# Presentation: 728468

## Colorado’s Health Emergency Line for the Public (COHELP): Addressing Surge Capacity through Information Exchange

**Gregory M. Bogdan, Ph.D. **
- Research Director
- Rocky Mountain Poison and Drug Center
- Denver Health
- Denver, CO

## Public Risk Perception

**Hotline Contacts**
**(% population)**

**Public Risk Perception**

- Event specifics (bioterrorism, child-targeted, new emerging disease) will effect the amount of public concern and numbers of people having information or others needs.

## Challenge for Preparedness

- 2004 Redefining Readiness Project*
- 60% of public would not heed official instructions to get vaccinated during smallpox outbreak
- 40% of public would not heed official instructions to shelter in place during a dirty bomb incident
- *	R. Lasker, Center for the Advancement of Collaborative Strategies in Health (www. cacsh.org)

## Public Needs Information on..... 

- General topic/event information
- Public health messages
- Personal and family protection
- State/local health dept guidelines
- Points of contact for referral agencies
- Health decision-support and evaluation

## “Natural Fits” 

- Poison control centers
- Nurse advice lines
- Drug information centers
- Public health agencies

## How a Medical Call Center Works

**Hospitals & Healthcare Facilities**

**M**
**C**
**C**

**General **
**Public**

**Health**
**Professionals**

**Local & State Public Health Agencies**

- Voice
- Fax
- Video
- Email
- Web

- patient surges reduced by providing information and triage through multiple paths

**How a Medical Call Center Works**

- Fax Email
- Voice Web
- Video

## COHELP Objectives

- Develop a standardized and prepared response to public health events
- Provide consistent, accurate information
- Collect and maintain structured data to better characterize events and responses
- Develop capability and capacity to adapt to emerging public health emergencies

## COHELP Service Users

**COHELP**
**877-462-2911**

**Health**
**Agencies**

**Public**

**Hospitals**
** ****& EDs**

**Healthcare**
**Providers**

**Clinics**

**Schools**

## Referral Procedures

**Referral Procedures**

**COHELP**

** ****Local Health**
**Agencies**

**Caller**

**Poison**
**Center**

**Healthcare**
**Providers**

**CDPHE**

**Nurse**
**Line**

## Provides 1-on-1 Information

- _Toronto – SARS outbreak, Mar to Jun 2003_
- Total Calls = >300,000
- 	Peak Daily Calls = 47,567
- 	Deaths: 44		Cases: 438
- _COHELP – Two Outbreaks, Jul to Dec 2003_
- Total Calls = 36,170
- 	West Nile Virus (WNV) Calls = 12,555
- 	Deaths: 47		Cases: 2,543
- 	Influenza/Pneumonia   Calls = 23,615
- 	Deaths: 809	Cases: 11,427

## Reduces Hospital Surge

- United States Poison Control Centers
- Of 2.4 million contacts about potential toxic exposures, 1.8 million (75%) were managed outside of health care facilities
- Denver Health Nurse Line
- Manages 40% of callers at home
- 70% callers changed plans
- 16% planned home care but 47% chose it after calling

## Other Benefits

- Standardized, accurate information delivery
- Call center infrastructure/technology
- Adaptability
- Integrated Web sites (_www.cohelp.us_)
- Trained information providers
- Defined referral procedures
- Structured data collection and reporting

## Lessons Learned

- Public health events will continue to occur and will require a response
- Need structured, coordinated systems to respond to these events that are:
- Cost-effective
- Efficient
- Accurate
- Consistent
- Adaptable

## More Lessons Learned

- Call volume driven by event specifics and media attention
- Easy to adapt messages to meet evolving public health and public needs
- Surveillance
- Ongoing surveillance signals
- call volumes, topics requested, collected data
- Sentinel event system
- can identify new health concerns

## For More Information

- “Health Emergency Assistance Line and Triage Hub (HEALTH) Model” report on AHRQ Web site by end of year
- _www.ahrq.gov_
- HEALTH Contact Center Assessment Tool on HSRNET or AHRQ Web sites
- _www.hsrnet.net/ahrq/surgecapacity/event3/resource.htm_ (available now)
- _www.ahrq.gov_ (available by end of year)