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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

It's said that a picture is worth a thousand words. At the Department of Health and Human Services' 24-hour command center, a picture is worth hundreds of pages of data and just might be worth millions of lives. Using any of the dozen or so large flat-screen monitors that cover the walls of the 17-month-old command center in HHS's Washington, D.C., headquarters, Health and Human Services Secretary Tommy Thompson and his team of technology specialists, biological and medical experts, and a staff meteorologist can visually track and prepare for events occurring domestically and internationally--events that have the potential to affect the nation's public health right now, in the near term, and in what-if scenarios.

The Secretary's Command Center, as it's officially called, includes a 20-terabyte storage network used to compile and analyze data supplied by dozens of geographical information systems and more than 100 other sources daily, including U.S. agencies such as the Centers for Disease Control and Prevention, Food and Drug Administration,

Department of Defense, CIA, FBI, and Department of Homeland Security. Relational databases take into account information ranging from Census Bureau demographic data to data from sometimes obscure sources such as the Australian Waders Studies Group. Why is a 300-member bird-watching group on the other side of the world on the command center's radar these days? It tracks bird-migration patterns, including those species that have droppings that could spread avian influenza, or bird flu. Using the data supplied by the group, the command center visually projects on a GIS map what regions and populations in U.S. territories might be vulnerable to avian influenza.

Data provided by the center's systems helps HHS staff pinpoint on world maps confirmed cases of West Nile virus, severe acute respiratory syndrome, and mad-cow disease. Staff can monitor the nation's blood supply, or forecast how radioactive smoke plumes of a dirty-bomb explosion might blow through a city's streets based on current weather conditions. The systems give Thompson and his team access to data on hospitals across the nation, including information about the kinds of specialty care they can provide. During a crisis, hospitals are requested to provide via a command-center Web site regular updates on the number of available beds. The command center manages the nation's 12 50-ton stockpiles of emergency medical supplies, vaccinations, and drugs, which are stored in undisclosed locations and can be delivered anywhere in the country within seven hours.

Several flat screens display television broadcasts from three satellite systems. The programming covers domestic and international television markets, ranging from CNN to Al-Jazeera. Staffers at the center perform analysis as news breaks, whether assessing the damage of a highway rollover of a truck carrying toxic material or extrapolating the impact on public health of a fire at a pharmaceutical plant in North Carolina.

Dean Ross

The command center looks out for major public-health consequences, center director Ross says.
During that fire, the command center assessed whether the smoke was toxic and used its weather systems to display wind conditions and monitor how smoke plumes from the burning chemicals would blow through the region's population. Command-center staff also kept tabs on whether the plant manufactured anything that would affect the nation's ability to get medicines that might be vital in a sudden emergency. Fortunately, the fire didn't pose a public-health hazard nor did it have a major impact on the availability of drugs, says Dean Ross, director of the command center.

"You can layer information from different sources and see patterns develop," Ross says. "We're looking for major public-health consequences," since events happening in one part of the country or the world can have a domino effect, he says.

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