VetNet: Integration of Veterinary and Animal Health Professionals

State: WI Type: Model Practice Year: 2004

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The Metropolitan Milwaukee Area "VetNet" (Veterinary Network) is an electronic information and alert messaging system developed by the City of Milwaukee Health Department (MHD) to enhance public health preparedness and response to animal health and emerging zoonoses. VetNet provides the MHD with linkage veterinarians and other animal health professionals (AHPs) previously not engaged in community emergency planning and preparedness. The MHD recognized the need to develop a more formalized communications network and relationship with the animal health community as result of responding to a monkeypox outbreak during the summer of 2003.

VetNet is currently comprised of members representing various AHPs practicing or employed by animal hospitals, clinics, shelters and other related facilities (i.e. Humane Societies, Domestic Animal Control Agencies, etc.). AHPs include veterinarians, veterinary technicians, and office staff from private practice facilities, and shelter and zoo staff. Other members of VetNet are animal control officers, sanitarians, health officers, epidemiologists and governmental veterinarians.

VetNet has forged a critical link between AHPs and the public health communities that facilitates communication by providing relevant information and related resource guidance integral to a coordinated response to outbreaks involving animals or zoonotic disease of human importance. VetNet also serves as a survey tool to solicit input and integrate AHP expertise in local and regional emergency planning, training and response. In the future, VetNet may also serve as a animal disease surveillance tool and portal for direct exchange of data of interest to public health authorities in this regard.

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Milwaukee City Health Department
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VetNet: Integration of Veterinary and Animal Health Professionals
The Metropolitan Milwaukee Area "VetNet" (Veterinary Network) is an electronic information and alert messaging system developed by the City of Milwaukee Health Department (MHD) to enhance public health preparedness and response to animal health and emerging zoonoses. VetNet provides the MHD with linkage veterinarians and other animal health professionals (AHPs) previously not engaged in community emergency planning and preparedness. The MHD recognized the need to develop a more formalized communications network and relationship with the animal health community as result of responding to a monkeypox outbreak during the summer of 2003. VetNet is currently comprised of members representing various AHPs practicing or employed by animal hospitals, clinics, shelters and other related facilities (i.e. Humane Societies, Domestic Animal Control Agencies, etc.). AHPs include veterinarians, veterinary technicians, and office staff from private practice facilities, and shelter and zoo staff. Other members of VetNet are animal control officers, sanitarians, health officers, epidemiologists and governmental veterinarians. VetNet has forged a critical link between AHPs and the public health communities that facilitates communication by providing relevant information and related resource guidance integral to a coordinated response to outbreaks involving animals or zoonotic disease of human importance. VetNet also serves as a survey tool to solicit input and integrate AHP expertise in local and regional emergency planning, training and response. In the future, VetNet may also serve as a animal disease surveillance tool and portal for direct exchange of data of interest to public health authorities in this regard.
During the monkeypox outbreak in 2003, the MHD became aware that there was no reliable and efficient way to contact AHPs and leverage necessary expertise to facilitate response to a rapidly evolving public health emergency. Monkeypox represented a disease never before seen in North America and with little information available regarding interspecies animal transmission, human susceptibility, routes of exposure and level of contact necessary to propagate disease within a population. Furthermore, the MHD had limited knowledge of animal surveillance systems, data availability or capacity within the community and surrounding region. This scenario created a level of complexity and challenge in conducting the public health epidemiological investigation. It became clear that the monkeypox outbreak investigation would have been greatly facilitated in terms of strategic plan development if veterinarians and the animal health community would have been integrated immediately into the emergency outbreak response. VetNet provides a tool in which AHPs can be rapidly alerted to provide assistance and expertise in managing zoonotic outbreaks of public health importance. To assure an effective response to a zoonoses or related outbreak scenario that is either natural or possibly deliberate in intent, an efficient and reliable means of communication with AHPs is essential. No other communication system between public health and AHPs was in existence prior to development of VetNet. Communication that previously occurred was both informal and unreliable. VetNet incorporates a broad range of interested AHPs from throughout Area, including small animal, emergency or urgent care. Whenever a message is sent, it is distributed in a manner that reaches a high percentage of a broad range of AHPs that are geographically distributed across a large metropolitan area. This distribution is important because it assures a level of representation that crosses jurisdictional boundaries as is common to most epidemiologic investigations involving human disease.
Agency Community Roles The MHD created VetNet within the framework of an individual goal and subcommittee formed as part of a workplan developed under funding provided by the Department of Homeland Security (DHS) Urban Area Security Initiative (UASI) to Metropolitan Milwaukee. The MHD is the chair of the subcomittee and facilitates setting agendas, generating minutes from meetings, development of a line item budget and coordination of specific subcomittee initiatives. Participants in the subcommittee include representatives from local public health agencies (environmental health), university extension services, domestic animal control officers, humane society staff and veterinarians in private practice. These stakeholders provide the input, review and consensus on how to best meet objectives of the strategic goal outlined in the overall UASI work plan. The subcommittee reports to a larger Steering Committee on meeting objectives set forth as part of initial UASI regional strategic planning. The MHD continues to promote and recruit other disciplines, organizations and agencies to participate in the subcommittee based on expressed interest in developing emergency plans, joint exercises and training opportunities of AHPs. Costs and Expenditures The cost of VetNet is about $15,000, including staff salary. Part of the $13,600 salary will come from DHS-UASI funding (the remainder will be provided by the MHD through tax levied funds). Stakeholder commitment is assured through both continuation of the subcomitte as well as coordination by the MHD in providing and sharing information with participating AHPs as well as assuring AHPs input in designing training seminars and emergency operations plans. Implementation The initial UASI funding received by the MHD was for period of18 months. The subcomittee identified three primary objectives: to develop and "pilot" a electronic communications and alert messaging system between public health and AHPs in a three county region (VetNt) to begin development of the framework for a regional animal health emergency response plan (Annex) for integration into each county emergency operations plan (EOP) and explore training opportunities for AHPs to enhance understanding of public health preparedness and planning processes and initiatives currently underway or already existing within the community. A second year of UASI funding is expected to allow for continued work in completing each of the above objectives. Specifically, the VetNet directory was developed using an address list purchased from the Wisconsin Veterinary Medical Association (WVMA) as well as through internet and Yellow Pages searches. All Area humane associations were included, as well as domestic and wildlife shelters that were identified. VeNet members were asked to provide an email address or a fax number to receive messaging and alert from the MHD. As additional sources of potential members are identified, more potential members were identified and recruited. Currently there are 184 members in the VetNet directory. MHD expects to have 250 members (90 facilities represented) over the coming year through continued outreach to veterinary technicians and other interested public health agencies. VetNet was also used by the MHD to launch a training survey to directory membership of purpose of assessing interest in future training opportunities. Results of the survey are currently being used to plan a symposium for AHPs to be coordinated by the MHD and UASI subcommittee members. Finally, outlines for a template for a draft animal health emergency response plan has been developed for further refinement and integration into existing UASI county EOPs.
It appears that VetNet, as a tool for electronic communications with AHPs is modestly successful based on the previously described process evaluation. Anecdotally, there appears to be a desire and interest on the part of AHPs to continue participation and involvement in VetNet and the regional collaboration lead by the MHD. MHD has included a total of 82 (over 80% of facilities invited) private practice hospitals, clinics, and other facilities in VetNet. From within those 82 facilities, 175 AHPs are reached directly by VetNet (the rest of the 193 current members work for government as veterinarians who do not work directly with animals or in public health or are retired veterinarians and did not respond to the survey). Twenty-six of the 82 facilities (32%) responded to a recent survey about AHP interests and needs and satisfaction related to VetNet. Ninety-six percent of the respondents stated that VetNet was at least "somewhat useful." Comments received described appreciation of timely information, request for blind copy email and request for MHD to send information about roles in public health emergencies involving animals. Feedback and suggestions from a broad range of AHPs and public health is also provided to MHD.
Sustaining the practice over time will require the retention of staff to research, prepare and send messages and interact with the AHP. This staff will either be paid with grant funding or operation and maintenance funding. VetNet is compatible with any existing Email and broadcast fax system MHD might use in the future. A full-time planning coordinator is being proposed through UASI funding to provide the necessary administrative and community outreach support critical to performing the above activities and achieving the desired outcomes. Finally, CDC Bioterrorism Cooperative Grant funding is being leveraged (current staff time) to facilitate many of the above subcommittee activities until a full-time planning coordinator can be recruited and hired.
 
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