"E-health systems, including the federal department's Health Alert Network and website, need to be further developed and exercised," the report says. "A nationally agreed framework for pandemic influenza surveillance should be underpinned by operational plans and improved ICT."
While the department received $10million in 2004-05 to build a secure information-sharing network, upgrade an existing disease surveillance system and introduce a web-based outbreak reporting system, little seems to have been achieved. The new Health Alert Network failed under test conditions, so users resorted to normal email systems.
Specific problems included unacceptable delays in distributing alerts, alerts not indicating the priority of the content, and the system not allowing multiple addressing.
Problems also struck the web-based management system, NetEpi, used for outbreak reporting.
NetEpi is only an interim system, but "there were criticisms and a lack of national consistency in its use, particularly in relation to data entry and field formats", the report says.
The department's exercise website also performed poorly, hindering communication and creating "information vacuums at critical points".
Meanwhile, the report says, an integrated disease surveillance system is "urgently needed".
Domestic disease surveillance is co-ordinated by the department through the Communicable Diseases Network Australia.
Although the department began building a Biosecurity Surveillance System in 2005, exercise participants found the information supplied was late, out of date and irrelevant.
The latest federal budget states the department will "further develop the national BSS" and introduce a new version of the National Notifiable Disease Surveillance System data warehouse for improved data storage and handling.
The department had not responded by late yesterday to questions put to it last Friday.
Opposition health spokeswoman Nicola Roxon said there had been a series of reports on Australia's readiness for a health emergency, "and these have found us wanting in a number of areas including IT".
"We need a comprehensive review of the preparedness of the health system to deal with a flu pandemic or bio-terrorist attack," Ms Roxon said.
In April, a report by the Australian Strategic Policy Institute warned that the stretched healthcare system would be overwhelmed by mass casualties.
Co-author Anthony Bergin said robust and standard communications networked between all emergency services should be in place: "These systems must have built-in redundancy that allows uninterrupted emergency communications in all conceivable contingencies. There needs to be a mechanism to limit general public access to mobile phone networks in order to guarantee communications between emergency services personnel in the event of a disaster."
Australian Homeland Security Research Centre executive director Athol Yates said there was a need for a permanently established health national incident response team. "Most of the people involved in the trial were policy people, not people with crisis experience. Government policy work is usually pretty slow, and everything goes up the chain for approval.
"During an incident, you need to quickly build situation awareness, and switch to a crisis response. We really need to build up these capabilities."
Mr Yates said there were many lessons to be learnt from the past. Tomorrow,the AHSRC will host a seminar for health planners and release a book called Western Isolation: The Perth Experience of the 1918-1919 Influenza Pandemic.
"It's surprising, but the preparation and response measures employed 100 years ago are totally relevant to what's happening today," he said. "The fever clinics, or assessment centres, are a means of keeping influenza patients separate from mainstream hospitals where people are giving birth or being treated for a broken leg.
"The report says the exercise organisers vastly underestimated the amount of resources they'd need for those centres. It was the same scenario in 1918, when a fever clinic was established at Sydney's Randwick Racecourse: they built the infrastructure, but had no staff because they were all occupied elsewhere."
Mr Yates said he suspected containment would fail pretty quickly today for similar reasons. "Quarantine facilities were rapidly overwhelmed, and people were escaping because the facilities were so appalling."
He warned that authorities could not rely on support from other states. "Response teams will need to be physically based in each state, because with planes arriving from all destinations to all capitals, you could have simultaneous breakouts."
Autor(en)/Author(s): Karen Dearne
Quelle/Source: Australian IT, 12.06.2007
