"The anthrax attacks of 2001 revealed serious deficiencies in the way hospitals and public health organizations are equipped to assess the nature and scale of a biological or chemical threat and communicate critical public health information," said Craig Feied, M.D., director of the Institute for Medical Informatics at Washington Hospital Center, and co-principal investigator of this grant. "We have to look beyond traditional communication methods and learn to deploy new real-time clinical data repositories, innovative Internet technologies, bioinformatics, and geographic information systems that will drastically improve secure information sharing, with the ultimate goal of better managing future health crises."
Seong K. Mun, Ph.D., professor of radiology and director of the Imaging Science and Information Systems (ISIS) Center at Georgetown University Medical Center is the principal investigator of this grant. Dr. Feied will lead the MedStar team along with co-site investigator Mark Smith, M.D., chair of the Department of Emergency Medicine at MedStar Health's Washington Hospital Center and Georgetown University Hospital.
This project, known as "Project Sentinel Collabortory" is built around the "InSight" real-time data repository currently in use at several MedStar hospitals. InSight contains one of the largest and fastest on-line clinical information databases in the world, and will serve as the data core for a new type of surveillance system linking several area hospitals with the District of Columbia Department of Health. The system will include de-identified medical information derived from inpatient and outpatient visits, together with external data related to weather, transportation, communication, animal health, product purchases, absenteeism, and other relevant information.
Experts suspect that in the case of a biological attack or a natural disease epidemic, hospitals could be easily overwhelmed by concerned people, bringing about gridlock and making it difficult to assess the extent of the situation, which could contribute to spiraling public fear.
Under this new research effort, the emergency departments at Georgetown University Hospital and Washington Hospital Center will develop a comprehensive set of software and Internet applications and new communication tools that will instantaneously link the two emergency rooms, the D.C. Department of Health, and select private medical practices. This will allow for an immediate compilation and analysis of their respective clinical, public health, and surveillance data, and for patient symptoms and environmental factors to be rapidly analyzed across the emergency rooms. With these tools in place, detection of an outbreak or an attack and its scope can be quickly assessed.
In building the real-time capability to share with the D.C. Department of Health, the systems will greatly improve the speed with which a threat can be assessed and communicated to the public. Without such a system, physicians and public health officers have been frustrated by their inability to share information electronically and to communicate effectively with regional and national authorities.
"This partnership between Georgetown University and MedStar Health leverages the unique strengths of the two institutions," said Dr. Smith. "Georgetown brings its expertise in research, previous work in biodefense, and grid computing and Internet 2. MedStar Health brings its Insight system and the clinical excellence of both Washington Hospital Center and Georgetown University Hospital."
Doctors at the Washington Hospital Center--the busiest emergency department in the nation's capital--were able to accurately track and manage the hundreds of patients presenting with possible anthrax symptoms during the 2001 attacks "The recent anthrax attacks showed us that even when extensive data was available, as it was at WHC, clinical care and public health activities were impeded by a lack of infrastructure and tools that let us communicate, consultant, and collaborate," said Dr. Feied. "A medical collaboratory built around a real-time clinical dataset will address these issues in an innovative way and substantially inform future efforts to enhance homeland security in an age of emerging illness and bioterrorism."
In addition to the threat of bioterror, diseases such as West Nile Virus and seasonal outbreaks of influenza are also public health threats. The new communications tools developed under this grant will have potential to track and detect the onset and follow the course of these and other epidemics. "We believe proper use of this rich dataset could allow for the detection of the first case of West Nile Virus in humans, which is clearly a concern for the entire DC metropolitan area," said Dr. Mun. "By creating this advanced surveillance system, we are contributing an important new service for improving the public's health."
Patient data will be shared between key organizations in full compliance with the newly enacted Health Insurance Portability and Accountability Act (HIPAA) laws. Georgetown's ISIS Center recently helped the Department of Defense convert its entire medical research and clinical operations into HIPAA-compliant status; they will employ similar tools to ensure that only authorized people can access these shared data sets and that all patient privacy will be respected.
This National Library of Medicine grant represents the first federal grant made jointly to Georgetown University and MedStar Health, and is the third that Georgetown University (through ISIS) has received from NLM. The other two grants were for projects aimed at improving quality of and access to health care at reduced costs, using advanced information technology.
For more information on the ISIS Center at Georgetown University Medical Center, please go to http://www.imac.georgetown.edu/. For more information on MedStar Health, please visit http://www.medstarhealth.org.
Interviews with Dr. Mun or about the overall grant structure can be coordinated by Lindsey Spindle, 202-687-7707. For interviews with Drs. Smith and Feied, please contact Paula Faria at Washington Hospital Center, 202-877-7594.
Georgetown University Medical Center is an internationally recognized academic medical center with a three-part mission of research, teaching and patient care (through our partnership with MedStar Health). Our mission is carried out with a strong emphasis on public service and a dedication to the Catholic, Jesuit principle of cura personalis--or "care of the whole person." The Medical Center includes the School of Medicine and the School of Nursing and Health Studies, both nationally ranked, and the world renowned Lombardi Comprehensive Cancer Center.
MedStar Health is a not-for-profit, community-based healthcare organization comprised of 25 integrated businesses including seven major hospitals in the Baltimore/Washington area. The hospitals, which include both teaching and community facilities, are Georgetown University Hospital, Washington Hospital Center and National Rehabilitation Hospital in Washington, D.C., and Franklin Square Hospital Center, Good Samaritan Hospital, Harbor Hospital Center, and Union Memorial Hospital in Baltimore. MedStar Health is the third-largest employer in the region with 22,000 employees and 4,000 affiliated physicians.
In June 2000, Georgetown University Medical Center and MedStar Health, Inc. finalized a clinical partnership agreement under which MedStar Health owns and operates Georgetown University Hospital. Georgetown University continues to own and operate its School of Medicine, the School of Nursing and Health Studies, and the research and education missions of the Lombardi Comprehensive Cancer Center. These units continue to be known collectively as Georgetown University Medical Center.