13 November 2001 The Honorable Barbara A. Mikulski Dear Senator Mikulski: As a representative of The Institute of Electrical and Electronics Engineers-United States of America (IEEE-USA) and our Medical Technology Policy Committee (MTPC), which I chair, and several of my colleagues from the MTPC, we wish to convey our appreciation to you for offering us the opportunity to meet with your staff member, Stephanie Sterling, on October 15, 2001. Our purpose was to present our input for improved counter-bioterrorism and its threats to the Public Health information technology and telecommunications infrastructure. In March of this year, our committee, MTPC, established a Working Group on Bioterrorism to address the potential public health concerns that we had envisioned possible if a serious bioterrorism event were to have occurred in our nation. Ironically, our earlier meeting that day happened to be with Senator Frist's staff in Room 608 of the Hart Building. We were in the hot zone apparently and are now learning first-hand what bioterrorism is all about. In attendance at our meeting with Ms. Sterling besides myself, were Dr. Michael McDonald, President of Global Health Initiatives here locally in Potomac, Maryland and Chair of MTPC's Working Group on Bioinformatics and Genomics; Dr. Luis Kun, Adjunct Professor of Public Health Informatics at Emory University and Chair of MTPC's Working Group on Bioterrorism and former Senior Fellow at CDC in Atlanta; Dr. Victor W. Weedn, MD, JD, Principal Research scientist at the Center for Light Microscope Imaging and Biotechnology, Carnegie Mellon University, Dr. Kathleen Carley, also from Carnegie Mellon University, and Dr. Edward Maibach, Worldwide Director of Social Marketing at Porter Novelli here in Washington, D.C. This letter is sent to you to express our thanks to you for your outstanding leadership in supporting counter-terrorist threat legislation and applaud your support as we all work to meet the unprecedented bioterrorism challenges of the past week. In addition, we wish to offer our organization's readiness through our volunteer committee and working groups to meet with your staff and assist in there planning and possible development of Information Technology (IT) and Telecommunications legislative enhancements aimed at improving the efficiencies of our national public health system when asked to meet the needs of a national emergency such as that occurring over these past few weeks. During the meeting with Ms. Sterling, one of the areas mentioned was the apparent lack of information technology and telecommunications focus that we had observed in the recent legislation (PL 106-505) and how this limitation needs to be addressed more explicitly in order to improve the responsiveness of the local and State Public Health organizations now in place. As an example of our discussions, we had noted the lack of off hours availability of many Public Health services in many of our nations local communities and the limited availability of on having means for information dissemination means available to the local Public Health offices. Our group suggested during the meeting with Ms. Sterling that more explicit legislative direction for funding, focused on enhancing IT and Telecommunications facilities at the local and State levels (see section 309D of PL 106-505), not just focused on generic facility enhancements which to many would imply simply the adding of staff or test equipment, would greatly improve local public health organization responsiveness to crises. We encourage federal support to vital, local and state Public Health offices in acquiring pagers, cell phones, access to Email and high- speed telecommunications services so that immediate capabilities not affordable at the local level can be provided in a uniform manner. In addition, it was noted that to accomplish what we see as support to the community public health activities in an emergency, some oversight management from the federal level should be established, possibly through our new Homeland Security Office. Dr. Luis Kun, one of the attendees at our meeting, is from Atlanta, Georgia. He now can attest first-hand to the fact that gaining accurate and timely information as to what to do and where to go for help in an emergency was very lacking. From his Atlanta home location, he encountered considerable difficulty in obtaining proper authorization to receive medication from local sources even though he verified that he was within the known and reported "hot zone" of the event that occurred in the Hart Senate Building. This is a prime example of how ineffective the dissemination of accurate information and authorization for action occurs at the layers below the Federal level. Finally, during our meeting with of some possible concerns for the impact that NIH's patient information privacy and confidentiality regulations under the HIPAA legislation may have on the gathering of terrorist information by our law enforcement agencies was made to Stephanie to alert those involved in this of a possible area of concern that needed review. The House has now approved a new bill that opens up these areas and our committee is in process of reviewing this now and would be happy to provide our insight to your staff. Again, all of us appreciate the opportunity to have met with your exceptionally well-versed staff member and we offer our volunteer services to you and your staff on any additional information or analysis needed. The Institute of Electrical and Electronics Engineers Inc. (IEEE) is one of the largest organizations within the American Institute of Medical and Biological Engineering (AIMBE). Its membership in the world is just over 360,000 members in 150 countries including almost 230,000 members here in the U.S. The IEEE-USA, a policy oriented arm of the IEEE, and especially its MTPC, was established to support the creation of position papers and public policy guidance documents based on sound engineering and scientific principles supported by our membership. If we can be of any service to you and if you wish to contact us, your staff can reach us through Ms. Deborah Rudolph of the IEEE-USA headquarters staff at (202) 785-0017 x8332, 202 785-0835 (fax), or d.rudolph@ieee.org. Respectively yours, Frank E. Ferrante
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