White House order puts HHS in charge of biosurveillance efforts

A new White House directive orders the Department of Health and Human Services to establish a national biosurveillance system to detect threats to human health and says the system should rely, where possible, on e-health records.The directive, Homeland Security Presidential Directive 21, covers many aspects of public health and medical preparedness for a naturally occurring or deliberately induced health emergency on a large scale. The directive states that it “will transform our national approach to protecting the health of the American people against all disasters. “For the most part, the directive gives HHS authority over the response to health emergencies. It appears to come down on the side of HHS in a number of areas where there has been uncertainty over whether HHS or the Department of Homeland Security was in charge. Both DHS and HHS have biosurveillance programs, for example.HSPD-21 calls for HHS to field a system “that is predicated on state, regional, and community-level capabilities and creates a networked system to allow for two-way information flow between and among federal, state and local government public health authorities and clinical health care providers.”It continues: “The system shall build upon existing federal, state and local surveillance systems where they exist and shall enable and provide incentive for public health agencies to implement local surveillance systems where they do not exist. To the extent feasible, the system shall be built using electronic health information systems.”Within six months, HHS must establish an Epidemiologic Surveillance Federal Advisory Committee in coordination with the departments of Defense, Veterans Affairs and Homeland Security. The committee must include representatives from state and local government public health authorities and appropriate private sector health care entities.The directive also creates a Cabinet-level Public Health and Medical Preparedness Task Force chaired by the HHS secretary. The task force will develop the implementation plan for the strategy.