ANNUAL REPORT OF THE EPICS PROJECT:
OCTOBER 1, 2000 – SEPTEMBER 30, 2001 

The preparation of an annual report serves not only to document progress for funding agencies, project stakeholders, and participants; it is also a means of reestablishing one’s bearings, as it is sometimes difficult to gauge actual progress in an endeavor as complex or multi-dimensional as the EPICS Project during the daily course of “doing” the EPICS Project.  Being immersed in the project forest, negotiating the changes in terrain along the way, surviving challenges to one’s footing, conserving scarce provisions and deploying them prudently, developing re-supply strategies for the long haul, and most importantly, keeping the group together and focused on its purpose and mission—these are the day-to-day realities of any project.  It is only by casting a look over one’s shoulder, in a state of recollection, that real progress can be adequately discerned.  Significant events and accomplishments, and lessons learned, set the stage for developing more enlightened maps and provide a sense of optimism and commitment for the future.  While this annual report might appear lengthy to some of our readers, it is because the year’s accomplishments are placed in their context; and we also want our annual reports to reflect our commitment to providing more detailed information about the internal workings of the EPICS Project.

A Year of Transition: Project Organization, Management, and Local Support

Fiscal Year (FY) 2001 was a year of planned transition in the EPICS Project, as one of the primary objectives was to have local agencies and participants assume a more active role in managing the project, especially since state-provided resources would expire on December 31, 2001 (see EPICS Fact Sheet).  Toward this end, we formed the EPICS Advisory Council, which is comprised of Commissioner Charles Hall, coordinators from the five EPICS service areas, the Orange County Cooperative Extension Service, Indiana State Department of Health, State Emergency Management Agency, and the EPICS Project Manager.  The Advisory Council met monthly throughout the year to discuss plans, activities, and progress in all five service areas and issues of top-level importance that affect all service areas equally.  In addition, five working groups were formed to address emergency management, health, fire, law enforcement, and transportation issues and potential information technology applications, and to develop each of these service areas more fully.  Most of these groups met routinely throughout the year to analyze needs, target areas for special attention, and assist in development efforts.  The services of a full-time EPICS Project Manager were contracted through Southern Indiana Community Health Care, Inc., the funds of which were provided through a Preventive Health Services Block Grant (Centers for Disease Control) administered through the Local Liaison Office of the Indiana State Department of Health.  The project team is grateful to the Orange County Commissioners for the support they have provided throughout the fiscal year, and to the Orange County Auditor for the support and assistance he has provided.  In addition, members of the Advisory Council and working groups are commended for their time and efforts throughout the year.

EPICS Telecommunications Infrastructure: Keystone Technology

The EPICS telecommunications network, the technological centerpiece of the project, connects all EPICS agencies to each other and their counterparts in state government.  The network encompassed 28 EPICS agencies during the fiscal year, with the inclusion of Orleans Family Practice, Patoka Family Health Care, Comprehensive Health Care, and the Orange County Health Department.  In addition, the Orange County government building was internally wired, in order to provide network and Internet access, through the building’s T-1, to 11 additional agencies that are not direct participants in the EPICS Project at the present time.  The courthouse on the town square was also connected to the government building, which provided those agencies with access to the network and the Internet.  The Intelenet Commission, Indiana Higher Education Telecommunication System, the Orange County Cooperative Extension Service, and Helix Technology are responsible for these important network developments, and we recognize them for their contributions.

General Communications and Coordination Capabilities for All EPICS Agencies

The EPICS telecommunications network provides the communications linkages, or information highway, that connects the health and public safety agencies to each other, and it sets the stage for a variety of interagency information applications to travel over the network.  One can never underestimate the importance of simple “information sharing” and “coordination” among public safety and health agencies, and how these activities contribute toward accomplishing the emergency preparedness mission.  E-mail and DNS (domain name service) were configured on computers in all EPICS agencies during the fiscal year.  In addition, we developed a variety of list serves to facilitate general, specific, and private communications among agencies.  List serves were developed and are in use for the EPICS Advisory Council, each of the five service areas and their working groups, and the Petra Users Group.  In addition, a General EPICS Mailing List was developed so all EPICS agencies, stakeholders, and participants can communicate with each other about important project issues and developments.  Web-based scheduling and communications software was made available to the 27 individual agencies, the five service-area working groups, and the project management team.  An Orange County Community Calendar was also developed and is now accessible to residents of the community on Orange County Safety Net.  The community calendar is a way of keeping residents informed about public health and safety events, such as health screenings, fund-raising activities, Severe Weather Awareness Week, and the EPICS Project.  Helix Technology merits special recognition for providing these important capabilities to EPICS agencies and Orange County residents.

Public Education: EPICS Agency World Wide Web Sites and Orange County Safety Net

Individual sites on the World Wide Web were designed and developed for all EPICS fire, law enforcement, emergency management, health, and transportation agencies during FY 2001, providing a means of communicating important health and safety information to the residents of Orange County.  These individual sites were organized into Orange County Safety Net, a single public interface, or web site, for all EPICS agencies and the project (see http://epics.co.orange.in.us).  The site also provides access to information from the Orange County Commissioners and the Orange County Auditor.  EPICS Project information is located on Orange County Safety Net, under About EPICS.  Interested parties will find the EPICS Project Fact Sheet and EPICS Project Annual Reports, beginning with this FY 2001 report.  Orange County Safety Net is hyper-linked to Indiana Safety Net, the State of Indiana’s public safety information network, which provides Orange County residents instant access to a treasure trove of electronic health and safety information resources.  In addition, EPICS agencies were trained to use the DESTIN tool, which allows agencies to update and manage content on their web sites from remote computer workstations throughout Orange County.  The Intelenet Commission’s IN-Map Project provided all of these services and capabilities to EPICS agencies, and we appreciate their support and accomplishments.

Development of Individual EPICS Service Areas Strengthens the Whole

The mission of the EPICS Project is countywide emergency preparedness, and we are trying to accomplish this mission by having all the public safety and health agencies work more actively with each other and the residents of Orange County.  Early in the project, we focused on the county emergency management agency and its mission, because the director of that agency must coordinate the activities of a large number of agencies across the county—fire, law enforcement, and transportation—as emergencies actually occur.  By adopting this initial strategy, we could involve all these agencies in the project at the same time.  We initially included local health agencies in the EPICS Project because health agencies have a vital role in all emergencies (e.g., fires, tornadoes, transportation accidents, snow emergencies, etc.); but we also included them because future planning for emergency preparedness must include potential biological threats and incidents, and health emergencies.  Local health agencies have an integral role in assisting the local emergency management agency, the State Emergency Management Agency, and the Indiana State Department of Health in these activities.      

But health and safety are ubiquitous phenomena, just as they are inextricably related to each other.  Even in the earliest stages of the project, we knew that we would develop information technology applications in each of the five EPICS service areas—emergency management, fire, law enforcement, health, and transportation—in their own right; and that by strengthening the parts we would strengthen the whole.  This strategy would increase the service providing capabilities in the county, maximize the use of the EPICS telecommunications network, and strengthen the overall mission of emergency preparedness.  In this context, we now turn to specific accomplishments within the five EPICS service areas during FY 2001.

Orange County Emergency Operations Plan.  An online emergency operations plan is now available to all 27 public safety and health agencies and the residents of Orange County.  It is accessible in a variety of digital formats on Orange County Safety Net under Emergency Management.  The Orange County Emergency Management Director is commended for managing this application to its completion.  Orange County is the first county in the State of Indiana to have an emergency operations plan available to its residents on the World Wide Web.

Visual Petra: Electronic Medical Records.  A new electronic medical record keeping system, Visual Petra, was developed and configured for operational use at Patoka Family Practice, South Central Family Health Care, and the Bloomington Hospital of Orange County Emergency Room.  A systems approach to security for this system was also designed and implemented.  Not only does Visual Petra make the same digital patient records available at these clinics and the hospital emergency room, in the event that a patient might be transported there, for example, in the middle of the night; it is also a significant step toward coordinating the delivery of health care across Orange and Crawford County.  A Petra Users Group was formed in January, and it is comprised of users at the clinics and hospital emergency room, system designers and developers, trainers, information technology support personnel, sponsors, and the project manager.  This forum will facilitate the exchange of information to increase user proficiency, enable the identification of additional training needs, and improve the record keeping system itself.  Petra Systems, Ltd., Practice Data Management, Helix Technology, Bloomington Hospital of Orange County, and the Indiana State Department of Health collaborated in this important accomplishment.

Two-Way Video Units.  Video units were installed at Patoka Family Health Care and South Central Family Health Care, and the latter agency is sharing its unit with the South Central Vocational School.  These video systems will enable teleconsulting with providers of needed health services in distant locations, making new health services available to county residents.  They will also provide a means of delivering continuing education to medical/allied health and public safety personnel in the county.  These two units and another that is presently available in the county government building will serve as “video hubs” for use by all EPICS agencies.

Integrated Law Enforcement Case Management & Accident Reporting System.  This new application enables the County Sheriff and the four town police departments to develop digital case files and accident reports in their own departments and to share this information with each other, the County Prosecutor, and four contiguous Indiana State Police Posts—creating an important new law enforcement capability.  The system incorporates Indiana State Police forms in all locales.  The courts will soon be involved in this effort through the County Prosecutor.  Orange County is the first in the state to adopt this type of system on a countywide basis.

“911 Caller” Map Locator.  When the Orange County emergency operator receives a “911 call” from a resident, business, or other organization, a digital map is displayed which pinpoints the location of the caller.  Since the fire departments do not presently have global positioning systems in their vehicles, we are developing a software application that will enable digital maps with directions to the 911 caller’s location to be provided to all EPICS Fire/EMS Departments and the County Ambulance Service.  This will enable quicker response times to emergencies, and it can help save lives and property.  Patrick Cassidy of the Orleans Fire Department recommended this important new application, and Helix Technology and the county’s 911 operator are coordinating the implementation effort, which is expected to be operational in October 2001.

High-Risk Accident Areas and Construction Zones.  A recent national report concluded that rural roads have the highest accident rates in America.  In part, this is because they are often two-lane roads, they incorporate many changes in terrain, and motorists tend to travel at higher rates of speed.  In order to provide important safety information to the residents of Orange County, the EPICS transportation working group has identified the need to post maps of the county, which indicate higher-risk accident areas on county roads, or ones that are correlated with the highest frequency of accidents.  We will develop a web-based application that will be accessible by residents on Orange County Safety Net.  In addition, construction areas will be marked, which will enable residents to take alternate roads, if available, or provide advanced notice that they will need to be prudent and travel at appropriate rates of speed in these areas.  This application will be developed during the second quarter of FY 2002.               

Computer, Software, Network Communications, and Visual Petra Training Programs

Training is a vital component of any technology implementation effort, and Helix Technology provided a basic computer and software training course for all EPICS agencies in November 2000.  The course included operation of personal computers, Windows, Microsoft Office, e-mail, and accessing information on the World Wide Web.  An advanced course was offered in Summer 2001, and it emphasized networked communications such as group e-mail, list serves, web-based scheduling packages, search engines, access to servers, and creation/sharing of digital files.

Practice Data Management commenced training on the new Visual Petra electronic medical records system in September 2001 at Patoka Family Health Care.  Training at South Central Community Health Care and the hospital emergency room will be completed in October 2001.  Additional Visual Petra training needs will be identified and managed through the Petra Users Group.

Welcome to New EPICS Partners

Purdue University Cooperative Extension Service, West Lafayette, IN joined the EPICS Project in early Spring 2001.  They will be developing safety education and emergency management training materials, which will be available through Orange County Safety Net.  The Emergency Medical Services Division of the State Emergency Management Agency attended the August meeting of the EPICS Advisory Council, and the regional coordinator will be working to increase the contribution of this important service area in the project.  RuralConsult.Com, a teledermatology service based in Terre Haute and Indianapolis, will provide training for EPICS health care agencies to use their services beginning in October 2001.  This provides a new health care service for residents of Orange County.  We have been working with the IU School of Medicine, Department of Endocrinology, to plan the development and implementation of enhanced diabetes treatment programs through web-based applications and other media such as two-way video consultations.  Diabetes was identified as a high-priority area in a recent health care needs assessment conducted by Indiana University for the Orange County Health Board. Medical Care & Outcomes, Inc., a follow-up health care provider in Indianapolis, will contribute their services in the areas of prescription and treatment compliance monitoring, as part of a federal grant.  This important new service will integrate follow-up care with treatment regimens provided in the clinics. The South Central Area Vocation School has partnered with EPICS to provide facilities for public safety and health education programs, and access to online health and safety information for Orange County residents through their computer lab.  They will also be collaborating with the IU School of Medicine and Indiana State Department of Health to develop an Area Health Education Center at a future date.

Grant Applications

Linda Wells, Southern Indiana Community Health Care, Inc., applied for a Community Action Program grant through the U.S. Department of Health and Human Services, Health Resources and Services Administration.  This grant application sought funding for personnel, enhanced diabetes treatment, and training for a wide range of information technology applications.  Hoosier Uplands, in collaboration with the EPICS Project Manager, submitted a grant application to the National Library of Medicine for upgraded telecommunications services at four SICHC clinics.  These high-speed circuits will enable clinics to expand the use of information technology applications such as e-mail, list serves, and web-based scheduling; accessing health information for clients and staff on the World Wide Web; Visual Petra electronic medical records; and new health services such as enhanced, web-based diabetes treatment applications and follow-up care services.  We also provided assistance to Hoosier Uplands for their U.S. Department of Commerce, Technology Opportunities Program grant application for EPICS II in Lawrence County, IN. 

EPICS Continuation Planning Efforts

A major effort for this year was to develop and implement a plan for the continuation of the EPICS Project into the future, since state-provided resources would expire on December 31, 2001.  This plan was developed through the efforts of the EPICS Project Manager and the EPICS Advisory Council.  It has five elements. 

(1)    EPICS public safety agencies will fund their own telecommunications/Internet services through local service providers beginning in January 2002.  The EPICS health clinics have requirements for higher speed circuits, or more bandwidth, compared to the public safety agencies, and these more expensive circuits will be funded through grants.  We signed a two-year contract for these services through AT&T.  In addition, we are putting in place a high-speed, digital circuit between the Orange County government center and the Bloomington Hospital of Orange County, so health clinics can access Visual Petra.  The Orange County Commissioners and the County Council approved funding for the T-1 in the county government center, in partnership with the Orange County Cooperative Extension Service and Indiana Higher Education Telecommunication System.  We were able to reduce our yearly telecommunications costs by two-thirds by implementing this portion of the EPICS continuation plan. 

(2)    Information technology support services are vital for the continuation of the EPICS Project, and we have a funded, one-year agreement with Helix Technology to provide these needed services to all EPICS agencies during FY 2002.

(3)    Continued training for EPICS agencies is also an important element of our plan, as personnel in all five EPICS service areas will need this training to ensure their continued proficiency in using a variety of information technology services and devices.  We funded Helix Technology to provide computer and software training services in FY 2002.

(4)    A contract between Southern Indiana Community Health Care, Inc. and the Indiana State Department of Health will provide for EPICS Project Management Services during FY 2002.

(5)    The EPICS Advisory Council, the five EPICS service area working groups, and the Petra Users Group will meet monthly during FY 2002, in order to manage and carry out the activities which are crucial for developing and sustaining the EPICS Project in Orange County.  Quarterly project management meetings, which are open to the public, will continue to be held at the 4-H Building in Paoli.  Dates and times will be posted on the Orange County Community Calendar, which is available on Orange County Safety Net.       

New EPICS Projects

From the beginning, the Orange County EPICS Project was designed as a model that could be replicated in other counties of Indiana.  We are very pleased that the EPICS Projects will be implemented in Lawrence and Marshall County during FY 2002.  The Lawrence County EPICS Project is a partnership between Hoosier Uplands, the Lawrence County Health Department, the Lawrence County Emergency Management Agency, and the Indiana State Department of Health.  We will plan collaborative emergency preparedness efforts between Lawrence and Orange County during FY 2002.  The Marshall County EPICS Project is being implemented through a partnership between the Marshall County Health Officer and the Indiana State Department of Health.  We wish both of these counties the very best in their EPICS projects.

Looking Ahead: October 1, 2001 – September 30, 2002

Although the accomplishments during FY 2001 are significant and substantial, we are always looking ahead in a project of this kind.  There is much to do, and here is a road map for the coming fiscal year.

• We need to increase the level of commitment to the mission and activities of the EPICS Project, especially in light of the tragic events of September 11, 2001 in New York City, Washington, D.C., and near Pittsburgh, PA.  These kinds of attacks on our country have radically increased the importance of the EPICS Project, in our opinion, as the project is a model for how entire communities can come together with local and state public safety and health agencies to plan for emergencies of all kinds.  We have a solid organizational foundation and set of technology tools in place; but the emergency preparedness activities themselves never end.  As we go about our project activities during the coming year, we should also remember the words we penned over three years ago, which we referred to as the spirit of the EPICS Project:

“The EPICS Project, through its implementation, pays homage to the many public safety and health professionals who have displayed acts of courage and heroism, everyday, as they make our communities safer places in which to live.” 

• We need to work with the Intelenet Commission and IHETS to disconnect the present telecommunications circuits, without incurring additional network costs; and we need to provide for migration to new network services through local telecommunications providers for all EPICS agencies no later than December 31, 2001.  This will assure uninterrupted communications, coordination, planning, and other EPICS service activities. 

• We need to successfully implement the Visual Petra electronic medical records system at Patoka Family Health Care, South Central Community Health Care, and the Bloomington Hospital of Orange County Emergency Room, providing the foundation for coordinated health care in the county.  In addition, we need to extend Visual Petra to other clinics, based upon the success of these efforts.  We also need to enhance the effectiveness of the Visual Petra Users Group as mechanism for always improving the operational effectiveness of Visual Petra as a critical part of the health care system.

• We need to develop new health care applications for residents of Orange and Crawford County, which include enhanced diabetes treatment and follow-up care through information technology applications.  The partnerships are in place for these efforts to begin.

• We need to successfully implement the “911-caller” map locator application for all EPICS fire/EMS departments and the county ambulance service in the first quarter of FY 2001.

• We need to update the online county emergency operations plan through the full participation of appropriate county agencies, using the new technology tools we have in place to do this more efficiently.

• We need to develop and successfully implement the new transportation services application, which involves the identification of high-risk accident areas and construction zones, and make this information available to the residents of Orange County through Orange County Safety Net by the second quarter of FY 2001.

• We need to extend the use of the new integrated law enforcement case management & accident reporting system to all law enforcement agencies, the County Prosecutor, the courts, and the four Indiana State Police posts that are contiguous to Orange County.  This will greatly expand the information sharing capabilities among these agencies.

• We need to expand the development and use of the 27 EPICS World Wide Web sites and Orange County Safety Net in coordination with local educational institutions, public safety & health agencies, and the county commissioners, in order to provide a full range of emergency preparedness education programs to Orange County residents.

• We need to provide reliable funding mechanisms for all five EPICS service areas through partnerships, grant writing activities, and appropriations.  These activities need to involve all 27 EPICS agencies, the County Commissioners, the County Council, state representatives and senators, Southern Indiana Community Health Care, Hoosier Uplands, and new EPICS partners.

• We need to provide routine reports on the accomplishments of the EPICS Project to residents, community leaders, and the news media, in order to increase the level of support for the project and provide resources. 

In Closing

On a more personal note, we would like to acknowledge the innumerable contributions of Dr. Hazel Katter, Indiana State Department of Health; Jerry Sullivan, Executive Director of the Intelenet Commission, for his support and significant financial contributions; Robert Demuth, State Emergency Management Agency, for his contributions to the project team; Norman “Red” Cundiff, Orange County Emergency Management Director, for his many efforts that extend way beyond the normal call of duty; and Charles W. Hall, Orange County Commissioner, for his vital, continued support of the EPICS Project and what it brings to Orange County, Indiana.

We hope to have other exciting and beneficial developments to report to you next year.  In the meantime, it’s back to the task at hand: emergency preparedness is a mission that never ends.

Respectfully submitted,

Philip D. Bruce
EPICS Project Manager
October 15, 2001