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Commentary: "Data rich, but information poor," officials from the California Health and Human Services Agency say using data to inform disaster response has been an educational experience.
Marko Mijic is the assistant secretary of program and fiscal affairs at the California Health and Human Services Agency (CHHS). Michael W...
The 2017 California wildfires were devastating, destroying lives and property throughout the state. These wildfires came quickly, giving residents little time to evacuate, while the rapidly changing weather conditions further fueled the speed and scope of the fires.
In the initial days of our response, we at the California Health and Human Services Agency (CHHS) had two priorities:
In October, as we responded to the northern California fires, it was challenging for us determine the impact on the facilities that are licensed or certified by our departments. This was primarily due to us not having all the necessary data compiled in a format that could inform and prioritize our response efforts. In fact, it took us nearly two weeks to compile all the data so that it could help inform our work. While we were compiling these data, we had to send staff into the region so that we could put eyes on the facilities whose status was unknown to us.
We established a Medical and Care Facilities Task Force out of the State Operations Center to coordinate our response and collect data on all the facilities that are either licensed or certified by the departments within CHHS. This included address, type of facility, license capacity, and recent census. We mapped these data to determine which facilities were in the evacuation zones and within the fire boundaries, which helped us determine where we might have capacity issues.
In the initial days, and throughout our response, we were in direct contact with each facility in the impacted region to determine status, capacity, and number of displaced individuals. These data gave us a daily snapshot of the number of facilities that were open and fully operational and number of facilities that were evacuated and/or closed. The data also told us the facilities that were destroyed or significantly damaged. Collectively this information allowed us to monitor repopulation efforts after evacuations were lifted and it was deemed safe to return.
In addition to the quantitative data, we also used qualitative data to validate our assumptions. This included data from the Department of Managed Health Care Help Center and the Department of Aging Long-Term Care Ombudsman. This gave us a comprehensive view of the situation. We used this information to engage with our local and federal partners to ensure patients had access to medical facilities, and clients in community care facilities were safe.
This was an example of where we are “data rich, but information poor” that made us realize the need to better utilize data to assess the impact of the wildfires and determine the short-term and long-term needs. Our challenge was pulling all the data together quickly and in a streamlined format. Simply put, we needed to turn the data into digestible information that would inform our response activities.
In December, as we responded to the southern California fires, we built on the lessons we learned in the northern California fires. Within 48 hours, we not only were able to assemble and visualize the data, but we were able to assess the impact and determine the scope. Additionally, we developed a GIS dashboard, which included evacuation zones and fire data, to help prioritize our response activities and monitor efforts in real time. This not only allowed us to assess the impact more timely, but significantly reduced the number of facilities whose status was unknown, resulting in less staff being sent out to check on facilities.
Although each emergency is different and each response is unique, we know that we must improve in a number of areas before the next emergency or disaster:
The data collection among our licensing entities must be standardized
It was difficult to determine the total number of facilities in the region and the extent of the impact because there were disparities in how each department collected these data. Standardizing these data fields and providing common definitions will allow us to match the data so that we can quickly assess the scope and identify potential access or capacity issues.
The outreach to facilities must be streamlined and coordinated
Each department had a different script when calling facilities to check on their status. This presented confusion when we went to aggregate the data. Developing a single script that is used across all licensing departments will ensure that the information collected is consistent and can be aggregated to provide a broader snapshot of the scope.
The data must be shared with internal and external stakeholders
Facilities were not only being contacted by the regulatory entities, but by statewide associations and family members. We need to develop an online and easily-accessible repository of facilities and their daily status. This will ensure that the public has the necessary information, and will reduce the number of calls the facility has to take during an emergency.
We are now working on implementing these lessons learned to prepare for the next emergency.
We would like to extend our thanks to the individuals across the CHHS departments who worked on our response to the wildfires, in addition to the local medical and health operational area coordinators as well as the regional disaster medical and health coordinators. We also would like to extend our appreciation to the following individuals who served on the Medical and Care Facilities Task Force: Ley Arguisola, Howard Backer, Jason Baker, Hussain Bhatia, Pam Dickfoss, Susan Fanelli, Micki Gibbs, Lindy Harrington, Craig Johnson, Jennifer Kent, Pat Leary, Jennifer Plescia, Sarah Ream, Joe Rodrigues, Dan Smiley, Karen Smith, Ali Sumer, Caroline Thomas-Jacobs and Chris Tokas.