Helen Burstin, M.D., M.P.H.Helen Burstin, M.D., M.P.H.DirectorDirectorCenter for Primary Care, Prevention, Center for Primary Care, Prevention,

and and Clinical PartnershipsClinical Partnerships

The Role of Community-Based Providers The Role of Community-Based Providers in Bioterrorism Preparednessin Bioterrorism Preparedness

Role of Community Providers Role of Community Providers in Bioterrorism Preparedness in Bioterrorism Preparedness

Front-line Front-line clinical providersclinical providers

Public Health Public Health InfrastructureInfrastructure

Public health departmentsPublic health departments State laboratoriesState laboratories Emergency preparednessEmergency preparedness

Patients present with Patients present with symptomssymptoms

Primary care providersPrimary care providers Community health centersCommunity health centers Emergency departmentsEmergency departments HospitalsHospitals

Why are Linkages to Community Why are Linkages to Community Providers Important? Providers Important?

Journal of Family Practice: SeptemberJournal of Family Practice: September20022002 Chen et al (AAFP National Research Network and AHRQ Chen et al (AAFP National Research Network and AHRQ

researchers)researchers) National survey of family physicians (pre-anthrax attacks)National survey of family physicians (pre-anthrax attacks) Two-thirds of family physicians feel unprepared to Two-thirds of family physicians feel unprepared to

deal with a bioterrorist eventdeal with a bioterrorist event

Why Do Community Providers Need Why Do Community Providers Need To Assist With BT Preparedness?To Assist With BT Preparedness?

PROBLEM #1: Patients often present to their provider PROBLEM #1: Patients often present to their provider with vague symptoms – may be confused with flu with vague symptoms – may be confused with flu

POTENTIAL SOLUTIONS: POTENTIAL SOLUTIONS: – Decision support could help clinicians target the key Decision support could help clinicians target the key

symptoms or signs of a BT-related diagnosissymptoms or signs of a BT-related diagnosis– Training and point-of-care information could prepare Training and point-of-care information could prepare

community providers to diagnose and manage patients community providers to diagnose and manage patients appropriatelyappropriately

Why Do Community Providers Need Why Do Community Providers Need To Assist With BT Preparedness?To Assist With BT Preparedness?

PROBLEM #2: Community providers do not interact with PROBLEM #2: Community providers do not interact with the public health departments or emergency respondersthe public health departments or emergency responders

POTENTIAL SOLUTIONS: POTENTIAL SOLUTIONS: – Develop ongoing relationship with the public health Develop ongoing relationship with the public health

infrastructure (e.g., health departments, EMS) infrastructure (e.g., health departments, EMS) – Develop community-based data sharing systems for ongoing Develop community-based data sharing systems for ongoing

surveillance for BT and other public health emergencies (e.g., surveillance for BT and other public health emergencies (e.g., flu)flu)

– Develop role for community providers (and volunteer Develop role for community providers (and volunteer providers) for public health emergenciesproviders) for public health emergencies

What AHRQ Is Doing To Help What AHRQ Is Doing To Help Community Providers Community Providers

Develop training and information tools that meets the needs of Develop training and information tools that meets the needs of community clinicians (e.g., Vanderbilt, University of Alabama community clinicians (e.g., Vanderbilt, University of Alabama website) website)

Support practice-based research networks of community-based Support practice-based research networks of community-based providers to address important questions related to BT providers to address important questions related to BT preparedness (e.g., Wisconsin, UNC, Cincinnati Children’s preparedness (e.g., Wisconsin, UNC, Cincinnati Children’s PBRNs) PBRNs)

Enhance and reinforce linkages and IT connectivity between the Enhance and reinforce linkages and IT connectivity between the health care system and the public health infrastructure (e.g., health care system and the public health infrastructure (e.g., Indiana PBRN)Indiana PBRN)