Decision Support System for Integrated Adaptive Response (PHASYS)

This project is an integral component of a larger project being conducted by the Preparedness and Emergency Response Research Center at the Graduate School of Public Health, University of Pittsburgh. The project is sponsored by the Centers for Disease Control, Department of Health and Human Services to develop models and metrics for improving performance in the public health system for the nation. The goal of this project is to develop a model and methods for achieving a "common operating picture" for the set of organizations, actors, and agents that have responsibility for maintaining public health in the United States. Organizations and actors, defined as hospitals, emergency medical services, and public health agencies operating with different levels of responsibility and authority in different locations and serving different clientele, need to act in concert to maintain effective performance of public health services. They need to collaborate to recognize and respond to emerging threats to public health in communities exposed to risk. This goal is based on the concept of "distributed cognition" outlined by Edwin Hutchins for complex operating environments. It acknowledges that no single individual or organization possesses all the knowledge or skills to manage a public health threat in a large-scale, complex, region. Rather, cognition is understood as a social, cultural, and technical process in which individuals, organizations, and institutions create a unique distributed system that provides decision support needed to coordinate their activities to accomplish a shared goal. This project will focus on the design and development of an electronic dashboard that will be embedded in a larger decision support system to enhance the adaptive performance of the public health system (PHS) to changing conditions. The decision support system (DSS) will be based on a theoretical framework of distributed cognition which has not been systematically developed in any previous collaborative network to support emergency services. Findings from this research will provide fresh insight and innovative metrics and models for supporting interdependent collaboration among the mix of agencies involved in the PHS, as well as contributing to a clearer, more informed understanding about how agencies learn to find a common basis for action in complex, dynamic operating conditions. In practice, the electronic dashboard for the PHS developed in this project and embedded within a larger DSS for all-hazards management will contribute to building a common profile of public health status for the region. In order to develop and test workable models and methods for improving performance of the public health system, this research will establish a "testbed" for exploring potential models and alternative strategies for action that will serve all components of this research program. The testbed will serve as the program 'laboratory' for trial demonstrations, pilot projects, quasi-experimental social and technical research for three other component projects of this larger research program. The design will support coordinated decision making among the multiple organizations and actors in the public health system (PHS) via visual display of timely, valid information regarding public health risk. A testbed enables the design, testing, and revision of conceptual models in a real-world environment before they are introduced into wider practice.