Integrated Decision Support System for Health Threats and crisis management

HEALTHREATS is a project promoted by the Local Health Department in Brescia ASL, developed from 2007 to 2010, in collaboration with a consortium of national and international partners financed by the European Commission in the area of the Public Health programme.

It was implemented with the experience gained with the “Decision Support System for the management of emergencies” project. The prototype of the experimental online system produced with this project could however not be considered as a complete decision making support, but it became evident that there was the necessity to follow a route which allows, thanks to in depth analyzing of the various public utilities, on one had to identify new routes to take to respond to unexpected events and on the other hand to reshape the health patterns making it more flexible.

Partners of the project were

  • ASL in Brescia, one of the territorial structures of the National Health System which is responsible for the health of the population in its operational territory.
  • Romanian Society for Disaster, a non governative Romanian organization which is responsible for the integrated system of emergency medicine and first aid.
  • “Spedali Civili” di Brescia General Hospital, the biggest public hospital in the Lombardy Region, with the most advanced experience and infrastructure in Northern Italy
  • INOVAMAIS, a Portoguese organization which promotes and manages international projects of innovation, research and technological development at a European and world level.
  • Laser Soc. Coop., un istituto di formazione bresciano con una vasta esperienza nella gestione di informazioni e di conoscenze, in particolare nel settore della salute;
  • The University of Brescia, Faculty of Engineering, an educational and scientific institution, with vast competence and results in research and development, particularly in the IT (Information Technology) field
  • Josef Stefan Institute, the largest research organization in Slovenia, highly qualified in the field of evaluation,decision support and training;
  • ACB Association of the Brescian Municipalities one of the most active local Italian associations
  • Institut za Varovanje Zdravia, the main Slovenian center for the organization in the field of health care,  economy and computer science;
  • Department de Salut de la Generalitat de Catalunya, the highest authorities of Catalonia in the identification of design strategies in health politics;
  • ARGONET Ltd., a leading software house and IT solutions development company in Milan, with high levels of technical and safety skills.

With HEALTHREATS, the Consortium set the objective of finding the way of effectively responding to as well as coordinating health threats, in particular regarding influenza pandemics. The result of HEALTHREATS was the realization of a package )PDT) which includes the processes for crisis management , the Decision Support System )DSS, a software system able to assist the managers responsible for the strategic decisions and for the launching of operational interventions acting to face the most diverse typologies of threats like influenza pandemics, earthquakes, environmental contamination of water, earth and air etc.) it is an educational programme to promote the training of the personnel involved in crisis management.

The objectives of the project foresee in detail

  • The definition of a methodology and the individualizing of coordinated processes for the management of a crisis.
  • The development of a DSS for the health managers who have to confront health threats and crisis situations.
  • An educational programme to promote the training of the personnel involved in crisis management
  • The foreseeing of integrated and inter sector health strategies to ensure a high level of human health protection.
  • The experimentation of the PDT package in Italy, Slovenia, Romania and Spain.

The project had a duration of three years and was structured into 8 “Work Packages” )WP) three with objectives of a transversal character for the entire duration of the project and relative to the coordination, dissemination of the results, to the evaluation. The other five foresaw more specific objectives:

  • The revision of the state of the art
  • Specification of the requirements of the system
  • The modeling process at an organizational level
  • The design and implementing of DSS
  • Training of the personnel

The first phase of work concentrated on the competence of the international consortium of HEALTHREATS and on the collaboration of the European institutes responsible for health threats, for the in depth knowledge of the European and world legislation regarding the national pandemic plans and to pinpoint the best actions and methodologies for crisis management, the evaluation of risks and the systems of communication, as well as the support systems for decision making by the analyzing of international scientific publication literature available.

Furthermore the group also collaborated in defining the requisites of the system that have to support the crisis managers in their complex responsibility of decision making) monitoring of the events and the management of the information, planning of the information, management and allocation of the resources). The activities carried out led to the definition of functional requisites, requisites on the user interfacing and operational and technical requisites. As far as the training is concerned, the activities carried out led to the characterization of the professional figure destined to the training activity subdivided into three levels, and to the categorizing of the corresponding training needs.

Argonet the company of Technological innovation, in collaboration with the Faculty of Engineering of the University of Brescia, designed and developed the DSS (creation of the architecture, detailed design, software development and the production of the system, acquisition of knowledge and the construction of the bases of knowledge, the verifying and evaluation).

Laser, responsible for the training phase, foresaw and realized a training plan for the personnel (top management, crisis managers, those responsible for the operational units), on the procedure aspects and the HEALTHREATS system, taking into consideration the possibility that it could be valid for the diverse nature of the social health departments.

In the advanced phase of the project the partners who had experimented the PDT package  played a significant role. The Catalan , Romanian, Slovenian and Portuguese partners  experimented the PDT package in their local context, indentifying the positive aspects and the negative aspects supported by Argonet on the technical side and by Laser for the training aspect.

All the phases of HEALTHREATS underwent and internal evaluation managed by JSI which allowed the highlighting of the strenghts and weaknesses and the adoption of more appropriate solutions to answer to the inevitable difficulties linked to the complexity of the project like, for example, the loss of a partner during a work procedure and the difficulties which came up from the communication between different realities.

The communication activity and the dissemination of HEALTHREATS was and important and fundamental part of the project. The objectives and the diverse phases of work were diffused by the publication of articles in specialized journals, the participation in international conventions in the sector and above all by the production of a newsletter and the activation and updating of a website.