Nevada Uses AHRQ Tool to Prepare for Health Emergencies
The Nevada State Health Division has been using a call center tool—the Health Emergency Line for the Public (HELP), developed through AHRQ's emergency preparedness program—to respond to public health incidents. The tool has enabled the State to reduce unnecessary hospital emergency department surges, helped educate and protect residents, and provided the State's public health departments with a central point of access.
In developing the HELP call center services, researchers at Denver Health's Rocky Mountain Poison and Drug Center sought ways to manage patients at home and outside the health care setting. By partnering with public health agencies, HELP provides a model for disseminating and collecting information during health emergencies. Since its launch in 2003, the HELP program has handled over 225,000 calls for a variety of events in multiple States, including West Nile virus, seasonal influenza, 2009 novel H1N1 influenza, and other health emergencies.
The Nevada State Health Division works with the State of Nevada to administer the program. The HELP program provides the Health Division with approved information for callers. It can also collect event-specific information to assist epidemiologists with situational awareness and disease-control efforts. This allows the health departments/districts to continue working in the community, rather than handling all the phone calls.
Tracey Green, MD, Nevada State Health Officer, says, "Large call volume can be handled through this information delivery system. It has been an important resource in a lot of different scenarios. This service gives the public an alternative means of obtaining information and having their concerns addressed, rather than going to an emergency room or doctor's office."
In January 2008, call center services were used to help manage health information dissemination following reports that two endoscopy clinics near Las Vegas had used unsafe infection control practices (e.g., reusing syringes, using single-use vials on multiple patients), which may have exposed more than 50,000 patients to blood-borne pathogens such as hepatitis and HIV. The Southern Nevada Health District received notification about acute cases of Hepatitis C and eventually identified a total of nine cases—eight in one clinic and one case in an associated clinic. Six of the cases had procedures on the same date and were genetically linked.
Other 2009 events during which State officials found the tool useful included a food-borne Hepatitis A outbreak and the novel H1N1 influenza. Additionally, the State Health Division used the call center services during a water quality issue in which a water supply relied upon by over 1,000 people in Churchill County was found to be contaminated by polonium-210.
Rocky Mountain Poison and Drug Center has over 220 staffers at its call center. In emergencies, the public is directed to the HELP program through press releases and media campaigns. The HELP toll-free line is available daily with the capacity to expand to 24-hour coverage if needed in an emergency situation. Trained information providers are available to answer questions, collect demographic data, and provide referrals. The call staff uses FAQ scripts prepared by State health epidemiologists to explain symptoms, treatments, and prevention measures to callers.
Information is available on topics such as mold, influenza/pneumonia, anthrax/white powder, severe acute respiratory syndrome, Hantavirus, tuberculosis, H1N1, and ricin. Other topics are added as information needs are identified.
The HELP model originated as a pilot for implementing some of the concepts and strategies developed in the AHRQ-funded Health Emergency Assistance Line and Triage Hub (HEALTH) model. HEALTH was designed to minimize surges in patient demand upon the health care delivery system during a bioterrorist event or other public health emergency.
Gregory M. Bogdan, PhD, Research Director and Medical Toxicology Coordinator at the Rocky Mountain Poison and Drug Center, notes, "The HELP program handles thousands of calls every year related to public health emergencies. It relies upon the resources of our poison center infrastructure to effectively and efficiently handle public information requests, collect data to assist public health agencies in managing events, and identify sentinel events of emerging problems as they occur. This helps reduce the demands on hospitals, emergency departments, clinics, and public health agencies."
In addition to Nevada, the Colorado and Hawaii State Health Departments use HELP program services as part of their emergency response strategies. Bogdan says, "Other states should consider establishing similar services with their own poison centers. This service was extremely helpful in managing the information demands of the public during the two waves of novel H1N1 influenza in 2009."