Emerging models for the integration and fusion of public health intelligence to enhance situational awareness

Collection, analysis and dissemination of actionable intelligence during a public health emergency are of critical importance. It is widely recognized that the efficient exchange of pertinent information before and during these events can make a difference in early warning and detection and appropriate reaction by first responders. Federal initiatives are being developed by the Department of Homeland Security (DHS) and Centers for Disease Control and Prevention (CDC) to promote intelligence exchange to enhance local public health agency (LPHA) situational awareness, improve interagency coordination, and assure adequate preparation and response. The DHS Health Security Intelligence Enterprise (HSIE), the National Biosurveillance Integration Center (NBIC), and the CDC BioPhusion Initiative are examples directed towards accelerating integration and sharing of LPHA intelligence. These models underscore the need for comprehensive situational awareness. These models also emphasize the need for vertical and horizontal partnerships between stakeholders as a means of achieving a common operating picture for LPHAs. Key challenges to the development and implementation of the HSIE, NBIC, and BioPhusion are building sufficient awareness and acceptance at the local level, effective leveraging of current DHS fusion center network infrastructure and coordination between federal agencies.These initiatives are being driven by Public Law 110-53 (NBIC), and Homeland Security Presidential Directive 21 (HSIE, BioPhusion). Success is dependent on input from State and LPHAs, which ensures end-user requirements, are defined, vetted, and duplication of effort minimized. Critical information exchange during emergencies is best accomplished through pre-planning and strategic thinking to meet the demand of contemporary natural and man-made catastrophes.