Transcript Slide 1
Susan K. Laird, MSN, RN
Clinical Director/Content Lead
CDC-INFO
Presentation to
AIRS CONFERENCE
Reno, Nevada, June 1, 2009
Objectives
• The purpose of this workshop is to…
– Share CDC-INFO background, successes
and challenges, and lessons learned.
– Identify CDC and CDC-INFO resources that
are available for use every day and in
emergency response.
Agenda
• Welcome and Introductions
• What is CDC-INFO?
• Background and Scope
• Role in Emergency Response
• Impact – Internal and External
• Questions/Discussion
What Is CDC-INFO?
CDC-INFO Vision
To be a trusted source
that partners, providers,
and the public come to
for accurate, timely and
consistent information.
What is CDC-INFO?
– Launched in 2005
– CDC-INFO employs 94 staff at its National Contact
Center
– Delivers health information 24/7/365
– Audience: Consumers, healthcare providers and
professionals
– English and Spanish service
CDC-INFO workload:
– More than 2.1 million telephone inquiries answered
since 2005
– Over 200,000 e-mails answered since 2005
– Distributes 9M publications annually
6
CDC-INFO Call and Email Counts
FY05
(Feb-Sep 05)
FY06
FY07
FY08
FY09
(Oct 08Apr 09)
Phone Calls
answered
325,820
496,580
377,015
372,969
309,035
Email Requests
answered
4,496
33,067
41,171
49,305
55,979
Publications
Shipped
N/A
N/A
3,210,942*
8,887,097
4,252,472
CDC-INFO’s Role in Public Health
and Communication
•
•
Best Practices in eHealth Science and Research
Health Communication and Marketing
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–
•
Multi-channel modalities to address differing informationseeking needs, preferences and behaviors
Audience Research: analyzing inquirers and demographics to
inform CDC programs
Public Health
–
Accurate, credible health information to positively impact health
behavior
•
•
–
–
“call to action”
Measure inquirers’ reported behavior change
Health Disparities and Health Equity
Emergency Response
CDC-INFO Structure and
Scope
Contact Center
(Vangent– 2 locations)
Program
Leadership and
Coordination
Emergency
Response
• Calls, email, and TTY
• Three levels of expertise to address
audience needs:
> Tiers 1, 2, 3, Correspondence
• Maintains and refines content database with
CDC program approval
• Technology and processes allow
CDC-INFO operations to handle call
volume increases from media
events, large campaigns, health
related emergencies, pandemics, or
bio-terrorist activities.
• Based on activation triggers and
coordination with ECS
• Ongoing independent, systematic,
and continuous evaluation of the
Contact Center and the Fulfillment
contracts
• Call monitoring, program
calibration, customer satisfaction
surveys, follow up surveys,
special event surveys, and
emergency surveys.
• Turnkey publication warehouse
and fulfillment operation
Publication
Ordering
/Fulfillment
Evaluation
EMT
Contact Center Operations
Location
Phoenix, AZ1
Supervision
Supervision
Tiers 1, 2, 3,
Tiers 1, 2, 3
Correspondence
Correspondence
Location
Rockville 2
Tier 33 Only
Only
Tier
Phone & Email
Contact Center
Operations
Contact Center
Management
2 Locations
Some remote staff
Quality Assurance
Vangent Staffing (Dec. 2008)
• Contact Center Operations
Management and Support - 8
• Phoenix and Rockville CSRs – 60
• Email Support- 13
• Content Development (SRA)- 9
• Training – 3
• Quality Assurance - 1
All calls recorded
1 in 25 calls per
Operator 3 rd party
evaluation
Training
Continuous:
Group &
Self-paced
Everything we do should help the contact center staff better meet the needs of consumers, providers and CDC partners
Contact Center Tiers
Tier 1 (general):
Prepared responses, clinic referrals, and publication orders
Tier 2 (research):
Requests requiring web and database research
Tier 3 (provider):
Calls requiring medical/public health expertise and escalate inquiries to CDC
Correspondence (email)
Emails from physicians, public health partners, and general public
Interactive Voice Response (IVR) system
Tier 1 – 20,819 calls
Tier 2 – 7,436
calls
Call Counts are for calls answered by Tier, December, 2008
Tier 3 –
4,092 calls
Content Development
• Prepared Responses are program cleared content
written in a question and answer format for contact
center reps to consistently and accurately answer
inquiries
• Over 8,000 Prepared Responses (PRs) in database
• Developed and cleared in collaboration with CDC
SMEs
• Plain language and scientific accuracy focus
• Focus on most frequently requested questions from
public and professional audiences
• Leverage existing CDC website content
• Maintains scientific integrity
• Meets Health Literacy and Plain Language goals
Content Development
What the public wants to know…
•
•
•
•
•
What is it?
What are the signs/symptoms? (What does it look like/feel
like?)
How will it hurt me – will I die? How sick, etc.
How can I catch it/prevent myself (and my family, loved
ones, etc.) from catching it?
If I get it what should I do? Do I stay home and drink fluids?
See a doctor? Go to the ER? Call 911?
Content Development
• What does CDC-INFO need to know to
best represent CDC Programs?
– What types of questions can we anticipate
from healthcare providers/hospitals?
– What types of questions can we anticipate
from state and local health departments?
Content Development
• What do you consider to be sentinel topics?
– Best to develop individual Prepared Responses for all potential
sentinel topics
• What constitutes an “event?”
– Do you have pre-defined “talking points” for events?
• Do you have “tipping points” defined?
– Is there a specific number of inquiries that could indicate an
event of some kind?
– When and how do you decide to ramp up?
Prepared Response Example
1053 - What is a healthcare provider's risk of HIV infection after occupational exposure?
The risk of a healthcare provider getting HIV after coming into contact with HIV-infected blood, through a needlestick or
cut, is very low (0.3 percent or about 3 chances out of 1,000). In fact, most injuries from needlesticks or cuts (99.7
percent) do not lead to infection.
The risk of a healthcare provider getting HIV after his or her:
* eye,
* nose, or
* mouth comes into contact with HIV-infected blood is also very low (0.1 percent).
The risk is also very low for a healthcare provider whose non-intact skin, such as a cut or scrape, comes into contact with
HIV-infected blood (less than 0.1 percent).
If you are a healthcare provider managing occupational exposures to blood/body fluids and have questions about
appropriate medical treatment after an exposure at work, you can call the National Clinicians' Post-Exposure Prophylaxis
Hotline (PEPline) at 1-888-448-4911 for guidance.
Call to Action
If you are a healthcare provider, and are concerned about contact you have had with blood or other body fluids, report it to
your supervisor right away. It is important to report the exposure to the right people in your workplace right away, because
you may need post-exposure treatment. If you do, it must be started as soon as possible.
PROBE:
Would you like to know what you should do if you are exposed to the blood of a patient?
See prepared response ID 1052, What should I do if I am exposed to the blood of a patient?
PROBE:
Would you like to know how effective postexposure prophylaxis (PEP) is in preventing percutaneous transmission in
healthcare personnel?
See prepared response ID 1408, Is postexposure prophylaxis (PEP) effective in preventing percutaneous transmission in
healthcare personnel?
[Partial example – there are publications and background materials on the full PR
Evaluation
– Impact and Process Evaluation
• Quality Assurance
• Customer Satisfaction
– Audience Research
• User profiles
• Health disparities and health equity
– Methodology
• Approved OMB package for evaluation surveys,
including emergency response
• CSR monitoring (audio and video)
• Scorecards for phone and email
• IVR post-call survey
• Email survey
• Call-back survey
• Mystery shopper and calibration/call review
– Results
• Overall CDC-INFO customer satisfaction consistently
meets or exceeds industry standard (75%)
• 50% of survey respondents indicate a behavior change
was made because of CDC-INFO health information
they received
Caller Demographics: Age
Age of CDC.gov Users
Age of CDC-INFO Callers
65+
3%
65+
8%
0-34
39%
50-64
23%
0-34
29%
50-64
33%
Age of U.S. Population
65+
13%
35-49
30%
35-49
35%
Sample Size: 77,624
50-64
18%
Sample Size: 1,297
0-34
47%
•CDC-INFO callers are younger and
older than CDC.gov users
35-49
22%
Source: CDC-INFO demographics are from
IVR Automated Survey
Caller Demographics: Gender
Gender of CDC-INFO Callers
Gender of CDC.gov Users
Male
28%
Male
34%
Female
66%
Sample Size: 78,092
Female
72%
Gender of U.S. Population
Source: ACSI Survey, 2006
•CDC-INFO callers are disproportionately female
Male
49%
Female
51%
Caller Demographics: Race
Race/Ethnicity of CDC.gov Users
Race/Ethnicity of CDC-INFO Callers
White
70%
White
53%
Black/African
American
22%
Other
4%
Black/African
American
21%
Hispanic/Latino
17%
Other
2%
Asian
4%
Race/Ethnicity of U.S. Population
White
66%
Black/African
American
13%
Other
2%
Hispanic/Latino
15%
Asian
4%
Hispanic/Latino
1%
Source: ACSI Survey, 2006
Sample Size: 76,715
•CDC-INFO callers are disproportionately
Black/African American
Asian
6%
Customer Satisfaction
Source: EMT, Dec. 2008
CDC-INFO Impact: Health Behavior
Change
Source: EMT Call Back Survey Results Dec. 2008
CDC-INFO Impact: Partners
•
19% of incoming calls are from partners*
– State and local governments
– Health professionals
– Technical “peer-to-peer” call handling needed
•
State and Federal coordination during emergency response
– Provide assistance with call and email handling
• Iowa – statewide mumps outbreak
• Rhode Island – meningitis in schools
• FEMA – Hurricane Katrina during and after, formaldehyde in trailers
• FDA – Various food outbreaks
• DoD – Camp LeJeune
• New Jersey – Hepatitis outbreak
• New York – H1N1
•
Partner Engagement Opportunities
– Tailor content specific to partners for emergencies and other events
– Cross-promotion across other CDC channels (www.cdc.gov/partners,
Partnership Matters, etc.)
– Resource to partners on public health trends to inform communication and
response strategies
* 13.8% English and 4.9% Spanish selected the Medical Professional picks on the IVR.
Includes Physicians with patients and health departments
CDC-INFO’S ROLE IN
EMERGENCY RESPONSE
CDC-INFO & Emergency
Response
CDC-INFO Surge Response
• CDC-INFO serves as the contact center
for HHS resources in the event of
pandemic flu or other disease outbreaks
• CDC-INFO implemented a state-of-the-art
system that provides critical surge
capacity to respond to 98,000 to 273,000
calls per day – with an average call time
of 3 minutes – based on the American
Red Cross experience during Hurricane
Katrina
• CDC-INFO increases response capacity
for public and healthcare provider
inquiries in emergency and natural
disaster events, disease outbreaks and
media events
• CDC-INFO extends state and local
responder capacity during high volume
and after hours inquiries
Agency Impact
• The IVR (call menu system) allows for
pre-recorded or on-the-fly messages
about events or campaigns
• OMB approved surveillance questions
that CSRs will ask during events
•17 questions for Health
Professionals
•12 questions for General Public
• Federal Coordinator brings together
other Federal agencies to ensure
resource sharing, standard protocol
adherence, and inter-connectivity
before, during and after an event.
How CDC-INFO Responds
During Emergencies
Stage 1
Notification and
Activation
• Triggers
• Inquiry volume
assessment
• Selection of contact
center staffing option
• Requirements Gathering
• Cost/Partner
Assessment
Multi-Stage
Scalability
Process
Stage 2
Mobilization
Stage 3
Operations
• Staffing ramp up
• Event Training
• Content updates
• IVR set up and
routing
• Inquiry volume
tracking
• FAQ/Content Tracking
• Reporting
• CSR Communication
• Quality Monitoring
• Technology enabled
Stage 4
Demobilization
• Staffing ramp down
• Inquiry volume
tracking
• Deactivation of surge
SOP, IVR and call
routing
Stage 5
Recovery/ Lessons
Learned
• Steady state staffing
• Lessons learned
analysis
CDC-INFO & Salmonella
CDC-INFO & H1N1
Timeline
•
•
MMWR Dispatch
Vol. 58 / April 21, 2009
•
Swine Influenza A (H1N1) Infection in Two Children — Southern
California, March–April 2009
•
On April 17, 2009, CDC determined that two cases of febrile respiratory
illness occurring in children who resided in adjacent counties in southern
California were caused by infection with a swine influenza A (H1N1) virus.
The viruses from the two cases are closely related genetically, resistant to
amantadine and rimantadine, and contain a unique combination of gene
segments that previously has not been reported among swine or human
influenza viruses in the United States or elsewhere. Neither child had
contact with pigs; the source of the infection is unknown. Investigations to
identify the source of infection and to determine whether additional persons
have been ill from infection with similar swine influenza viruses are ongoing.
Timeline – 4/21/2009
• 4:17 PM - Influenza Coordination Unit sends
“heads up” to CDC-INFO Leadership
• 4:18 PM – Content Team asked to develop Log
Call. Contact Center management team notified
of potential surge
• 5:30 PM – Log Call process initiated at CDCINFO Contact Center