Stockpile Management Receiving and Tracking software, an application that combines inventory management and GIS technology, displays maps of Nebraska showing the location of state medical supply dispensing sites (Note: Facility names are not displayed for reasons of privacy.)

The Nebraska Health and Human Services System (NHHSS) is responsible for safeguarding public health in this midwestern state, famous for its cornfields and agricultural production. NHHSS responsibility includes preparing for and responding to catastrophic events that might affect the public's health. During such an event (e.g., a devastating tornado or flood), NHHSS personnel would work with the federal Centers for Disease Control and Prevention (CDC) to receive and distribute medical supplies and medicines from CDC's Strategic National Stockpile (SNS), a national repository maintained for just that purpose.

Timely action under such a scenario is an important aspect. Once federal and local authorities agree that the SNS is needed, medicines should be delivered to the state within 12 hours. The SNS program works with governmental and nongovernmental partners to upgrade their capacity to respond, and critical to the success of this initiative is ensuring that each state maintains a plan to receive, stage, and dispense SNS assets.

In preparing its plan, NHHSS decided to incorporate an inventory management application into the GIS technology it was already using for various health-related programs. "GIS is a powerful tool for public health and disaster response because visual representations of data help decision making, planning, and overall public health response efforts," says Keith Hansen, emergency response coordinator, NHHSS.

The new application would have to give NHHSS an efficient way to manage a sudden influx of supplies, aid in deciding where and how much to distribute to local receiving agencies, and track distribution. NHHSS collaborated with Esri Business Partner GeoAge (Jacksonville, Florida) to develop what they called the Stockpile Management Receiving and Tracking (SMRT) application. NHHSS chose GeoAge because it has extensive experience in developing public health applications and proposed to build a stand-alone system that could be easily incorporated with the existing NHHSS GIS system.

For easy but secure access, SMRT was built as a Web-based system using ArcIMS, which NHHSS had experience with, and Microsoft .NET. NHHSS users can designate facilities at all levels from main hub to final dispensing site and record their locations. They can import inventory lists, create pick lists, manage users, and cross-reference information. When a specific state geographic area is affected, they can use the census population data layer to determine local population and thus calculate medicine dosage requirements for that area. Hub staff can create inventory transactions, record them geographically to determine where inventories are scheduled to arrive, then confirm that a shipment was received at the desired location.

"This is an extremely effective tool for the distribution and tracking of stockpile supplies," says Chris Chalmers, GIS coordinator, NHHSS, and director, GIS Public Health Research Program, University of Nebraska, "and it will help state and local health officials get the supplies to the areas of the state that desperately need them."

The application was tested in spring 2006 during a statewide TERREX 5.5 exercise headed by NHHSS in collaboration with CDC, GeoAge, and the University of Nebraska. More than 20 local health departments participated, as well as the Air National Guard; Crete Carrier transportation company; and the Nebraska Department of Roads, Emergency Management Agency, and State Patrol.

"Exercises like TERREX 5.5 don't happen overnight, and planning for this exercise began more than a year ago," says Chalmers. The scenario simulated a bioterrorism outbreak of pneumonic plague that spread quickly across the entire state. The Emergency Coordination Center served as the hub for emergency efforts and housed 30 computers with e-mail and Web access and a communication center with telephones, walkie-talkies, and satellite phones. The SMRT application ran alongside the existing NHHSS GIS used for everyday operations. High-resolution video projectors displayed detailed interactive GIS maps running ArcGIS Desktop (ArcInfo) with the ArcGIS Spatial Analyst and ArcGIS Network Analyst extensions. E-mail and activity logs were also displayed as events unfolded.

"During an emergency, communication and coordination are two of the biggest challenges to overcome," says Robert Leopold, deputy director, Regulation and Licensure, NHHSS. "GIS is an effective tool for enhancing the communication and coordination of multiple tasks to effectively respond to any public health emergency."

More Information

For more information, contact Chris Chalmers, Nebraska Health and Human Services System (e-mail: chris.chalmers@hhss.ne.gov, Web: www.hhss.ne.gov), or Jeff Arnold, GeoAge (e-mail: jeff.arnold@geoage.com, Web: www.geoage.com).