MSIPC Fundamentals: Interaction between IPs and Local and State Health Departments Joyce Lai, MPH–...

transcript

MSIPC Fundamentals: Interaction between IPs and Local and State Health Departments

Joyce Lai, MPH– Michigan Department of Community HealthNoreen Mollon, MS– Michigan Department of Community Health

October 29, 2014

www.michigan.gov/hai

Outline

MDCH Organization Communicable Disease Surveillance

Reportable Diseases Michigan Surveillance Data Systems

MDSS MSSS Sentinel Surveillance for ILI

SHARP Outbreak Response Surveillance and Reporting Prevention Initiatives

Other MDCH Entities that frequently interact with IPs

MDCH Mission Statement

MDCH will protect, preserve, and promote the health and safety of the people of Michigan with particular attention to providing for the needs of vulnerable and under-served populations

MDCH Organization

Operations Administration

Medical Services Administration

Behavioral Health &Developmental

Disabilities Administration

Office of Inspector General

Offices of Services To the Aging

Chief OperatingOfficer

DIRECTOR

Public HealthAdministration

MDCH Organization

Public Health Administration

Bureau of Local Health& Administrative Services

Bureau of Family, MaternalAnd Child Health

Bureau of Disease Control, Prevention, and Epidemiology

Bureau of Laboratories

Division of Health Wellness And Disease Control

Office of Public Health Preparedness

MDCH Organization

Bureau of Disease Control, Prevention, and Epidemiology

Division of Genomics, Perinatal Health, and Chronic Disease

Division of Immunization

Division of Environmental Health

Division of Communicable Disease

Surveillance Section

Communicable Disease Surveillance

Communicable disease reporting is required by Michigan law: Michigan Public Health Act No. 368 Communicable

Disease Rules: R 325.171-3, 333.5111 Rule revision allows the State the right to periodically

update the list of reportable diseases This reporting is expressly allowed under HIPAA

Hepatitis C Virus Neisseria meningitidis Histoplasma capsulatum Bordetella pertussis

Why Communicable Disease Surveillance is Important To identify outbreaks To assure treatment, preventive treatment and/or

education To evaluate prevention and control programs To help target prevention resources To facilitate epidemiologic research To assist national and global surveillance efforts

Salmonella sp.Influenza VirusChlamydia trachomatis Mycobacterium tuberculosis

Public Health Depends on Collaboration

HealthcareProviders

ClinicalLaboratories

Local HealthDepartment

State HealthDepartment

Centers for DiseaseControl and Prevention

Isolates and specimenssent to State Lab for

additional testing

Communicable Disease Reporting Entities Physicians* Laboratories* Hospital ICP Private citizens School systems* Pharmacists Veterinarians Medical Examiners

Hospitals* Child care facilities Long-term care

facilities* Pre-hospital

emergency services Police Fire EMS

*Required to report

Communicable Disease “Brick Book”

The current 2014 version (electric crimson), provides a good summary of the communicable disease rules, requirements, and responsibilities

Michigan Reportable Diseases

~90 disease/conditions are reportable in Michigan

Also reportable are ‘unusual occurrences’, outbreaks and epidemics of any disease or condition (including healthcare-associated infections)

Specific reporting rules and definitions can be found at www.michigan.gov/cdinfo

Case Rules and Definitions

Example of Streptococcus pneumoniae reporting algorithm

Case Rules and Definitions

Acute / Chronic Hepatitis C Reporting Flowchart

Timeliness and Completeness of Communicable Disease Reports

In general, all reportable diseases are required to be reported within 24 hours of confirmation

Report contents Demographic info – name, date of birth, sex, race Contact info – address, phone number Disease details – onset date, lab results

Surveillance is only as good as the data received The timeliness and effectiveness of public health

responses are dependent on prompt and accurate surveillance reporting

Authority of State and Local HDs

Michigan is a “home rule” state, meaning local HDs have autonomy within their jurisdiction

The MDCH operates independently from the local HDs

The primary role of the MDCH in communicable disease control is to provide: expert consultation reference level diagnostics laboratory services childhood vaccines support local HDs upon their request Maintenance and administration of the MDSS

All communicable disease reports should be reported to your local HDs

Map of Michigan Local HDs

Public Health Investigative Authority

State and local HD personnel are authorized to investigate reported diseases, including: Contacting health providers Conducting additional case-finding Conducting epidemiological studies Conducting specimen collection Gathering information on medical history, lab results,

diagnostic procedures, treatment, and health outcomes

The MDCH works collaboratively with the local HDs and participates in investigations when requested

Confidentiality, HIPAA, and PHI

Disclosure of protected health information (PHI) to health authorities without individual consent or authorization is permitted when disclosure is required by law or is authorized by law for a public health purpose (www.hhs.gov/ocr/hipaa/)

All information provided to public health authorities is kept confidential

Helpful Links

www.michigan.gov/mdch Click on ‘Providers’ and then ‘Chronic and

Communicable Diseases’ www.michigan.gov/hivstd - HIV/STD/Viral Hepatitis

www.michigan.gov/cdinfo - Communicable Disease resources, forms, links, reports, and publications

www.michigan.gov/mdss - Michigan Disease Surveillance System (MDSS)

www.michigan.gov/hai- Healthcare-Associated Infection Surveillance & Prevention

Michigan Surveillance Systems

Michigan Disease Surveillance System (MDSS)

Michigan (Emergency Department) Syndromic Surveillance System (MSSS)

Sentinel Surveillance for Influenza-Like Illness

Disease Detection/Reporting Timeline

ExposureSymptom

OnsetSeeking of

Medical Care

Diagnosis

Reported to Local HD

Reported to State HD

ED SyndromicSurveillance

Michigan DiseaseSurveillance System

Michigan Disease Surveillance System

Web-based communicable disease surveillance system Disease can be reported 24/7 from your computer Used to facilitate coordination between local, State,

and federal public health agencies Streamlines disease reporting; more efficient and

closer to real-time Allows for more timely public health interventions Reduces delays in public health follow-up by grouping

disease based on county of patient residence

Data in the MDSS can be accessed and edited by multiple parties which facilitates the sharing of information without requiring multiple phone calls

Allows for instantaneous retrieval of summary reports MDCH Weekly Surveillance Report (

www.michigan.gov/cdinfo) Data sent to CDC National Notifiable Disease Surveillance

System (NNDSS – www.cdc.gov/nndss) for Morbidity and Mortality Weekly Reports (MMWR – www.cdc.gov/mmwr)

Michigan Disease Surveillance System

MDSS Reporting Pathways

Community Physicians InfectionPreventionists

Hospital Labs

Local Health Department

• Case Follow-up• Local Surveillance• Electronic Reports

• Statewide Surveillance• Weekly Surveillance Reports (WSR)

CDC• National Notifiable Disease Surveillance System (NNDSS)• Morbidity and Mortality Weekly Report (MMWR)

Adding/Editing Cases in MDSS

Searching Records in MDSS

Pulling MDSS Data

MDSS Statistics

Year ReferralsIndividual Case Reports Transactions

UniqueUser

Log Ins

2007 83,876 77,686 400,000 ----

2008 136,057 104,616 429,848 783

2009 160,326 119,843 618,731 893

2010 158,225 113,765 697,258 906

2011 213,639 159,185 803,092 982

2012 211,150 146,069 1,018,304 1,126

2013 185,362 126,812 1,059,023 1,155

MDSS Electronic ReportingLABORATORY 2006 2007 2008 2009 2010 2011 2012 2013

MDCH REGIONAL LAB - LANSING 16,407 7,039 13,589 20,723 16,245 18,567 22,305 20,905

DETROIT MEDICAL CENTER LAB 1,167 8,652 8,758 8,882 9,816 10,147 8,981 7523

MDCH REGIONAL LAB - DETROIT 1,206 1,323 2,040 1,596 1,662 1,714 369 12

ARUP LABORATORIES 2,100 3,656 2,678 3,314 3,498 3,209 5,680 5621

GARCIA LABORATORIES -- -- 483 -- -- 8

HURLEY HOSPITAL LAB (3/09) -- -- -- 3,024 3,792 5,031 4,448 2874

MAYO CLINICAL LABS (8/09) 1,548 6,668 3,985 4,317 3375

LABCORP (9/09) 1,226 3,375 4,225 4,957 5149

MDCH REGIONAL LAB – OAKLAND (9/09) 863

MDCH REGIONAL LAB - OAKLAND CO LAB - PONTIAC 2,823 2,552 2,188 2106

MDCH REGIONAL LAB - OAKLAND CO LAB - SOUTHFIELD 425 676 552 758

MDCH REGIONAL LAB - KALAMAZOO 340 1,359 127 123

MDCH REGIONAL LAB - UPPER PENINSULA 57 0 0 0

MDCH REGIONAL LAB - KENT COUNTY 412 1,757 268 204

MDCH REGIONAL LAB - SAGINAW COUNTY 308 1,632 3,189 2288

SPARROW LABS (2/11) 1,735 2,281 2161

SPARROW LABS – ST LAWRENCE LAB (2/11) 2,104 2,712 2965

QUEST DIAGNOSTIC – AUBURN HILLS (8/11) 4,969 12,510 16420

McLAREN OAKLAND HOSPITAL 16

McLAREN CENTRAL MI HOSPITAL 5

McLAREN MACOMB HOSPITAL 27

McLAREN FLINT HOSPITAL 27

McLAREN BAY HOSPITAL 26

McLAREN GREATER LANSING HOSPITAL 7

Total 20,880 20,670 27,548 41,176 49,421 63,662 74,884 72600

More Info on the MDSS

Contact: Your Local Health Department Communicable

Disease Program Your Regional Epidemiologist Edward Hartwick, MS, MDSS Coordinator

HartwickE@michigan.gov

http://www.michigan.gov/mdss

(517) 335-8165

Michigan (Emergency Department) Syndromic Surveillance (MSSS)

A surveillance system that detects and tracks the chief complaints of ED patients throughout the state

Chief complaints are classified into syndromic categories that could indicate a possible public health emergency

Web-based application displays the data in real-time

Alerts are automatically sent when rates of a given syndrome are detected to be higher than the predicted norm

# of facilities: 95

# of users: 173

# of referrals per day, Statewide: 12,343

# of referrals per day, per facility: 130

MSSS Data

Each message sent to the MSSS consists of: Demographics: date of birth, sex Residence: home zip code Visit Info: date, time, class (e.g. urgent care, ER) Chief Complaint

MSSS Chief Complaints

Chief complaints are classified into the following syndromes:

Hemorrhagic Botulinic Neurological Other Default

Gastrointestinal Constitutional Respiratory Rash

MSSS Classification Examples

Chief Complaint Syndrome“slurred speech” Botulinic

“general weakness” Constitutional“stomach pain” Gastrointestinal

“difficulty breathing” Respiratory“nose bleed” Hemorrhagic

“headache” Neurological “hives and itching” Rash“right foot injury” Other

“med refill” Default

MSSS Alerts

A detection algorithm monitors the data hourly

An e-mail alert is sent to State and regional epidemiologists if an aberration is detected If the actual value of a syndrome exceeds the predicted

value for a given syndrome in a geographic area

Users can view the data in charts, graphs, or maps

Use of MSS Data

Early detection of outbreaks Enhanced surveillance during high-profile events:

World Series Super Bowl MLB All-Star Game Final Four Detroit Auto Show

Seasonal influenza monitoring Situational awareness

Sentinel Provider Surveillance for Influenza-Like Illness (ILI) Michigan component of the CDC U.S. Outpatient

Influenza-like Illness Surveillance Network Influenza sentinel reports provide data on over

12,000 outpatient office visits per week and are an important part of influenza surveillance in Michigan

Contact Stefanie DeVita at 517-335-9104 or DevitaS1@michigan.gov for more information

Michigan Influenza Sentinel Hospital Network MDCH is working to establish a network of sentinel

hospitals that report influenza-associated hospitalizations

Hospitals that agree to participate would be asked to provide: Weekly report consisting of the number of influenza-

associated hospitalizations in each of five age categories Total number of admissions during that time frame Contact:

Sally Bidol (bidols@michigan.gov)

Surveillance for Healthcare-Associated and Resistant Pathogens (SHARP) Unit

Objectives of the SHARP Unit: Coordinate activities related to HAI surveillance and

prevention in Michigan Improve surveillance and detection of antimicrobial-

resistant pathogens and HAIs Identify and respond to disease outbreaks Use collected data to monitor trends Educate healthcare providers, state and

local public health partners, and the public on HAIs

SHARP Activities

Outbreak Response Surveillance and Reporting MDRO Prevention Initiatives Consulting/Education

Staphylococcus aureus

Clostridium difficileKlebsiella pneumoniae

The MDCH SHARP staff are available to offer our services and expertise in healthcare-associated outbreak investigations

MDCH can help facilities coordinate molecular testing with the MDCH Bureau of Laboratories to identify genetic-relatedness between patient isolates (at no cost)

Outbreak Response

Acinetobacter baumannii

Surveillance and Reporting

Vancomycin-Intermediate Staphylococcus aureus (VISA) and Vancomycin-Resistant Staphylococcus aureus (VRSA) are required to be reported according to the communicable disease rules

Unusual occurrences and outbreaks of HAIs are also mandated by law to be reported

However, individual HAIs (like a CLABSI), are not required to be reported to state or local health departments

33 states have laws requiring HAIs to be reported to state health departments, the majority of which publically release hospital HAI rates (http://www.jstor.org/stable/10.1086/663204)

Surveillance and Reportingwww.michigan.gov/hai

In Michigan, hospitals can voluntarily report HAIs to MDCH SHARP via the National Healthcare Safety Network (NHSN)

NHSN is a web-based surveillance program designed by CDC: Uses standardized HAI surveillance definitions Users can enter and analyze HAI data

The data sent to SHARP from Michigan hospitals are de-identified and the numbers aggregated for the purposes of producing state-wide HAI surveillance reports

HAIs tracked by MDCH SHARP surveillance:• Central Line-Associated Blood Stream Infection (CLABSI)• Surgical Site Infection (SSI)• Catheter-Associated Urinary Tract Infection (CAUTI)• Ventilator-Associated Pneumonia (VAP)• Clostridium difficile LabID surveillance• MRSA LabID surveillance• Antimicrobial resistance in select pathogens

Subclavian central venous line

Mechanical ventilator

Surgical incision showing signs of infection

Clostridium difficile

Foley catheter insertion kit

CLABSI

CDI LabID

MRSA LabID

HAI Surveillance

SHARP Surveillance Currently there are 97 Michigan hospitals sharing HAI data with SHARP, with all 97 hospitals releasing their data to the

Michigan Health and Hospital Association MHA Keystone Center, and 14 hospitals releasing their NICU data to the Vermont Oxford Network (updated 9-17-14).

2009 2010 Q1

2010 Q2

2010 Q3

2010 Q4

2011 Q1

2011 Q2

2011 Q3

2011 Q4

2012 Q1

2012 Q2

2012 Q3

2012 Q4

2013 Q1

2013 Q2

2013 Q3

2013 Q4

2014 Q1

2014 Q2

2014 Q3

Number of Acute Care Hospitals that have Signed a Data Use Agreement with MDCH SHARP

Master Agreement MHA Data Release VON Data Release

SHARP Reports

SHARP releases state-wide HAI reports quarterly, semiannually, and annually which are posted at www.michigan.gov/hai All hospital data are de-identified and aggregated Individual hospital data is not made public

SHARP also compiles hospital specific HAI reports which are only shared with those individual hospitals

SHARP HAI Datawww.michigan.gov/hai

2011 Q1 2011 Q2 2011 Q3 2011 Q4 2012 Q1 2012 Q2 2012 Q3 2012 Q4 2013 Q1 2013 Q2 2013 Q3 2013 Q40

Michigan MRSA LabID Rates

MI MRSA LabID MI MRSA Bld LabID

2013 Q1 2013 Q2 2013 Q3 2013 Q40%

Inpatient MRSA LabID Onset Distribution

CO Bacteremia Community-Onset (CO) HO Bacteremia Healthcare Facility-Onset (HO)

2011 Q1 2011 Q2 2011 Q3 2011 Q4 2012 Q1 2012 Q2 2012 Q3 2012 Q4 2013 Q1 2013 Q2 2013 Q3 2013 Q40

Michigan C. diff LabID Rates

iff La

2013 Q1 2013 Q2 2013 Q3 2013 Q40%

Inpatient CDI LabID Onset Distribution

Community-Onset Community-Onset, Healthcare Facility-Associated Healthcare Facility-Onset

SHARP HAI Datawww.michigan.gov/hai Standardized Infection Ratios (SIR)

Type of Infection Number of Hospitals

Procedures Done Device Days or Patient Days

Observed1 Predicted2 MI SIR3 MI p-value4 MI 95% CI5

CAUTI6 87 N/A 100,676 DD 274 219.2497 1.250 0.0004 1.108, 1.404CLABSI7 84 N/A 91,900 DD 86 192.9266 0.446 <0.0001 0.359, 0.561CLABSI ICU8 84 N/A 82,973 DD 77 170.4866 0.452 <0.0001 0.359, 0.561CLABSI NICU9 17 N/A 8,927 9 22.4400 0.401 0.0016 0.196, 0.736SSI10 81 13,514 N/A 239 309.5430 0.772↓ <0.0001 0.679, 0.875SSI COLO11 80 2400 N/A 117 143.9260 0.813↓ 0.0237 0.675, 0.971SSI HYST12 74 2162 N/A 48 40.7430 1.178 0.2595 0.878, 1.549MRSA Bac LabID13 85 N/A 1,189,685 PD 79 89.4367 0.883 0.2685 0.704, 1.095

C.diff LabID14 85 N/A 1,109,626 PD 834 926.2102 0.900 0.0022 0.841, 0.963

Michigan Data US Data

1Observed: Number of infections (CAUTI, CLABSIs or SSIs) reported during the time frame.2Predicted: The number of CAUTIs or CLABSIs predicted based on the type of hospital unit(s) under surveillance, or the number of SSIs predicted based upon 2009 national SSI rates by procedure type. 3SIR: Standardized Infection Ratio: Ratio of observed events compared to the number of predicted events, accounting for unit type or procedure. An SIR of 1 can be interpreted as having the same number of events that were predicted. An SIR that is between 0 and 1 represents fewer events than predicted, while an SIR of greater than 1 represents more events than expected. 4P-value: An SIR p-value of <0.05 is considered significantly different than expected. It can be either significantly worse (if the SIR is greater than 1 and the p-value is <0.05) or significantly better (if the SIR is less than 1 and the p-value is <0.05). 595% CI: 95% confidence interval around the SIR estimate. A 95% CI indicates that 95% of the time, the actual SIR will fall within this interval.6CAUTI: Catheter-Associated Urinary Tract Infection. CAUTIs are defined using symptomatic urinary tract infection (SUTI) criteria or Asymptomatic Bacteremic UTI (ABUTI) criteria. UTIs must be catheter-associated (i.e. patient had an indwelling urinary catheter at the time of or within 48 hours before onset of the event).7CLABSI: Central Line-Associated Blood Stream Infection. CLABSIs are laboratory-confirmed bloodstream infections (LCBI) that are not secondary to a community-acquired infection, or an HAI meeting CDC/NHSN criteria at another body site. BSIs must be central line associated (i.e., a central line or umbilical catheter was in place at the time of, or within 48 hours before, onset of the event).8CLABSI ICU: CLABSIs from ICU locations only9CLABSI NICU: CLABSIs from NICU locations only 10SSI: Surgical Site Infection. Includes any superficial incisional, deep incisional, or organ/space SSI. 11SSI COLO: Inpatient Colon surgeries 12SSI HYST: Inpatient Abdominal Hysterectomies 13MRSA Bacteremia LabID: Inpatient facility-wide MRSA bacteremia Laboratory-identified Event14Clostridium difficile LabID: Inpatient facility-wide Clostridium difficile Laboratory-identified Event↓ or Indicates statistically significantly lower or higher than previous quarter (respectively). Green Text or Red Text indicates significantly fewer or greater infections than expected .

2013 Q1* 2013 Q2* 2013 Q3* 2013 Q4*0

CAUTI Standardized Infection Ratios

Time Period

*=Significantly different from 1**=Significantly different from previous month

2013 Q1* 2013 Q2* 2013 Q3* 2013 Q4*-1.66533453693773E-16

CLABSI Standardized Infection Ratios

Time Period

2013 Q1* 2013 Q2** 2013 Q3 2013 Q4* **0

SSI Standardized Infection Ratios

Time Period

2013 Q1* 2013 Q2 2013 Q3 2013 Q4* **0

SSI COLO Standardized Infection Ratios

Time Period

2013 Q1 2013 Q2 2013 Q3 2013 Q40

SSI HYST Standardized Infection Ratios

Time Period

2013 Q1* 2013 Q2 2013 Q3 2013 Q40

MRSA Bac LabID SIRs

Time Period

2013 Q1* 2013 Q2*,** 2013 Q3* 2013 Q4*0

CDI LabID SIR

Time Period

MDRO Prevention Initiatives SHARP also has started two prevention initiatives aimed to

reduce the incidence and prevalence of MDROs in healthcare facilities in Michigan:

Clostridium difficile (CDI) surveillance and prevention initiative

Carbapenem-Resistant Enterobacteriaceae (CRE) surveillance and prevention initiative

Enterobacter cloacaeCitrobacter freundii Klebsiella pneumoniaeEscherichia coli

SHARP recruited facilities into the two initiatives

Both will measure the baseline prevalence and incidence of their respective organisms

Then there will be a period of measurement during which facilities are encouraged to begin implementing infection prevention interventions to reduce the transmission of these organisms

MDRO Prevention Initiatives

Planning Stage Baseline Stage Intervention Stage

Education and Consulting

Another primary focus of the SHARP unit is increasing awareness of HAIs, answering FAQs, and disseminating best-practice and evidence-based recommendations and guidelines

Examples of entities/persons that ask for our guidance: IPs

Local HDs Healthcare workers Schools

Gyms Correctional Facilities Students Public

Special Collaboration

SHARP collaborates with the MDCH Viral Hepatitis Unit: Investigating potentially healthcare-related viral

hepatitis infections (e.g. David Kwiatkowski) Works jointly on injection safety-related educational

campaigns (e.g. One and Only campaign) Contact information

(517)335-8165 www.michigan.gov/hivstd (click on the hepatitis link)

SHARP Unit Contacts(517) 335-8165www.michigan.gov/hai

o Jennie Finks, DVM, MVPH – HAI Coordinator and Unit Managerfinksj@michigan.gov

o Jennifer Beggs, MPH – Infectious Disease and Preparedness Epidemiologistbeggsj@michigan.gov

o Allison Murad, MPH – National Healthcare Safety Network (NHSN) Epidemiologist murada@michigan.gov

o Noreen Mollon, MS – Infection Prevention Consultantmollonn@michigan.gov

o Gail Denkins, RN – CDI Prevention Initiative Coordinatordenkinsg@michigan.gov

o Brenda Brennan, MSPH – CRE Prevention Initiative Coordinatorbrennanb@michigan.gov

Other MDCH Entities that Interact with IPs

Bureau of Labs (BOL) Office of Public Health Preparedness (OPHP) Licensing and Regulatory Affairs (LARA)

Michigan Occupational Safety and Health Administration (MIOSHA)

Healthcare Facility Engineering Michigan Care Improvement Registry (MCIR)

MDCH Bureau of Labs (BOL)

Main Phone: (517) 335-8063

Tours available quarterly, to schedule call (517) 335-9654

MDCH BOL Testing www.michigan.gov/mdchlab

List of Tests performedBy MDCH BOL

Forms required toRequest testing

Regional Reference Labs

Report Suspected Bioterrorism: Lansing: (517) 335-8063 Kalamazoo: (269) 373-5360 Grand Rapids: (616) 632-7210 Saginaw: (989) 758-3825 Oakland County: (248) 858-1310

Office of Public Health Preparedness (OPHP)

Purpose of OPHP is to establish strategic leadership, direction, assessment, and coordination of activities to ensure statewide readiness and interagency collaboration to respond to public health emergencies.

Michigan Emergency Management System

President of US Governor

Michigan State PoliceState Director of Emergency Management

DHS / FEMA Emergency ManagementDivision (EMD) MDCH

EMD District Coordinators

Local Health Departments

Local Emergency Management

Health Preparedness Regions

All emergencies and disasters are local

www.fema.gov/nims

Emergency Preparedness Collaboration

Utilities

Transportation

EmergencyManagement

Fire &Rescue

PublicHealth

HospitalsEMS

LawEnforcement

Public Works

Industry /Private Sector

www.fema.gov/nims

Emergency Preparedness Training MI-TRAIN (http://mi.train.org)

Emergency Preparedness Communication

Statewide communication capabilities:

Michigan Statewide Comprehensive Interoperable Communication Plan

Public Health Safety Communication System (800Mhz radios)

Health Alert Network (HAN)

MI HAN (https://michiganhan.org)

Emergency Preparedness Regions

8 Michigan Emergency Preparedness Regions: Modeled after State Police

Regions Encompass 45 Local HD

Emergency Preparedness Centers

Each Region contains: Medical Director Hospital Bioterrorism

Coordinator Epidemiologist

Strategic National Stockpile

Able to distribute large quantities of pharmaceuticals and medical supplies during an emergency

Local HDs and hospitals are prepared to receive MISNS assets

MISNS is capable of delivering assets via ground or air transport

OPHP Contacts

Linda Scott – Hospital Preparedness Coordinator (517) 335-8150 scottl12@michigan.gov

Mary Macqueen – Public Health Preparedness Coordinator (517) 335-8150 macqueenm@michigan.gov

MIOSHA – Michigan Occupational Safety and Health Administration

MIOSHA operates under Licensing and Regulatory Affairs (LARA)

For healthcare inquiries contact MSIPC’s MIOSHA liaison Eric Zaban: (517) 882-1022

For general consultation and/or training contact: (517) 322-1809

www.michigan.gov/miosha

LARA- Health Facilities Engineering

Provide enforcement and interpretation of the minimum healthcare facility design standards to reduce the risk of transmission

Kasra Zarbinian (517) 241-3422

www.michigan.gov/hfes

Michigan Care Improvement Registry (MCIR) www.mcir.org

Web-based system created in 1998to collect children’s immunizationinformation

Expanded in 2006 to include adults (lifespan registry) Consolidates immunization information from

multiple data sources and provides immediate, real-time, patient immunization history

Assists with all-hazard preparedness by tracking vaccines and medications during a public health emergency

MCIR Activity

9 million records

Over 83 million shot records

29,000 registered users

5,500 active provider sites

The Benefits of MCIR

High healthcare provider participation (90%) Reports indicate ‘pockets of need’ Flexibility, allowing linkages with other public

health systems Types of information available in MCIR: Patient Immunization status at time of visit

Reminders/recall letters Coverage level reports High risk influenza Newborn screening Lead results Early hearing detection and intervention (EHDI)

Immunization Information

Annual Fall Conferences – www.michigan.gov/immunize

AIM Kits – www.aimtoolkit.org

Influenza information “FluBytes”– www.michigan.gov/flu

Quarterly Newsletters – send an e-mail with SUBSCRIBE in the subject line to franklinr@michigan.gov

Beatrice Salada, State MCIR Coordinator saladab@michigan.gov www.mcir.org

Thanks!

Questions or comments?

Joyce Lai (734) 727-7204 LaiJ@michigan.gov

Noreen Mollon (517) 335-6582 MollonN@michigan.gov

MSIPC Fundamentals: Interaction between IPs and Local and State Health Departments Joyce Lai, MPH–...

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