Systems on front line against SARS
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When the Centers for Disease Control and Prevention opened an emergency operations center in Atlanta in March, few in America had heard of Severe Acute Respiratory Syndrome.
When the Centers for Disease Control and Prevention opened an emergency operations center in Atlanta in March, few in America had heard of Severe Acute Respiratory Syndrome.Only a few months later, SARS is a household word, but it has not spread across the United States. The emergency center has used information systems to contain the disease, said the co-director of the IT team working on the SARS outbreak.'The Emergency Operations Center has provided us with a very effective technology infrastructure for managing SARS activities,' said Dr. Dale Nordenberg, associate director for informatics and CIO of CDC's National Center for Infectious Disease.'We dispatch people, keep track of who's dispatched where and can actually see maps of where people are on our teams,' Nordenberg said. 'They are all projected up on a wall where we can simultaneously monitor news from multiple stations and look at [geographic information system] mapping of things of interest, be it where our people are being dispatched internationally or domestically, as well as where SARS cases are being identified.'Using the latest bioinformatics technology, CDC scientists determined the genetic structure of the SARS virus within less than two weeks in April. In contrast, Nordenberg said, 'the AIDS virus took us eight or 10 years, I think.' A 40-node parallel-processing cluster supported the 'blast analysis' that produced the genetic map.Some of the most effective technology is hardly new. At the top of Nordenberg's list of the most valuable technologies is the Web. 'I don't believe we would be in as good a situation as we are today, were it not for the communications infrastructure the Web provides,' he said.The SARS team is using intranets and secure Web portals for two-way communication with almost 500 CDC staff members assigned to the SARS outbreak and their counterparts worldwide. The systems create a climate of sharing and trust, Nordenberg said.When the outbreak began in China, CDC formed a SARS team immediately. It grew along with concern about the disease. At least 10 teams were assigned to handle the spread of the disease in hospitals, air travel's role, quarantines and transmission from a single Hong Kong hotel.Simultaneously, Nordenberg and his colleagues began building the systems that would manage the effort and support the teams' activities. It was a race to create a set of systems that could respond to as-yet undefined needs. When the outbreak began, the nature of the illness was not understood.Nordenberg said the data on-ramp and off-ramp were built simultaneously, so that the information could be analyzed just as it was being captured. A data warehouse based on software from SAS Institute Inc. of Cary, N.C., was a key component. One important tactic was posting good documentation'data dictionaries, codes and user instructions'for users to consult from the start.'The challenge was to rapidly ramp up this integrated information infrastructure so that [it linked] each one of these diverse but related activities: the transmission studies; the quarantine studies; and the information management challenges of receiving specimens domestically and internationally, and linking them up with the epidemiologic data that's coming in,' Nordenberg said.The SARS IT team included specialists from throughout CDC, plus a staff of contractors who pulled together to get the systems up quickly. 'It's been an interesting challenge to integrate those folks,' he said.
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Dale Nordenberg, right, and Dan Reed plot CDC's IT strategy at the new Emergency Operations Center.
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