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Public Health Information Sharing AlongPublic Health Information Sharing Alongthe Canada-U. S. Border: the Canada-U. S. Border:

Opportunities for ImprovementOpportunities for Improvement

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Overview

• Background • Study design and limits• Observations• Relevance to this audience

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InfoFlows

Province

Public

Individual

Intn’l

Media

Federal

Public HealthUnits

Primary Care Giver

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EWIDS

• Early Warning Infectious Disease Surveillance Project (EWIDS).

• assist regional health agencies identify and control infectious disease outbreaks

• border states base funding of $15,000 each towards:– the improvement of laboratory conditions and

surveillance capabilities, – the improved cross-border sharing of

information, and – the maintenance of a database storing results

from all regional sentinel/clinical labs.

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Border Initiatives

Great Lakes•Indiana •Michigan •Minnesota •New York •Ohio •Pennsylvania •Wisconsin •Ontario

Eastern Border •Nova Scotia •New Brunswick •Maine •New Hampshire •New York •Québec •Vermont

Pacific•Alaska •Yukon •British

Columbia •Alberta ???•Washington •Oregon •Idaho •Montana

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Border InitiativesBorder Initiatives

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Question Set:

1. From your perspective, what are the main barriers to sharing health information across the Canada-U. S. border?

2. Who has the authority to share such information?3. Which public health information sharing initiatives across the

Canada-U. S. border are you or your group focussing on? If more than one, how are they related?

4. Is the information being shared done predominantly for the purpose of alerting other public health groups, or is research being shared as well?

5. What, in your opinion, are the outstanding issues that still need to be addressed regarding the sharing of information (including health data and alerts) across the Canada-U. S. border?

6. Are there any other concerns about improving information sharing across the Canada-U. S. border – or other issues regarding Canadian participation in these efforts – that you would like to see addressed?

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Study limitations:

• disparate backgrounds of the interview subjects so no comments can be considered as agreed upon by all.

• limited representation with respect to some of the regions under consideration

• narrow focus of this study on information sharing precluded a wider analysis of other areas of cross-border public health emergency preparedness, such as the transportation of laboratory samples.

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Results:

• Improve federal participation in border initiatives• ensure that those who have the permission to share

public health information be aware that they hold such authority

• Recognize turn over of border group members and incorporate strategies to update rosters inform new members…

• a desire more consistent, dedicated source of funding to support cross-border initiatives

• Bring in non participating provinces/states and work towards harmonized policies/agreements.

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Results:Results:

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Take homes:

• Issues not unique to US/Canada border• Formal arrangements are necessary to

address critical issues/emergencies• But formal agreements are not enough• Most issues/barriers to the sharing of

information are not legal ones• Roles --- and relationships--of all levels

of government must be understood

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Take homes:

International

National National

State/Regional Province/Territory

Local Local

*

*International Health Regulations

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acknowledgements:

• Christopher KnudsonCarleton University, Ottawa

• Captain Andrew StevermerHealth Emergency Preparedness LiaisonHealth and Human Services

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André La PrairieHealth Emergency Liaison Officer (Canada)Office of the Assistant Secretary for Preparedness and Response Health and Human ServicesWashington, DC 20201 email: andre.laprairie@hhs.gov andre_la_prairie@phac-aspc.gc.ca