Systemic Failure and Health Catastrophe: The Final Report from the Flint Water Advisory Task Force

"The Flint water crisis is a story of government failure, intransigence, unpreparedness, delay, inaction, and environmental injustice. The Michigan Department of Environmental Quality (MDEQ) failed in its fundamental responsibility to effectively enforce drinking water regulations.

The Michigan Department of Health and Human Services (MDHHS) failed to adequately and promptly act to protect public health. Both agencies, but principally the MDEQ, stubbornly worked to discredit and dismiss others’ attempts to bring the issues of unsafe water, lead contamination, and increased cases of Legionellosis (Legionnaires’ disease) to light."

Matthew M Davis, MD, MAPP, Chris Kolb, Lawrence Reynolds, MD, Eric Rothstein, CPA, Ken Sikkema, Executive Summary Statement, Flint Water Advisory Task Force Final Report, 2016, p. 5

From the Michigan Department of Environmental Quality, to the Michigan Department of Health and Human Services and all the way to the Governor’s office, there are more than enough culpable participants in the failure to protect the health of Flint’s children. According to pediatrician Mona Hanna-Attisha, MD, who first alerted government officials of concerns for her patients, the lead-contaminated water could impact as many as 8000 children.¹

The unimaginable happened. The repercussions are still unknown. But for persons engaged in disease surveillance, public health, health informatics and policy-making, the Final Report is a "must-read" to gain understanding of how separate individual and agency failures compounded to allow a catastrophic outcome. We recommend all practitioners review the report.

1. Abby Goodnough, Flint Weighs Scope of Harm to Children Caused by Lead in Water, nytimes.com, January 29, 2016

 

Training for Surveillance of Heart Disease, Stroke and Other Chronic Diseases in State Health Departments

Please see the message below regarding the National Association of Chronic Disease Directors Geographic Information Systems (GIS) Training for Surveillance of Heart Disease, Stroke and Other Chronic Diseases in State Health Departments (SHDs).

Eligible State Health Department Applicants:

State health departments from any of the 50 US states and the District of Columbia are eligible to apply, with the exception of Arkansas, California, Colorado, Florida, Kansas, Louisiana, Idaho, Indiana, Iowa, Maine, Massachusetts, Michigan, Minnesota, Mississippi, Montana, Nebraska, New Hampshire, New Mexico, New York, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Texas, Utah, Vermont, and Wisconsin. These states are excluded because they have already participated in the GIS Training for Surveillance of Heart Disease, Stroke and Other Chronic Diseases.

State Applications are due January 9, 2015; notification of award by February 16, 2015.

You can find the application attached here:

http://www.chronicdisease.org/?page=GISNov2014Announce

ISDS Works to Improve Inter-Jurisdictional Data Sharing

Sharing public health data and practices among public health authorities enhances local and regional situational awareness and epidemiological capacities. Although technology is a critical medium for data sharing, positive working relationships and trust must come first.

To promote inter-jurisdictional syndromic surveillance data sharing and facilitate skill development among practitioners, a *Regional Data Sharing Workshop* was developed and piloted by ISDS. A non-formal education approach, which stresses self-directed learning and peer-to-peer problem solving, was used to design and plan Workshop activities. The effect of the Workshop on data sharing and participant skills was assessed using quantitative and qualitative methods.

Thirteen surveillance professionals from seven state and local public health agencies, mainly from the U.S. Department of Health and Human Service (HHS) Region 5, planned and participated in the 2-day Workshop. The participants selected data sharing for heat-related illness surveillance using BioSense 2.0 as a use case to focus Workshop activities and discussions.

Assessment findings indicated that Workshop participation increased syndromic surveillance data sharing among Region 5 jurisdictions and, furthermore, built new knowledge and skills that advanced surveillance competencies and performance. Survey data showed that 13 new data sharing partnerships are underway or planned as a result of the Workshop. Comparisons of participant responses on a syndromic surveillance skills inventory before and after workshop participation indicated positive gains in skills for:

• Data processing;
• Data analysis and interpretation;
• Communicating syndromic surveillance information;
• Data quality assurance; and
• Establishing data sharing partnerships.

The Regional Data Sharing Workshop is an effective and efficient means for promoting syndromic surveillance data sharing and skill development. With the opportunity to collaborate and discuss data sharing in-person for a specific, regionally relevant purpose, participants strengthened inter-jurisdictional relationships, leading to more data sharing and improved skills that benefit syndromic surveillance work. These results present a strong case for repeating similar workshops in other HHS regions in order to build regional data sharing and to improve public health practice nationwide.

Request for Proposals: Pilot Project for Public Health Case Reporting Using C-CDA

National Association of County & City Health Officials (NACCHO)  along with the Council of State and Territorial Epidemiologists (CSTE) announce a funding opportunity for state and local health departments to participate in a pilot project for the implementation of public health case reporting from electronic health records (EHR) to public health agencies using Consolidated Clinical Data Architecture (C-CDA).

CDC and the Office of the National Coordinator (ONC) Standards and Interoperability (S&I) Framework, Public Health Reporting Initiative (PHRI) are working to reduce the reporting burden on healthcare providers and public health agencies by harmonizing data elements across public health domains and developing a standardized data structure through the implementation of C-CDA. The PHRI has produced two work products: a set of harmonized data elements and a C-CDA library of templates for several public health conditions, which will be tested and demonstrated at pilot site(s). This pilot will help determine if and how the PHRI products can serve as resources to facilitate implementation of public health case reporting from clinical providers to public health agencies.  

If interested, please submit an application to Monica Huang mhuang@cste.org at the CSTE National Office by Friday, March 15, 2013.

Please click here for additional background information and instructions (pdf) »