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Monday, November 11, 2019  

Kaiser Permanente Colorado a model for bioterror surveillancePublished 10/21/2002

by Dean Anderson

Is it the flu or is it anthrax? That’s a question those who monitor health symptoms nationwide could be asking themselves in the event of a possible terrorist attack.

But with the help of Kaiser Permanente Colorado, national health officials will be able to answer that question in a matter of hours rather than a matter of weeks.

Kaiser Permanente Colorado currently operates a surveillance program to track the spread of influenza across the state. The program will now be expanded to monitor symptoms that could be associated with a bioterrorism attack.

The organization is assisting with national homeland security efforts by teaming with a consortium of health care agencies to provide real-time data of health symptoms in the state.

The Centers for Disease Control and Prevention has awarded a $1.2 million grant to the consortium to develop a warning system that will analyze patient records for clusters of symptoms that could be associated with bioterror agents.

Under the surveillance system, daily checks will be made in Denver, as well as Minneapolis and Boston. Researchers will be looking for spikes in certain types of symptoms across a broad range of patient types.

Given that it is flu season, researchers conceded that they would be seeing a range of symptoms that also appear when people are exposed to substances such as anthrax.

It is intended for the system to become a national model for identifying bioterrorism, allowing medical personnel to alert and treat potential threats.

The system is computer based. Every day electronic medical records will be scanned to see if any symptoms are abnormally high in patients. If symptoms do appear elevated, the system can scan by ZIP code, age, gender, and workplace of patients to identify possible outbreaks.

Kaiser Permanente Clinical Research Investigator Dr. Debra Ritzwoller said if researchers notice any abnormalities a doctor will be brought in to analyze the data and make a determination whether the Centers for Disease Control or other agencies should be notified.

The system saves time in analyzing data, which could ultimately save lives. With the infrastructure in place, symptoms can now be brought into clearer focus on a larger scale.

"You could have a patient hitting each of those (Denver clinics) and no one in those offices would see this as an aberration from normal," Ritzwoller said. "Anyone that’s ultimately analyzing is through claims-based data. They wouldn’t see that for 60 to 90 days. We can do this within 24 hours.

"I think it’s important to have it in place," Ritzwoller continued. "But I guess I’m an optimist. I don’t really honestly believe this is going to happen in the near and immediate future. Many, many (health) plans are investing in infrastructure. It’s imperative that plans like us are able to do this population-based type of surveillance.

"We need these kinds of things in place."

Ritzwoller said the consortium will be working with an expert panel from the CDC that will recommend diagnosis that will be scanned for.

Ritzwoller said the plan is also in complete compliance with the new HIPAA regulations that go into affect next April. No transfer of patient level data will take place.

"The big question I’ve had is ‘Why Denver. Do we think the next attack will be here,’" Ritzwoller said. "It’s the demonstration site because we’re one of the three plans that have the capability. We hope to expand this system to our other partner health plans."

Kaiser Permanente insures about one in every six households in Denver.

The national consortium includes Kaiser Permanente, Harvard Pilgrim Health Care (with Harvard Vanguard Medical Associates), Optum, HealthPartners Research Foundation and the American Association of Health Plans.

Kaiser Permanente is a non-profit organization that is the largest health care provide in Colorado. The organization was recently named one of the top 15 health care organizations in the country. The clinical research department includes 70 investigators, including six physicians who see patients in the Denver/Boulder medical offices. The unit receives grants from federal agencies like the National Institutes of Health.

Last week researchers at the Heritage Foundation, a think-tank operation in Washington D.C., released a computer model that estimated the effects an actual anthrax attack would have on Denver.

Using computer-modeling software from the Department of Defense, the group simulated a terrorist attack from a small private airplane that released 440 pounds of military-grade powdered anthrax over the city. Over 24 hours the spores would blow over 100 miles to the east and expose more than 800,000.

It was estimated that between 450,000 and 590,000 people would die.

The model was purely theoretical and did not allow for people to leave the area or anyone to seek medical treatment, which would have greatly reduced those numbers.

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