Viral Vigilance Texas Health Alert Network

by David Orenstein free-lance writer

Many people—particularly parents and pediatricians—probably remember the discovery of a rabid sheep at the Children’s Animal Center at the Fossil Rim Wildlife Center near Glen Rose last summer. The case was unfortunate and worrisome, but it also was a high-profile example of why the Texas Department of State Health Services operates a Health Alert Network and continues to expand and improve it.

When an infectious disease, a food-borne illness, or other epidemiological situation arises, public health officials must get the word out quickly and reliably for two reasons: to warn physicians, hospital staffs, and emergency services personnel to look out for cases, and to collect medical and lab reports that will build up data on the problem and its progress.

“The HAN is important to use as a platform for doing those type of activities,” says Julie Rawlings, the state bioterrorism coordinator and deputy state epidemiologist. “It is a very robust platform. It is a very secure network.”

Many physicians are familiar with the HAN because they have received the phone calls, faxes, or emails that apprise them of emerging situations and solicit appropriate reports. Behind those messages, however, the 28-month-old HAN is a sophisticated system composed of a high-speed, secure network, a database of about 14,000 medical and public safety contacts, and a set of applications, such as disease reporting and surveillance software, that epidemiologists can use to analyze the spread and development of incidents.

In addition to enabling officials to broadcast alerts, the HAN provides a secure system for gathering and transmitting reports and other data. Encrypted transmissions and a firewall to protect the system’s server guarantee patient privacy and allow officials to analyze situations without worrying about setting off a premature public panic.

The system—the applications, data files, and database—is accessible through the Web (https://txhan.tdh.state.tx.us/) but access soon will be doubly protected: Authorized users must enter a user name and password, plus have a digital certificate to use critical applications, says Glen Bason, director of the HAN. This fall the state expects to begin rolling out a more flexible but more secure two-step authentication system that includes portable key fobs with unique certificates. Each user’s fob is linked in a specialized database to that user’s username and password. No one can access the system without combining the right fob with its matching log-in.

Once users are on the system, they will be able to do only what top officials have decided they are allowed to do. Some users might be able only to read information, while others will be authorized to send alerts, use the epidemiology applications, or examine lab and medical reports.

Right now the system can gather reports from labs electronically because major lab companies adhere to healthcare data standards such as HL7. Eventually, the HAN will be able to gather physician reports electronically, either by providing physician offices with electronic forms to complete or by extracting relevant data directly from patient electronic medical records after the office has granted such access.

Other improvements will enhance and expand communications among public health officials. At Dr Rawlings’ request, Mr Bason and his staff are implementing an enhanced chat room-like system that will allow epidemiologists around the state to talk to each other directly and securely. Over time, Dr Rawlings would also like to forge a link with health officials in Mexico.

Public health is a complex, high-stakes endeavor. The HAN gives officials and physicians the tools they need to find those germs in sheep’s clothing.

The author of this monthly column, David Orenstein, is a technology and business writer in Silicon Valley. To learn more about a technology topic in Computing Care, e-mail him at davealli@comcast.net.