Ms. Dee Mombourquette, RNMs. Dee Mombourquette, RN Communicable Disease Prevention and Communicable Disease Prevention and

Control CoordinatorControl Coordinator


Influenza FactsInfluenza Facts3 types 3 types Type AType A (Avian, Bovine, Humans, Animals), (Avian, Bovine, Humans, Animals), Type BType B (Humans), (Humans), Type C (Humans and Animals)Type C (Humans and Animals)

Symptoms- Fever, cough, sore throat, headache and lethargySymptoms- Fever, cough, sore throat, headache and lethargy

Mode of Transmission – Mode of Transmission – Droplets, Droplets, Touching contaminated surfacesTouching contaminated surfaces

Annual Hospitalizations – 20,000 Canadians; ~4000 die of complications Annual Hospitalizations – 20,000 Canadians; ~4000 die of complications

Epidemic – Prevalence of disease within a communityEpidemic – Prevalence of disease within a community

PandemicPandemic – Outbreak, rapid transmission, affects large population – Outbreak, rapid transmission, affects large population


Avian Flu – Threat?Avian Flu – Threat?

Bird-Human transmissionBird-Human transmission

Consequence of mass outbreak – disasterConsequence of mass outbreak – disaster

Experts predict up to 50 million deathsExperts predict up to 50 million deaths

No definitive vaccineNo definitive vaccine

However, mortality rate could decline as However, mortality rate could decline as the virus mutates.the virus mutates.

Can we eat chicken?Can we eat chicken?


Flu pandemics then and nowFlu pandemics then and now

>50 millionEstimated Death>20 million

AntiViralTreatmentsBed Rest, Aspirin

VaccinesPreventive measuresGauze Masks, Disinfectants

4 DaysTime for Transmission4 months

JetsTransportationShips & Trains

>6.5 billionWorld Population1.8 billion

2006/2007Year1918

NOWTHEN


Avian Flu JourneyAvian Flu Journey

1997-first human victim in Hong Kong1997-first human victim in Hong KongAcross Country transmission Across Country transmission 348 confirmed Human cases of H5N1; 218 deaths (WHO 348 confirmed Human cases of H5N1; 218 deaths (WHO January 2008)January 2008)



Pandemic Flu hypothetical scenarioPandemic Flu hypothetical scenarioSTAGE 1STAGE 1 Emergence of Emergence of

VirusVirus Drift & ShiftDrift & Shift No immunityNo immunity

STAGE 2STAGE 2 Replication of Replication of

mutated stainmutated stain

STAGE 3STAGE 3 Sustained Sustained

virus virus transmission transmission H HH H


Pandemic PredictionsPandemic Predictions

Strike without WarningStrike without Warning

Severity will depend onSeverity will depend on Emerging StrainEmerging Strain Extend & Ease of spreadExtend & Ease of spread Number & Groups of people affected/exposedNumber & Groups of people affected/exposed

Estimated that up toEstimated that up to 35% Nova Scotia population could be ill35% Nova Scotia population could be ill 165,000 individuals may need hospitalization165,000 individuals may need hospitalization 1300 deaths1300 deaths

Estimated Costs (National)Estimated Costs (National) Up to $1.4 billion in Healthcare expendituresUp to $1.4 billion in Healthcare expenditures Up to $28 billion in Economic lossUp to $28 billion in Economic loss


NS Pandemic Influenza PlanNS Pandemic Influenza Plan

CommunicationsCommunications

SurveillanceSurveillance

Public health Public health measuresmeasures

VaccinesVaccines

Anti-viralAnti-viral

Health servicesHealth services

NSPIPNSPIP

http://www.gov.ns.ca/govt/pandemic/docs/plan/Full_NS_Pandemic_plan.pdf


Key PlayersKey Players


InteroperabilityInteroperability

Between:Between: Information (sharing)Information (sharing)

Different SystemsDifferent Systems

Programs & activitiesPrograms & activities

Managements & Managements & ProcessesProcesses

““Sharing the right information with the right people at the right time”Sharing the right information with the right people at the right time”


CommunicationCommunication


Surveillance - Surveillance - FluFluWatchWatch

http://www.phac-aspc.gc.ca/fluwatch/index-eng.php



Pandemic Management teamPandemic Management team

Nova Scotia Communicable Disease Manual


Emergency Management PlanEmergency Management Plan


School ResponseSchool Response


Pandemic Model Of CarePandemic Model Of Care


Problems / SolutionsProblems / Solutions

Plan not tested and Drilled Plan not tested and Drilled Pandemic Simulation & Response Drill;Pandemic Simulation & Response Drill;

Collaboration with other Govt. Depts. like Agriculture, Airports etc; Collaboration with other Govt. Depts. like Agriculture, Airports etc;

Need for structured data collection, collation & analysisNeed for structured data collection, collation & analysis Business IntelligenceBusiness Intelligence

Unclear Roles & ResponsibilitiesUnclear Roles & Responsibilities Clear Communication to decision makers;Clear Communication to decision makers;

Ethical Issues Ethical Issues Clearly understand rationing of careClearly understand rationing of care Prioritization of access to vaccines/drugs Prioritization of access to vaccines/drugs


The role of Health Informatics The role of Health Informatics Professional is Significant.Professional is Significant.

ConnectConnect Integration of SystemsIntegration of Systems

Share- High value DataShare- High value Data Data Data KnowledgeKnowledge PolicyPolicy

Data AnalysisData Analysis SurveillanceSurveillance

InnovationInnovation New ServicesNew Services

Healthcare Project Healthcare Project ManagementManagement

IT Systems realizationIT Systems realization



Important LinksImportant Links

http://http://www.gov.ns.ca/govt/pandemic/pandemic_plan.aspwww.gov.ns.ca/govt/pandemic/pandemic_plan.asp http://http://www.gov.ns.ca/govt/pandemic/canada.aspwww.gov.ns.ca/govt/pandemic/canada.asp http://http://www.chica.orgwww.chica.org// http://www.phac-aspc.gc.ca/fluwatch/index-eng.phphttp://www.phac-aspc.gc.ca/fluwatch/index-eng.php http://http://www.safecanada.ca/link_e.asp?categorywww.safecanada.ca/link_e.asp?category=10&topic=193=10&topic=193 http://www.phac-aspc.gc.ca/influenza/pandemic_e.htmlhttp://www.phac-aspc.gc.ca/influenza/pandemic_e.htmlhttp://www.phac-aspc.gc.ca/cpip-pclcpi/index-eng.phphttp://www.phac-aspc.gc.ca/cpip-pclcpi/index-eng.php

Thank you!Thank you!

http://www.gov.ns.ca/govt/pandemic/pandemic_plan.asp

http://www.gov.ns.ca/govt/pandemic/pandemic_plan.asp

http://www.gov.ns.ca/govt/pandemic/canada.asp

http://www.gov.ns.ca/govt/pandemic/canada.asp

http://www.chica.org/




http://www.safecanada.ca/link_e.asp?category=10&topic=193



http://www.phac-aspc.gc.ca/influenza/pandemic_e.html

Health & Medicine

Pandemic Flu Health Information and Work Flow Project - Sunil Nair Health Informatics Dalhousie University