Swine flu and the perils of negligence

By Jianggan Li | 4 May 2009 | Permanent link | 0 comments

During the SARS outbreak six years ago, hospitals and health authorities noticed a sudden surge of workload that they could not cope with, or was too dangerous to conduct manually.

They had to track everyone visiting the hospital premises and the contacts each of them made; they had to monitor the temperature of everyone in the hospitals; they had to manage assets such as surgical masks and flu vaccines which suddenly were in high demand.

IT systems were developed to cope with these challenges; and as the speed of the virus’s spread, these systems were developed and put in use in a hurry. There was no time for proper project management and documentation.

Suddenly we are in a similar situation again. The outbreak of the A(H1N1) virus in Mexico and the United States has reached (from nowhere) a phase 5 outbreak. According to the World Health Organisation, this is only one level below an official pandemic.

Old systems from SARS are put back in use: people have to fill-in health declaration forms and pass through temperature checks at airports; transport operators are ordered by the authorities to submit passenger lists for fast tracking; health protection agencies are weighed down with work; and hospitals are cancelling leave for IT staff.

They know how important IT is to help hospitals go through a tough period and legacy IT systems from SARS are re-activated.

However, IT departments have come to realise that many old systems are problematic. They were developed using old technologies which often don’t fit with other, more current, IT systems in the hospital; and most of them have not been refined or updated since the SARS epidemic, which happened six years ago.

Even worse, the lack of documentation means it will take them a lot of time to modify the systems to make them work. Not the best way of using limited resources in a tough period.

An insider at one of the region’s major healthcare networks told me that these legacy systems had not been improved because “we can’t evaluate the risk of having another pandemic outbreak, so it is very hard to justify the cost of developing a system for that uncertain moment.”

Sadly, in the frenzy of developing ‘one patient, one record’ and ‘paperless hospitals’, the pandemic response became a lower priority for many hospitals and health authorities. Probably not the health protection agencies, but without prompt, decisive action taken by hospitals, they cannot do much alone.

It is not true that such legacy systems were completely neglected. But it shows a sense of frustration among some health IT practitioners to the (relative) lack of attention pandemic response systems receive.

Fortunately by all accounts so far, A(H1N1) remains relatively less deadly and experts know far more about the A(H1N1) virus than they knew about SARS when the latter first broke out. However, viruses mutate fast and a second wave of infections could become catastrophic.

And let’s not forget the perils of avian influenza, which remains a threat.

With the death rate and infection rate slowing down globally, there is a real sense of complacency in the air and many will probably forget about these systems, just as we did after SARS.

Let’s hope this doesn’t happen again.