October 19, 2007

Michigan Department of Community Health (MDCH) Director Janet Olszewski today signed the Great Lakes Border Health Initiative's (GLBHI) Public Health Data Sharing Agreement and the Infectious Disease Emergency Communication Guideline. The Public Health Data Sharing Agreement and the Infectious Disease Emergency Communication Guideline are valuable new tools for Michigan and the other GLBHI partners to use in the event of an infectious disease outbreak.

With the addition of her signature, GLBHI is pleased to announce that its five active members - Michigan, Minnesota, New York, Ontario and Wisconsin - of have ratified the voluntary data agreement and accompanying guideline that will assist in the early identification and notification of illnesses that could affect the residents of the member states and Canadian province.

Recent history has demonstrated with sometimes frightening consequences that diseases do not respect state and national boundaries. The SARS outbreak in Canada in 2003 is one example. It quickly became clear that communication lines between states and countries were antiquated in the age of modern travel, where local diseases can become global problems in a matter of hours. Prior to 2003, a message regarding a local infectious disease outbreak would have to take a roundabout route involving 2 local health departments - both a state and provincial health department - and two federal health agencies before it was complete.

There were no guidelines in place for a local health department in Michigan to talk to a local health unit in Ontario.

The CDC recognized the need for more streamlined communication and made funding available to states on the international borders of the U.S. asking them to work with their counterparts in Canada to improve infectious disease surveillance and communications while maintaining the privacy and security of an individual's personal health information.

As a result, GLBHI was founded and began the groundwork for the documents that would become the Public Health Data Sharing Agreement and the Infectious Disease Emergency Communication Guideline.

Using the World Health Organization's International Health Regulations as a guide (http://www.who.int/csr/ihr/en/), the GLBHI Public Health Communications subcommittee drafted guidelines regarding the types of information that is sharable across international borders and then surveyed local and international partners to discover what information would be needed during a disease outbreak.

The GLBHI Legal subcommittee consulted with the CDC's Public Health Law program to ensure that any agreements between the states and Ontario, Canada would be legal (under the U.S. Constitution, states may not sign binding agreements with other countries without Congressional approval of the agreements). The voluntary, non-binding Data Sharing Agreement was the result. The Communication Guideline is used as a manual to implement the sharing of approved information in the event of a public health emergency. Tests of the Guideline occur every six months to ensure accuracy and familiarity with the protocol established therein. Tabletop exercises have also been held using these documents to measure the effectiveness they would have in "real life" situations.

Both the Public Health Data Sharing Agreement and the Infectious Disease Emergency Communication Guideline are available at www.michigan.gov/borderhealth.

As the GLBHI partnership has developed between the U.S. Great Lakes border states and Ontario, additional methods of sharing information have been developed. Canadian public health staff have recently been added to the CDC's secure communicable disease alert network, the Epidemic Information Exchange (Epi-X). Soon U.S. public health staff will be able to receive alerts from the Public Health Agency of Canada via the Canadian alert network, Canadian Integrated Outbreak Surveillance Centre (CIOSC), as well.

Despite great advances in electronic data sharing, personal patient data is still shared via secure methods due to the differing electronic systems in use at each jurisdiction. Information technology participants in GLBHI have developed and tested a method of linking each state's Health Alert Network to each other so that data may be shared electronically in a secure environment.

For more information about GLBHI, please visit www.michigan.gov/borderhealth or contact Kathy Allen-Bridson at (517) 335-8199 (allen-bridsonk@michigan.gov) or Michelle Bruneau at (517) 335-6533 (bruneaum@michigan.gov).