On December 12 and 13, NACCHO participated in a CDC-led site visit for the Nurse Triage Line Project (NTL) partners to visit the Hennepin Poison Control Center and several facilities on the United Health Group’s Minneapolis campus. Staff Andrew Roszak and Sara Rubin, along with NACCHO member Robert Einweck (member of the Medical Countermeasures Workgroup and Antiviral Dispensing Workgroup), represented NACCHO during these site visits. Over the past two years, the NTL project team has conducted site visits, community stakeholder meetings, simulation exercises, and conference presentations across the country to share information about the project and better understand how such a concept can fit into existing surge response plans in communities.
Based on lessons from the 2009 H1N1 pandemic, the CDC, in collaboration with NACCHO and the Association of State and Territorial Health Officials, among other partners, launched an effort to explore the acceptability and feasibility of using a coordinated network of nurse triage telephone lines during a pandemic. These lines will be used to assess the health status of callers, help callers determine the most appropriate site for care (e.g., hospital emergency department, outpatient, home), provide clinical advice, and provide access to antiviral medications for ill people, if appropriate. As part of this effort, the integration and coordination of poison control centers (PCCs), existing nurse advice lines, 2-1-1 information lines, and other hotlines are being investigated. Utilizing a network of nurse triage lines is one of many potential tools that may be useful in reducing medical surge during a severe pandemic. The NTL project is largely based on the success of the Minnesota Flu Line during the 2009-10 H1N1 pandemic, so it is only fitting that we had yet another opportunity to visit the state.
Visit to Hennepin Poison Control Center in Minneapolis
The NTL project team spent an afternoon chatting with poison center leadership and then touring their facility. For the past 41 years, the Hennepin Medical Center has hosted this PCC, which is the only center of its kind in Minnesota and also serves residents of North and South Dakota. In 2012, this poison center answered more than 70,000 phone calls, with approximately 61,000 calls related to exposure and the rest information only. For exposure calls, poison centers are known for keeping 92 percent of callers at home to manage their symptoms effectively without additional healthcare. A recent report showed that for every $1 spent on poison control services, $13 are saved in potential medical costs. This poison center in particular follows a pharmacist model and most of the specialists in poison information are pharmacists by training. Additionally, the poison center uses Poison Information Providers, who are generally pharmacy technicians or EMTs, to field calls that do not involve toxicity.
Visit to United Health Group
The NTL project team spent a full day with leadership of United Health Group discussing the project and touring their facilities. The team visited United Health Group’s data center to learn about their advanced voice technologies and also visited the Optum Command Center. Of particular interest is United Health Group’s NurseLine which is available to 35 million consumers 24 hours, 7 days a week. To date in 2013, the NurseLine has fielded more than 1.5 million calls of which 60 percent are triage and 20 percent are educational. The NTL Project team has met with several key stakeholders to understand how they might participate in the triage line system during a flu pandemic.
