Enabling Rapid and
Sustainable Public Health
Research During Disasters
Summary of a Joint Workshop
by the Institute of Medicine and the
U.S. Department of Health and Human Services
Forum on Medical and Public Health Preparedness for
Catastrophic Events
Board on Health Sciences Policy
Megan Reeve, Theresa Wizemann, and Bruce Altevogt,
Rapporteurs
INSTITUTE OF MEDICINE
OF THE NATIONAL ACADEMIES
THE NATIONAL ACADEMIES PRESS
Washington, D.C.
THE NATIONAL ACADEMIES PRESS • 500 Fifth Street, NW • Washington, DC 20001
NOTICE: The workshop that is the subject of this workshop summary was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.
This activity was supported by contracts between the National Academy of Sciences and the American College of Emergency Physicians; American Hospital Association; Association of State and Territorial Health Officials; Centers for Disease Control and Prevention (Contract No. 200-2011-38807, TO #30); Department of Defense (Contract No. HT0011-11-P-0186); Department of Defense, Uniformed Services University of the Health Sciences (Contract No. HT9404-12-1-0022); Department of Health and Human Services’ Administration for Children and Families (Contract No. HHSP2332014001533P); Department of Health and Human Services’ National Institutes of Health: National Institute of Allergy and Infectious Diseases, National Institute of Environmental Sciences, National Library of Medicine (Contract No. HHSN26300007 [Under Base 1 #HHSN2 63201200074I]); Department of Health and Human Services’ Office of the Assistant Secretary for Preparedness and Response (Contract No. HHSO100201000021P); Department of Homeland Security’s Federal Emergency Management Agency (Contract No. HSFE20-13-P-0212); Department of Homeland Security, Office of Health Affairs (Contract No. HSHQDC-13-J-00384 [Under Base 1 #HSHQDC-11-D-00009]); Department of Transportation’s National Highway Traffic Safety Administration (Contract No. DTNH22-10-H-00287); Department of Veterans Affairs (Contract No. 101-G09041); Emergency Nurses Association; Food and Drug Administration (Contract No. HHSF22301027T [Under Base Contract DHHS-8598]); Infectious Diseases Society of America; Martin, Blanck & Associates; Mayo Clinic; Merck Research Laboratories (Contract No. APA-2014-1666); National Association of Chain Drug Stores; National Association of County and City Health Officials; National Association of Emergency Medical Technicians; Pharmaceutical Research and Manufacturers of America; Robert Wood Johnson Foundation; Society for Disaster Medicine and Public Health; Target Corporation; Trauma Center Association of America; and United Health Foundation. The views presented in this publication do not necessarily reflect the views of the organizations or agencies that provided support for the activity.
International Standard Book Number-13: 978-0-309-31330-8
International Standard Book Number-10: 0-309-31330-9
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Copyright 2015 by the National Academy of Sciences. All rights reserved.
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Suggested citation: IOM (Institute of Medicine). 2015. Enabling rapid and sustainable public health research during disasters: Summary of a joint workshop. Washington, DC: The National Academies Press.
“Knowing is not enough; we must apply.
Willing is not enough; we must do.”
—Goethe
INSTITUTE OF MEDICINE
OF THE NATIONAL ACADEMIES
Advising the Nation. Improving Health.
THE NATIONAL ACADEMIES
Advisers to the Nation on Science, Engineering, and Medicine
The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences.
The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. C. D. Mote, Jr., is president of the National Academy of Engineering.
The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Victor J. Dzau is president of the Institute of Medicine.
The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. C. D. Mote, Jr., are chair and vice chair, respectively, of the National Research Council.
WORKSHOP PLANNING COMMITTEE1
DAVID ABRAMSON, National Center for Disaster Preparedness, Columbia University, New York, NY
GEORGES BENJAMIN, American Public Health Association, Washington, DC
BERNARD D. GOLDSTEIN, Department of Environmental and Occupational Health, University of Pittsburgh Graduate School of Public Health, PA
JACK HERRMANN, National Association of County and City Health Officials, Washington, DC
DAVID LAKEY, Texas Department of State Health Services, Austin
ROBERT J. URSANO, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD
BEVERLY L. WRIGHT, Dillard University, New Orleans, LA
HOWARD ZUCKER, New York State Department of Health, New York
HHS Staff
STACEY ARNESEN, National Library of Medicine, National Institutes of Health
DIANE DIEULIIS, Office of the Assistant Secretary for Preparedness and Response
SAMUEL L. GROSECLOSE, Centers for Disease Control and Prevention
JOSEPH “CHIP” HUGHES, National Institute of Environmental Health Sciences, National Institutes of Health
AUBREY MILLER, National Institute of Environmental Health Sciences, National Institutes of Health
IOM Staff
BRUCE M. ALTEVOGT, Forum Director
MEGAN REEVE, Associate Program Officer
BRADLEY ECKERT, Research Associate (until September 2014)
_______________
1Institute of Medicine planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published workshop summary rests with the workshop rapporteurs and the institution.
ASHLEY OTTEWELL, Research Associate (since September 2014)
ALEX REPACE, Senior Program Assistant
ANDREW M. POPE, Director, Board on Health Sciences Policy
FORUM ON MEDICAL AND PUBLIC HEALTH
PREPAREDNESS FOR CATASTROPHIC EVENTS1
ROBERT P. KADLEC (Co-Chair), RPK Consulting, LLC, Alexandria, VA
LYNNE R. KIDDER (Co-Chair), Consultant, Boulder, CO
ALEX J. ADAMS, National Association of Chain Drug Stores, Alexandria, VA
ROY L. ALSON, American College of Emergency Physicians, Winston-Salem, NC
WYNDOLYN BELL, UnitedHealthcare, Atlanta, GA (until June 2014)
KATHRYN BRINSFIELD, Office of Health Affairs, Department of Homeland Security, Washington, DC
D. W. CHEN, Office of the Assistant Secretary of Defense for Health Affairs, Department of Defense, Washington, DC
SUSAN COOPER, Regional Medical Center, Memphis, TN
BROOKE COURTNEY, Office of Counterterrorism and Emerging Threats, U.S. Food and Drug Administration, Washington, DC
BRUCE EVANS, National Association of Emergency Medical Technicians, Upper Pine River Fire Protection District, Bayfield, CO
JULIE L. GERBERDING, Merck Vaccines, Merck & Co., Inc., West Point, PA
LEWIS R. GOLDFRANK, New York University School of Medicine, New York
LORI GRUBSTEIN, Robert Wood Johnson Foundation, Princeton, NJ (since September 2014)
DAN HANFLING, University of Pittsburgh Medical Center, Center for Biosecurity, Bethesda, MD
JACK HERRMANN, National Association of County and City Health Officials, Washington, DC
JOHN L. HICK, Hennepin County Medical Center, Minneapolis, MN
JAMES J. JAMES, Society for Disaster Medicine and Public Health, Bethesda, MD
PAUL E. JARRIS, Association of State and Territorial Health Officials, Arlington, VA
_______________
1Institute of Medicine forums and roundtables do not issue, review, or approve individual documents. The responsibility for the published workshop summary rests with the workshop rapporteurs and the institution.
LISA G. KAPLOWITZ, Office of the Assistant Secretary for Preparedness and Response, Department of Health and Human Services, Washington, DC
ALI S. KHAN, Centers for Disease Control and Prevention, Atlanta, GA (until September 2014)
MICHAEL G. KURILLA, National Institute of Allergy and Infectious Diseases, Washington, DC
DONALD M. LUMPKINS, Federal Emergency Management Agency, Department of Homeland Security, Washington, DC (since March 2014)
JAYNE LUX, National Business Group on Health, Washington, DC
LINDA M. MACINTYRE, American Red Cross, San Rafael, CA
SUZET M. MCKINNEY, Chicago Department of Public Health, Chicago, IL
NICOLE MCKOIN, Target Corporation, Furlong, PA
MARGARET M. MCMAHON, Emergency Nurses Association, Williamstown, NJ (until January 2014)
AUBREY K. MILLER, National Institute of Environmental Health Sciences, Bethesda, MD
MATTHEW MINSON, Texas A&M University, College Station
ERIN MULLEN, Pharmaceutical Research and Manufacturers of America, Washington, DC
JOHN OSBORN, Mayo Clinic, Rochester, MN
ANDREW T. PAVIA, Infectious Disease Society of America, Salt Lake City, UT
STEVEN J. PHILLIPS, National Library of Medicine, Bethesda, MD
LEWIS J. RADONOVICH, Department of Veterans Affairs, Washington, DC
SONIA A. RASMUSSEN, Centers for Disease Control and Prevention, Atlanta, GA (since September 2014)
MARY J. RILEY, Administration for Children and Families, Department of Health and Human Services, Washington, DC
KENNETH W. SCHOR, Uniformed Services University of the Health Sciences, Bethesda, MD
ROSLYNE SCHULMAN, American Hospital Association, Washington, DC
RICHARD SERINO, Harvard School of Public Health, Boston, MA
MARGARET VANAMRINGE, The Joint Commission, Washington, DC
W. CRAIG VANDERWAGEN, Martin, Blanck & Associates, Alexandria, VA
JENNIFER WARD, Trauma Center Association of America, Las Cruces, NM
JOHN M. WIESMAN, Washington State Department of Health, Tumwater
GAMUNU WIJETUNGE, National Highway Traffic Safety Administration, Washington, DC
IOM Staff
BRUCE M. ALTEVOGT, Forum Director
MEGAN REEVE, Associate Program Officer
BRADLEY ECKERT, Research Associate (until September 2014)
ASHLEY OTTEWELL, Research Associate (since September 2014)
ALEX REPACE, Senior Program Assistant
ANDREW M. POPE, Director, Board on Health Sciences Policy
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Reviewers
This workshop summary has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published workshop summary as sound as possible and to ensure that the workshop summary meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We wish to thank the following individuals for their review of this workshop summary:
NELL ALLBRITTON, Louisiana Department of Health and Hospitals
J. PERREN COBB, Massachusetts General Hospital
SALLY PHILLIPS, Department of Homeland Security
ALONZO PLOUGH, Robert Wood Johnson Foundation
Although the reviewers listed above have provided many constructive comments and suggestions, they did not see the final draft of the workshop summary before its release. The review of this workshop summary was overseen by KRISTINE GEBBIE, Flinders University School of Nursing and Midwifery. Appointed by the Institute of Medicine, she was responsible for making certain that an independent examination of this workshop summary was carried out in accordance with institutional procedures and that all review comments were carefully
considered. Responsibility for the final content of this workshop summary rests entirely with the rapporteurs and the institution.
Contents
Organization of the Workshop and Report
Overview of Topics Highlighted During Presentations and Discussions
2 SCIENCE PREPAREDNESS: CONDUCTING RESEARCH DURING PUBLIC HEALTH EMERGENCIES
Building a Robust Science Response
Federal Disaster Research Initiatives and Resources
3 HEALTH RESEARCH NEEDS AND ACTIONS: LESSONS FROM RECENT DISASTERS
Shared Lessons Across Disasters
4 ADDRESSING INSTITUTIONAL REVIEW BOARD BARRIERS TO HEALTH RESEARCH IMPLEMENTATION
The Public Health Emergency Research Review Board
State Health Department IRB Perspective
5 PARTNERING WITH THE COMMUNITY TO ENABLE RESEARCH
Partnering for Epidemiology Research
Establishing Trust in the Community
Partnering with Unions, Workers’ Organizations, and Workers
6 IMPROVING DATA COLLECTION CAPABILITIES AND INFORMATION RESOURCES
NIH Disaster Research Response Project
Disaster Epidemiology: Applied Public Health Investigation and Research During Disasters
The National Emergency Medical Services Information System
Disaster Research and Response: Applied Public Health Perspective
7 CONSIDERATIONS FOR RAPID AND SUSTAINED FUNDING MECHANISMS FOR RESEARCH IN DISASTERS
Private Funding: Grantmakers in Health
8 IMPROVING THE ROLE OF EXTRAMURAL RESEARCH NETWORKS
Convergence of Multiple Types of Disaster Research
Advancing Science During Crisis
Pharmaceutical Research During a Disaster
9 COORDINATING LOGISTICS TO EXECUTE RAPID RESEARCH IN DISASTER RESPONSE
Integrating Disaster Research into the Incident Command Structure
Rapid Research: The U.S. Critical Illness and Injury Trials Group
Federal Perspective on Logistics for Rapid Disaster Research Response
Making Research Useful to the Response
10 ACTIONS TO BUILD THE FUTURE OF DISASTER RESEARCH
Defining the Key Questions and the Core Dataset
Data Collection: Building Day-to-Day Systems, Networks, and Trust
Creating Connections Between the Research and Practice Communities
D BIOGRAPHICAL SKETCHES OF INVITED SPEAKERS AND PANELISTS
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