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| S. Delisle(IIR 06-119) |
Early detection is critical for infectious disease outbreaks of public health importance. Disease surveillance can be potentially enhanced through automated monitoring of electronic medical records compared to manual case reporting systems |
To automate the use of data from VHA’s computerized patient record system (CPRS) to enhance outbreak detection by including illness progression and severity to reduce “noise” of common syndromes |
Clinical data was grouped by respiratory disease severity using diagnostic and procedures notes, laboratory results, and free text of clinical notes |
Automated surveillance for influenza should integrate information from prescriptions and free text clinical notes. Case detection with emergency medical records focusing on influenza-like cases with fever can reduce delay and workload to detect influenza epidemics |
| C. I. Kiefe(BTI 02-092) |
The VHA medical system can play an essential role following a biological terrorist attack or infectious outbreak due to its extensive record in disaster preparedness |
To develop and test web-based teaching modules to increase VHA clinicians’ knowledge about biological warfare agents |
Web-based educational intervention was tested at 15 VHA facilities via a randomized controlled trial with 332 participants |
The VHA program demonstrated higher anthrax, but not smallpox, post- training provider knowledge than the information offered on the CDC’s website |
| M. Sano(BTI 02-233) |
Limited efforts to prepare general public for a bioterrorism incident have been conducted |
To develop educational materials for veterans about bioterrorism; to provide coping mechanisms for getting though a bioterrorism incident; to evaluate methods for material delivery |
A Veterans’ Survey on Bio-Terrorism (VSOB) (the initial and a follow up) was mailed to 2923 veterans |
VSOB, the first instrument to evaluate veterans’ knowledge, attitudes, beliefs, anxiety and educational needs connected to bioterrorism, was developed |
| A. Dobalian(RRP 06-134) |
Existing research within and outside of VHA does not sufficiently address health issues for mentally ill and/or frail veterans during evacuations |
To understand evacuation and response in VHA nursing homes after Hurricanes Katrina and Rita |
Data were collected via 13 semi-structured interviews with organizational representatives at 4 VHA medical centers and two representatives at the regional level |
Administrators primarily relied on local resources, prior experience and local planning rather than on state and federal response systems in their response to the hurricanes. Despite significant difficulties during patient evacuation, VHA response was generally perceived as positive. Retaining staff and a viable organization during and after a disaster presented a difficulty. Respondents reported unaddressed preparedness needs even more than one year post-disaster |
| F. M. Weaver(RRP 06-135) |
Individuals with spinal cord injuries and disorders are at particular risk during disasters due to impaired mobility and special needs, such as power wheelchairs and ventilator dependency |
To use identified lessons learned from natural disasters that impacted veterans with spinal cord injuries and disorders (SCI&D) in developing a toolkit, which focuses on enhancing natural disaster preparedness for facilities caring for veterans with SCI&D |
Thirty interviews were conducted (16 with providers and 14 with veterans with SCI&D). Most interviewees had experienced at least one weather-related natural disaster |
Veterans with SCI were usually evacuated to unaffected areas or were admitted to SCI centers. Previous disaster experiences provided lessons to guide providers’ and veterans’ actions. Pre-established response plans served as useful starting points. Family and local agencies’ social support was essential for veterans to attain a sense of personal preparedness. The above information was used to develop tools for disaster preparedness. |
| B. Schmitt(IIR 02-080) |
VHA is particularly vulnerable to a postal attack directed at government facilities. Thus, it has an interest in identifying the most advantageous response to small and large-scale bioterrorist events |
To conduct a cost-effectiveness analysis comparing response strategies to a small and a large-scale anthrax attack |
A decision analytic model was used to compare 3 basic response strategies to a small scale anthrax attack. The optimal response to a mass inhalation anthrax attack was evaluated. Outcomes included costs, Quality-Adjusted Life Years, and incremental cost-effectiveness |
For the small-scale anthrax attack, the least costly strategy was administration of antibiotics post-attack; post-attack antibiotic and post-attack vaccination strategy was the most effective. Pre-attack vaccination was the least effective. Pre-attack vaccination was preferable to post-attack antibiotics alone when the probability of anthrax exposure was ≥16%. For the large-scale mass attack scenario, analysis is in progress |
