LPHA data management surge capacity during the 2009 H1N1 influenza pandemic: The city of milwaukee health department experience

The emergence of pandemic H1N1 influenza in the United States during 2009 created unprecedented challenges for local public health agencies (LPHAs) in the surveillance, treatment and prevention of illness within the community. One key area, crucial to the mapping of sound strategic direction but often overlooked by LPHAs during pre-planning, is the capacity to accommodate a surge in event data collection, analyses and management. During the spring wave of the pandemic, the City of Milwaukee Health Department (MHD) recorded over 3200 probable and confirmed cases of disease, the highest count in the U.S. During the following fall, MHD administered over 25,000 doses of monovalent H1N1 vaccine. These activities not only required unparalleled coordination between State, regional and private healthcare authorities but also significant management of rapidly assembled and reported data from a variety of sources and infrastructure. At the MHD, the compilation and analysis of this data was complimented by the use of the Wisconsin Health Information Exchange (WHIE), Wisconsin Electronic Disease Surveillance System (WEDSS) and Wisconsin Immunization Registry (WIR). While there were many hurdles associated with processing such large volumes of data, lessons learned on-the-fly resulted in rapid advancements in department capabilities. Sufficient data-related surge capacity was essential to preparing and targeting public health interventions such as messaging and vaccination outreach, to analyzing severity and adjusting response strategies. Robust surge capacity for LPHA data management must be embedded as a critical core function for LPHAs, preferably prior to responding to any significant or extended public health emergency