Public Health Intelligence: Learning From the Ebola Crisis

Today’s public health crises, as exemplified by the Ebola outbreak, lead to dramatic calls to action that typically include improved electronic monitoring systems to better prepare for, and respond to, similar occurrences in the future. Even a preliminary public health informatics evaluation of the current Ebola crisis exposes the need for enhanced coordination and sharing of trustworthy public health intelligence.We call for a consumer-centric model of public health intelligence and the formation of a national center to guide public health intelligence gathering and synthesis.Sharing accurate and actionable information with government agencies, health care practitioners, policymakers, and, critically, the general public, will mark a shift from doing public health surveillance on people to doing public health surveillance for people.The Ebola crisis continues to have a major impact on the nation and much of the world. Ebola and similar critical public health and health care delivery crises lead to dramatic calls to action that seek to understand the nature of the problem, to develop strategic intelligence on the scope and reach of the problem, to develop tactical responses, and to build protections to manage future risk. Typically, the creation of electronic monitoring systems to better prepare for, and respond to, similar occurrences in the future is indicated.Public health crises can expose failures in (1) the process (e.g., events, task performance, or actions), (2) policy (e.g., absent, outdated, poorly disseminated, or unevenly implemented guidelines), and (3) responsiveness (e.g., poorly coordinated or deployed resources, inadequate, ineffective strategic responses, etc.). The common thread underlying failures associated with such public health crises is deficiencies in actionable intelligence that inform process, policy, and responsiveness. Once actionable intelligence has been appropriately gathered and disseminated, adequate resources must be deployed to implement containment and preventive interventions.Public health system informatics is the field designed specifically to assess the national capability of our combined network of public health departments and health care delivery sites to intelligently manage crises and ensure population safety. Public health informatics activity builds, maintains, and evaluates the national intelligence required to address the full spectrum of decision-making needs and includes: individual health consumers seeking information about their individual risk and the resources to assist them in times of need; health care providers seeking to understand and interpret practice guidelines; public health program managers seeking to organize proper responses, deploy resources, and communicate the progress in mitigating and eventually eliminating the threat; and policymakers governing national public health system integrity.Even a preliminary public health system informatics evaluation of the current Ebola crisis highlights several failures in the gathering, management, dissemination, and responsiveness of national public health intelligence. Such an examination offers some critical lessons and helps us to better understand the fundamental components of maintaining a heightened national public health intelligence capability, not only for Ebola, but in general, for all public health crises.