Layout 1 ISDS Annual Conference Proceedings 2012. This is an Open Access article distributed under the terms of the Creative Commons Attribution- Noncommercial 3.0 Unported License (http://creativecommons.org/licenses/by-nc/3.0/), permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ISDS 2012 Conference Abstracts U.S. Dept. Veterans Affairs (VA) SMEC-bio Reporting for Leadership Decision Support Shantini D. Gamage*1, 2, Loretta A. Simbartl1, Stephen M. Kralovic1, 2, 3, Katherine S. Wallace4 and Gary A. Roselle1, 2, 3 1National Infectious Diseases Service, Veterans Health Administration (VHA), Washington, DC, USA; 2University of Cincinnati College of Medicine, Cincinnati, OH, USA; 3Cincinnati VA Medical Center, Cincinnati, OH, USA; 4Office of Operations, Security and Preparedness (OSP), VA Central Office, Washington, DC, USA Objective To assess Reports sent from the United States VA Subject Matter Expertise Center for Biological Events (SMEC-bio) – a proof-of- concept decision support initiative – to the VA Integrated Operations Center (VA IOC). Introduction VA is the U.S. federal agency responsible for providing services to America’s Veterans. Within VA, VHA is the organization responsible for administration of health care services. VHA, with 152 Medical Centers and over 900 outpatient clinics located throughout the U.S. and territories, provided care to over 5 million patients in 2011. After the 2009 H1N1 influenza pandemic, OSP, which oversees VA senior level briefing of preparedness issues, conceptualized and initiated SMEC-bio as a protocol-based mechanism to incorporate timely VHA subject matter expertise into leadership decision making via the VA IOC. Previous work has examined collection and integra- tion of data from VA and interagency sources for trend and predictive analyses (1). This current work is an initial assessment of SMEC-bio reporting, which has been in development for the past year and func- tions on an ad hoc basis for decision support; needs and gaps can be assessed toward a formalized communication plan with the VA IOC. Methods In May, 2011, SMEC-bio designed a Report template. All SMEC- bio Reports submitted to the VA IOC using the template were as- sessed based on reason for the Report, timing, data sources used, and outcome. A gap analysis was conducted to identify areas for further improvement. Results Eight SMEC-bio Reports were produced since the template was initiated in May, 2011. The reasons for reporting fell into the follow- ing categories: 1) briefings of interagency protocol activations [e.g. National Biosurveillance Integration System (NBIS) protocol]; 2) Re- quests for Information (RFIs) from the VA IOC regarding specific bi- ological events (e.g. 2012 H3N2v influenza associated with swine at fairs); 3) RFIs from the VA IOC on general infectious diseases issues (e.g. 2011 dust storm in Arizona); and 4) SMEC-bio-initiated Reports to provide situational awareness to the VA IOC on a biological event (e.g. the measles outbreak at the time of the 2012 Super Bowl in In- diana). Reports in response to RFIs were all submitted within the day, often within hours including those that required data collection and interpretation, indicating that SMEC-bio can be a viable source for timely decision support to senior leadership. Some Reports, such as the one on possible infectious diseases issues after hurricane Irene in August, 2011, were subsequently shared by VA IOC with VHA Op- erations and with field facilities, thus highlighting the potential for facilitating provision of timely subject matter expertise for local re- sponse. The primary information source for Reports was the Centers for Disease Control and Prevention website, press releases, and intera- gency briefings. Data sources used were the VHA centrally-adminis- tered electronic health records system and syndromic surveillance via VA-adapted ESSENCE. Gap analysis results included common themes for bioprepared- ness: uncertainty in data quality and interpretation, communication of results and confidence levels to leadership, and coordination among stakeholders. Furthermore, the development of a decision tool to guide selection of events for reporting will be a critical initial re- quirement of a formal communications plan. Conclusions As SMEC-bio progresses from proof-of-concept phase to devel- opment status, knowledge gained from ad hoc reporting, as described in this work, will be critical for developing a routine and effective communications plan. Other ongoing work that will support com- munications include staffing assessments, development of analysis tools, and incorporating automated report capabilities. Keywords Reporting; Decision Support; Communications Acknowledgments The authors thank JC Cantrell, VA IOC Director, and VA IOC staff for helpful interactions regarding reporting. References 1. Wallace, KS, et al. U.S. Department of Veterans Affairs Integrated Op- erations Center (VA IOC): Collaborations for Surveillance, Analysis, and Prediction for Infectious Disease Threat Preparedness — Pilot Review of Dengue Occurrence. Emerg. Health Threats J. 4:s155, 2011 *Shantini D. Gamage E-mail: shantini.gamage@va.gov Online Journal of Public Health Informatics * ISSN 1947-2579 * http://ojphi.org * 5(1):e185, 2013