Medical Informatics and Preparedness

The terrorist attacks of September 2001 and the subsequent deliberate dissemination of anthrax have stimulated public awareness of the need in both the public health and clinical health care systems to quickly detect and respond to altered patterns of disease in communities across the nation. Debate over the capacity of the existing systems to fully respond to these demands has created a sense of urgency for immediate action to improve these functions. Public health resources were taxed to provide early detection and rapid response. The clinical care delivery system faced challenges of emergency response to urban casualties, highlighting the value of clinical information systems that facilitate information management in crisis situations. The effective application of informatics to these data collection, analysis, and dissemination tasks could allow the rapid deployment of systems that would greatly enhance our preparedness. Much of the infor-matics experience gained in health information system implementation efforts over the past several decades is directly applicable to the new challenges of bioterrorism and emergency response. By utilizing this collective knowledge in areas such as architecture , infrastructure, standards, and knowledge representation , newly created systems are more likely to yield maximum benefits. As an organization, AMIA is already focused on issues of public health infor-matics, having developed a national consensus agenda for the field at its 2001 Spring Congress. 1 The AMIA 2001 Annual Symposium provided an additional opportunity to bring together clinicians, medical informatics professionals, researchers, and policy makers in a concerted effort to document current informatics approaches that support rapid detection and response to crises. Key to the Association's mission is a working group program that enables interested professionals who share a common clinical theme to advance the unique perspectives of their groups. JAMIA is pleased to present a set of papers based on presentations and discussions at the Annual Symposium that can serve as an anchor in developing the informatics response to war, bioterrorism, and disaster. These papers provide a conceptual overview of the clinical and public health challenges and summaries of the ways in which biomedical informatics can support the health care system response to these challenges. The special section begins with two reports of current activities. Teich et al. 2 provide a summary of the special plenary session on the informatics response to bioterrorism, disaster, and war that was a last-minute addition to the AMIA meeting, including specific recommendations from the speakers. Lober et …