Software helps plan infectious illness treatment

In the face of a bioterrorism attack or even a major flu outbreak, state, county, and local health departments will be expected to act quickly to bring vaccinations and other medical care to all who need it. The speed at which health care facilities treat patients in such an event can be the difference between life and death for thousands or even millions of people.

Now, those agencies have help coming in the form of RealOpt, a software program created by a Georgia Tech professor. Based on a clinical model developed by the Centers for Disease Control and Prevention (CDC), Eva Lee, PhD, a professor of industrial and systems engineering at Georgia Tech, wrote the program to help health departments organize the most efficient plan for treating infectious illness, whether natural or a man-made outbreak.

The program was tested by county health departments in Georgia and North Carolina last fall and is to be made available free to health departments all over the country.

Officials say the program is a big step in preventing the spread of something like influenza or small pox. In the event of an outbreak or bioterror attack, they say, local health departments truly have only a matter of days to vaccinate or isolate just about every man, woman, and child in a city or metro area. And while the departments have plans in place, the RealOpt software program can give them a good indication of how their existing plan would perform in an actual outbreak, factoring in possible panic and even language barriers, and what changes could be made to make it run as smoothly as possible.

Ms. Lee tells State Health Watch that greatly improving a health department’s efficiency in such an emergency could mean the difference between vaccinating 20,000 people at one location and only being able to get to 10,000, thus greatly limiting or even preventing the disease’s ability to spread outside the affected area.

Until actually faced with an emergency, it may be hard for health departments to determine how many doctors and nurses will be needed, how long it will take for frightened citizens to come to a center, how long for them to complete required paperwork, and how infected patients can be separated from those who are still healthy.

Recognizing that local health departments needed guidance on what human resources would be required to treat the affected population, the CDC created a model to assist in the effort. Ms. Lee, who also is an associate professor at Emory University’s Winship Cancer Institute, assembled a Georgia Tech team to use the CDC model as a guide to build a more powerful program.

She tells State Health Watch that RealOpt can be used to prepare for a possible outbreak as well as for emergency reassignment of health care workers within a clinic and between clinics during an actual outbreak. By determining their preparedness, she says, health departments will have a thorough estimate of what resources and funds they will need to treat their communities before an actual outbreak occurs.

Many variables analyzed

The program takes many variables associated with an emergency health care facility’s treatment of a very large group of people and, through simulation and optimization, pinpoints the most efficient way to move patients through the facility.

Using the program, a health department can determine the most efficient facility layout, the number of health care professionals needed in various areas, the number of vaccinations needed, and the time it will take to treat patients.

Processing data in real time

In addition to being used as a planning tool, RealOpt also can be used to process data in real time during an emergency. Thus, as patient flows fluctuate, the program can direct reallocation of a facility’s resources in a fraction of a second, sending additional doctors or nurses where they are needed or more attendants to a paperwork processing area.

Ms. Lee says the real-time processing of her program is a significant advantage compared to commercial scheduling systems that are available and can take several hours to process inputs and generate a response. Run time for RealOpt is within a minute, she says. She describes it as "extraordinarily detailed" in the many factors it considers when optimizing a patient flow pattern.

There will be chaos

Asked about a recent study that predicted severe psychological and emotional problems in citizens during a bioterrorism attack, Ms. Lee says she agrees there would be chaos, although she thinks that rather than people refusing to come to a health center or get vaccinated, the problem will be that everyone will want to come in at once. "Terrorists could come to a health center," she cautions. "Security is a huge risk. How people will respond is a very big issue."

When centers go through a practice drill, she points out, it is not as easy to see what problems will arise as it is with a computer simulation.

According to Ms. Lee, she and her team already are at work on the next phase of the project, expanding the scope of the program to include an even more complex problem — how to quickly and efficiently get thousands or even millions of patients to treatment facilities. That effort will work out the best locations in which to establish emergency care facilities based on roads and population density. Facilities could include anything from a school gym to a football stadium. That phase should be ready for testing in the spring.

The final phase of the program will include simulations of the spread of infectious disease through the population and within treatment clinics.

[Contact Ms. Lee at (404) 605-7173.]