The business end of bioterror

Robert Nabors, an EDS vice president, says the company's strongest health opportunity lies in database solutions that would allow information sharing and communications among public officials, private facilities and medical personnel in the field.

Olivier Douliery

Officials: Feds must fund $2 billion more for states, communities

Government health departments will be among the largest purchasers of homeland security solutions at the state and local level as the nation struggles to develop the capability to respond to biological terrorist attacks.

State and local governments are just starting efforts to build health alert systems and establish other programs that will allow officials to quickly share information about biological agents, infectious diseases, symptoms and treatments during a terrorist attack.

Government and industry officials said these efforts will provide opportunities for companies with expertise in collaborative technologies, such as portals, business intelligence tools, knowledge management and distance learning.

Although first responders have received high priority in the initial funding for homeland security, federal aid for bioterrorism preparedness is rapidly catching up. In 2002, for example, Congress approved $3.5 billion for first responders and $918 million for bioterrorism preparedness.

But the federal government is expected to provide an additional $2 billion for bioterrorism preparedness to state and local government through 2004, according to the National Association of City and County Health Officials of Washington.

About one-third of that money would go toward information technology solutions for systems that public health officials would use to track and monitor infectious diseases, according to officials of the Centers for Disease Control and Prevention. The other two-thirds goes toward efforts that include building up pharmaceutical stockpiles and developing and manufacturing new vaccines, they said.

CDC is distributing the initial block of bioterrorism funding through cooperative agreements made with state and local governments. On average, states received between $10 million and $30 million through this channel, according to state officials.

One project supported by this funding is the Health Alert Network, essentially an electronic alert system that lets CDC officials notify state and local public health officials about potential outbreaks of infectious diseases and bioterror attacks.

About 90 percent of state and local governments are connected to the CDC through the Health Alert Network, said Patrick Libbey, executive director of the National Association of City and County Health Officials. The network has done a good job of allowing the federal government to share information with state and local public health departments, he said.

One frequent criticism of the system by state and local public health officials is that it does not provide these same warnings and alerts to hospitals, emergency rooms or physicians.

Federal officials responsible for coordinating bioterrorism preparedness are likely to rely more in the future on distance learning technology to train health care professionals on the frontlines of biological defense, said French Caldwell, vice president and research director of global public policy with the market research firm Gartner Inc., Stamford, Conn.

"The federal government is counting on a lot of people -- who it has no direct control over -- to provide information. E-learning is a way to provide a level of awareness and training [to them]," Caldwell said.

In its present form, some homeland security and public health experts have deep concerns about the basic structure of the Health Alert Network and whether it can accomplish a mission that is expanding and changing from month to month. Their concerns center on getting information from public health departments to doctors and hospitals.

The Pennsylvania Department of Health has sought to address this problem by integrating the Health Alert Network into a more sophisticated system known as the Pennsylvania National Electronic Disease Surveillance System, or PA-NEDSS.

The system follows a conceptual data model developed by CDC and used in other states. The approach uses the Internet to collect and transmit data, including infection disease surveillance data. It incorporates electronic laboratory reporting and the use of uniform coding schemes and data transmission protocols.

Pennsylvania officials hope eventually all 46,000 physicians, 235 hospitals and 200 clinics throughout the state will be able to participate in the surveillance system, said Joel Hirsch, bureau director for epidemiology at the Pennsylvania Department of Health.

Ciber Inc. of Denver provided the initial assessment, and Deloitte Consulting of New York did 95 percent of the actual integration, including project development and architectural configuration, said Mary Benner, chief information officer for the Pennsylvania Department of Health. The project, which cost about $11 million, was funded through a combination of federal and state funds, she said.

The trickle of homeland security funds to state and local governments to date hasn't dampened optimism that integrators share for this opportunity. A number of companies with years of experience supporting the government health care sector have developed solutions for bioterrorism preparedness that they are waiting to deploy. Some companies have existing solutions that they hope state and local customers will want to purchase.

"We're just waiting for the various state and local governments to put out requirements," said Robert Nabors, vice president of the Electronic Data Systems Corp.'s enterprise solutions unit. "We know that funding is going to increase in the later years, once they make the requirements clear."

Ed DeSeve, senior vice president and managing director with the state and local solutions group of Affiliated Computer Services Inc., Dallas, said he expects additional federal funds to begin flowing by this summer. State and local governments should begin issuing requests for proposals before the end of the year, he said.

Of the 49 solutions that EDS of Plano, Texas, has developed for homeland security, several are targeted for public sector health care, Nabors said. The company believes its strongest opportunity lies in developing and implementing interoperable databases that would allow information sharing and communications among public health officials, private health care facilities and medical personnel in the field, he said.

DeSeve said he believes ACS' Pre-Pass program, a computerized system that allows state officials to monitor the credentials, weight and cargo of trucks traveling across state lines, could be expanded to help block terrorists who might attempt to transfer biological agents or toxic materials.

In addition, the company is looking at whether its patient notification solution, which relies on wireless applications, could be used to improve the ability of emergency medical professionals to communicate with hospitals, he said.

For these solutions to be deployed, federal funding must continue.

"We are making progress, but we aren't there yet," Libbey said. "You can't make up for decades of neglect of the public health infrastructure with one year of funding." *

Staff writer William Welsh can be reached at

About the Author

William Welsh is a freelance writer covering IT and defense technology.

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