LEADERS Project Overview

LEADERS

ScenPro, Inc.

LEADERS Project Overview

LEADERS

The Goal of LEADERS


“By applying state
-
of
-
the
-
art technologies,
design a system to enhance the current
medical surveillance process and provide
the earliest possible detection of covert
biological warfare incidents or significant
outbreaks of disease.”


-
BGEN Klaus Schafer



LEADERS

Agenda

•
Problem Description

•
The LEADERS Solution

•
Technical Approach

•
Project History

•
Medical Surveillance Modules Description

•
Command and Control Modules Description

•
Schedule

LEADERS

Where We Are Today...

•
There is
NO
comprehensive approach to
supporting

joint
Military and Civilian medical
surveillance initiatives

•
There is a limited ability to identify and
confirm covert biological warfare incidents or
significant outbreaks of natural disease

•
Existing surveillance systems operate in a
vacuum with minimal ability to share data
across organizations


LEADERS

What is LEADERS...

•
A suite of services and applications that provide a
comprehensive, user
-
driven approach to medical
surveillance and outbreak management.

•
A National
-
level solution designed to support
Military, Civilian, State, and Federal Healthcare
Professionals.

•
A state
-
of
-
the
-
art surveillance concept based on
enhanced capabilities provided by an Application
Services Provider (ASP) .

LEADERS

Technical Approach

•
Iterative Approach

–
Requirements are not
assumed

on day one

–
Technology is accessed based on

current

user

needs

–
Requirements
are

categorized
-

then implemented

–
Functionality is prioritized and then delivered based on
criticality

–
Needs are
reprioritized

after each iteration

•
Extensive User Involvement

–
Requirements are gathered and validated with the end
user community

–
On
-
going consultation during development and testing

LEADERS

Technical Approach (cont.)

•
Application Service Provider (ASP) Model

–
Participating organizations do not require any
infrastructure to deploy LEADERS

–
All hardware, databases, and application software reside
at ASP site

–
Users access LEADERS via a browser over the Internet

•
Flexible Use Model

–
Subscription based

–
Participating organizations choose which components
they would like to subscribe to


LEADERS

The LEADERS Success Story

•
Nov ‘99
-

World Trade Organization Summit

–
8 Hospitals in Seattle Metro Area

•
April ‘00 Israeli Defense Forces Exercise

–
2 Hospitals in Downtown Tel Aviv

–
Israeli CDC

•
July ‘00 Republican National Convention

–
ASP Solution
-

74 Hospitals in PA, DE, NJ

•
August ‘00 Democratic National Convention

–
ASP Solution
-

21 Hospitals in LA County

•
Jan ’01 Presidential Inaugural

–
ASP Solution
-
16 DoD Hospitals/Clinics

–
Commercial Hospitals in DC/MD/VA

•
Jan ’01 Super Bowl
–

Tampa Florida

–
ASP Solution

–
Five Hospitals in Two Counties
–

Plus Reach back to CDC

LEADERS

“Organizational” Architecture

LEADERS

Functional Architecture

Covert
Attack
Overt
Attack
Outbreak
Disaster
Hi Profile
Event
Data
Collection
Event
Analysis
Map-Based
Analyis
Incident
Mgmt.
Pathogen
Ident.
PEMS
KDD
MedView
IEP/ViewPort
RAPID
LEADERS

National/Global View of LEADERS

Public

Health

Dept.

Emergency
Management
Agencies


Hospital
Networks


Gov.
Agencies

Military

Support

Organizations

Covert Biological Warfare Scenario

Major Disease Outbreak

LEADERS


SERVICES AND APPLICATIONS

•
State PHO

•
CDC

•
Local PHO

•
Fire

•
Police

•
EMS

•
DoD

•
Civilian

•
VA

•
Community
Centers

•
FEMA

•
CDC

•
Red Cross

•
JFC

•
CBIRF

•
Special Ops

LEADERS

Medical Surveillance Modules

•
User
-
driven surveillance applications

•
Monitoring and visualization capability


based on a defined geographic area

•
Knowledge discovery tools provide


rapid ID of health anomalies

•
Agent identification/confirmation


capability

•
Incident management and resource


allocation tools

LEADERS

Data Collection

•
Continuous Data Feeds

–
LEADERS will publish an XML Document Type
Definition (DTD)

–
Plans support for HL7 data via XML feed

–
Participating organizations EXTRACT data based on
XML DTD

•
Web
-
based Manual Data Collection

–
Data entry based on individual patient encounters

–
Minimal data entry tasking

–
Focus on ease
-
of
-
use

LEADERS

Medical Surveillance Application

LEADERS

Map
-
Based Temporal Analysis
-

MedView

•
MedView provides a
geographical view of
medical surveillance
network

•
Users have the ability
to view defined
syndromic data over
time

Sepsis or non-traumatic
shock:
TOTAL: 0
TOTAL LAST 24 eh: 0
Unexplained bilateral
paralysis or stroke-like
symptoms
TOTAL: 0
TOTAL LAST 24 eh: 0
Unexplained death with
history of fever
TOTAL: 0
TOTAL LAST 24 eh: 0
Upper/lower respiratory with
fever
TOTAL: 0
TOTAL LAST 24 eh: 0
Diarrhea/vomiting/abdominal
pain, other GI distress
TOTAL: 0
TOTAL LAST 24 eh: 0
Mental status change,
delirium
TOTAL: 0
TOTAL LAST 24 eh: 0
None of the above
TOTAL: 0
TOTAL LAST 24 eh: 0
Rash and fever
TOTAL: 0
TOTAL LAST 24 eh: 0
Diarrhea/vomiting/abdominal
pain, other GI distress
TOTAL: 9
TOTAL LAST 24 eh: 9
LEADERS

Investigate Detected Patterns

Alerts are automatically
assigned to specific analysts
for investigation and are
tracked through to resolution.

LEADERS

Incident and Event Portal

•
Supports Command and Control activities for
incident and event planning and management

•
Based on DARPA research and technology

–
Deployed at multiple sites and exercises

•
IEP Development Approach

–
Review existing components with USAF and
Civilian surveillance communities

–
Identify and prioritize new requirements

–
Develop new modules, refine existing capabilities

–
Migrate existing modules to LEADERS

LEADERS

IEP Functionality

Incident Management

•
Incident data entry

•
Incident report generation

•
Emergency contact mgmt.

•
Emergency contact alerts

Casualty Tracking

•
Data collection

•
Location and triage history

•
Count reporting

IEP Dashboard

•
Multiple views of IEP data

•
User customizable

•
Search engine

•
Content management

ViewPort

•
Geographic display of data

•
Locate assets and resources

•
Spatial analysis of data

Checklist Management

•
Create checklists

•
Manage checklists

•
Activate checklists



Medical Facility Tracking

•
DEPT Status Tracking

•
Bed Count Tracking

•
Historical Reporting

•
Alarms and Alerts


LEADERS

IEP Modules

•
IEP Dashboard

•
ViewPort

•
Incident Management
Module

•
Emergency Contacts
Module

•
Checklist Manager Module

•
Casualty Tracking Module

•
Critical Care Tracking
System

LEADERS

Conceptual IEP Dashboard

•
‘Desktop’
View of
Available
Applications

•
Content
Management
Support

•
Easily
Customized
by the User

LEADERS

Incident Management
-

ViewPort

•
Incident/Event Management
and Resource Visualization
Tool

•
Provides real
-
time situational
awareness for Commanders
and responders within a
geographic context

•
Supports incident/event pre
-
planning, training, and after
-
action review in a visual
environment

LEADERS

IEP
-

Emergency Contacts Module

•
Real
-
Time Paging

•
Real
-
Time
Messaging

•
Easy To Update

LEADERS

IEP
-

Checklist2000 Module

•
Manages
Checklists
Using


Playbook
Approach

•
Checklists
“Pushed” to
Users

•
Role
-
Based

LEADERS

IEP
-

Casualty Tracking

•
Palm CaTT

–
Wireless Application

–
Bar Code

–
Captures Minimal Data
Set at Incident Site

–
Store/Forward Capability

–
Route Ambulances

•
Web CaTT

–
Synchronizes Field Data
to Hospital

–
Allows for More Defined
Data Capture at Hospital
Site

Palm CaTT

Startup

Status

Counts

LEADERS

IEP
-

Casualty Tracking

Example
Web
CaTT

Screen
Shot

LEADERS

IEP Critical Care Tracking System

•
Tracks Critical
Bed Care
Availability

•
Multiple
Jurisdictions

•
Multiple Stations

•
Network
Alarming

•
Built
-
In
Reporting
Capability

LEADERS

Pathogen ID with R.A.P.I.D.

•
Idaho Technology’s
R.A.P.I.D.
(Ruggedized
Advanced Pathogen
Identification
Device)

requires
minimal operator
experience

•
Designed for
transport and
operation under
extreme conditions

LEADERS

Security Overview

•
Primary Security Concerns

–
Authentication

to verify the identity of the
communicating parties

–
Access Control

to determine who may have access to
information within a system

–
Privacy

to protect sensitive information from being
viewed indiscriminately

•
Security focuses

–
Network communications

–
Application Server components

–
Database Access

LEADERS

Security Options
-

Phase 1

•
Secure Sockets Layer (SSL)

–
Network encryption (
privacy
)

–
Application Server authentication

•
LEADERS User Accounts

–
Username/password required for
authentication

–
Does NOT provide database access

•
LEADERS System Roles

–
Access Control

to LEADERS modules

•
Oracle8i Data Encryption

LEADERS

Security Options
-

Phase 2

•
Public Key Infrastructure (PKI)

–
X.509v3 Digital Certificates for authentication

–
Lightweight Directory Access Protocol (LDAP) for
access control

•
Alternative Authentication Mechanisms

–
SmartCards

–
Biometric authentication

LEADERS

System Administration

•
System Administration functions
integrated

into the
IEP

•
Central management of access to all LEADERS
components

•
Restricted

access to System Administration
functions

•
Managed
over the Web

•
Delegation
of responsibilities to customer
organizations

•
Creation and management of user accounts

•
Management of roles and user/role assignments

LEADERS

ASP Network Infrastructure

•
High Availability
Design

–
Fully Redundant
Components

–
Redundant Connections

–
Full Mesh Configuration

–
Complete failover
systems

–
QoS Bandwidth
Management

–
Separate Web/Application
and Data Networks

LEADERS

Schedule Overview

•
Months 1
-

4

–
Develop LEADERS V1.0 pilot

–
Deploy an initial operating capability at the ATIC

•
Months 5
-

12

–
Additional software releases

•
Revised functionality for existing components

•
New modules

–
Staggered deployment to 5 additional sites

•
Air Force will identify tiger teams for each site

•
Consortium and Air Force will define schedule and
dependencies

LEADERS

LEADERS Summary



ASP
-
Based service model


Integrated medical surveillance/command
and control toolset


System available 24 x 7


Large scale data collection


Enhanced ability to identify potential covert
attacks and significant outbreaks of disease


Agent identification and confirmation device


Incident and event management and
advanced visualization tools