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On High Alert

The Health and Human Services IT team has built a command center that monitors public health and equips the nation to respond in the event of a crisis.
The technology used at the HHS command center helps dramatically break down barriers to communication and access to vital information relevant to public health. "The biggest challenge in public health is communication," Ross says. The command center is connected via 11-1/2 miles of cable to a control room down the hall that houses the computers that run the systems. There are triplicate backups for all systems, including power, air-conditioning, data, and telephony. In the event the command center can't be accessed because of a crisis affecting the D.C. area, two hot-site backup centers and a mobile center are ready to take over.

Technologies key to running the center include Windows 2000 and XP systems, SQL-based relational databases, and a variety of government off-the-shelf, consumer off-the-shelf, and in-house software. IP-based phone lines facilitate HHS videoconferences with WHO in Geneva at a cost that's the same as a local call. If dial tone goes down in Washington because of weather or other circumstances, IP-based calls can be placed in Geneva and routed back to the United States, Ross says. Thompson and his team also are able to communicate in person or via videoconference with government leaders, medical experts, and international groups. In February, when the poison ricin was discovered in mail at Sen. Bill Frist's office, Ross says, the center quickly pulled together a conference call with 70 people from government and elsewhere who were knowledgeable about cases of chemical terrorism.

The graphical systems allow the analysis of complex data to be conveyed visually using maps and charts, even in situations where participants in videoconferences or meetings are from other countries and aren't fluent in English. Data from a complex 100-page report can be translated into "a visual map," highlighted with colors to indicate what's going on during a particular health crisis. "These pictures are definitely worth a thousand words--a thousand English words," Ross says.

The command center often deals with local issues, since they have the potential to escalate to national levels. "About 95% of what's looked at here isn't at a federal level, but you don't know when it will go over that threshold," Ross says. For instance, command-center staffers recently closely monitored an earthquake in California that did little damage but was only 20 miles from a nuclear plant. "That could've had a domino effect," Ross says.

Governors can call on the federal government for assistance during situations that are clearly not a national health crisis but that become too difficult for local resources to handle. In February 2003, after a fire at a Rhode Island night club that killed 100 people and injured many others, Gov. Don Carcieri called on Thompson's command-center resources for help. Using the center's Event Management System, which includes a database of information about the nation's medical experts, Thompson's crew assembled teams of specialists that were sent to Rhode Island to assist in treating the victims' injuries--both physical and emotional.

The command center's value doesn't stop with managing health emergencies. HHS systems can be used to help prevent potential crises. Before February's Super Bowl XXXVIII at Reliant Stadium in Houston, health officials relied on the center's GIS capability to develop a plan to temporarily relocate much of the area's blood supply in case a terrorist attack on the stadium injured many and created obstacles to emergency workers accessing a nearby major regional blood center.

In preparation for a possible attack on Congress before President Bush's State of the Union address, which was attended by a large number of the nation's top leaders, the center's systems were used to devise a plan with the Red Cross to reallocate blood supplies in the Washington area.

Whether it's managing and responding to real emergencies or potential ones, the HHS command center is critical to the nation's safety and defense, thanks in no small part to the technology behind the scenes. Says Ross, "The systems provide us with forward-looking information that allows for much more informed decisions." In today's climate, that's good to know.

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