How Washington State Leverages Data to Improve Emergency Preparedness

September 29, 2024 | Erin Laird

PPE: gloves, masks, hand sanitizerWhen an emergency strikes, supplies like personal protective equipment (PPE) need to be deployed rapidly and strategically. Local, state, and federal partners must work together to identify and meet community needs—a process that requires timely access to actionable data about medical countermeasures and other vital public health supplies. State health agencies need to know how many public health supplies are on hand so they can make informed decisions and react to developing situations.

In March 2024, ASTHO, with support from the Administration for Strategic Preparedness and Response (ASPR) and HHS Coordination Operations and Response Element, selected three state health agencies—Ohio, Massachusetts, and Washington—to identify and pilot scalable solutions to improve data and information sharing for public health response.

ASTHO conducted a site visit to the Washington State Department of Health (WA DOH) in June 2024 to learn about their medical logistics center and observe the first in a series of regional tabletop exercises—Highly Efficient Local Logistics Operations Tabletop Exercise (HELLO TTX)—they conducted to better understand logistical considerations of requesting, receiving, and distributing PPE and medical countermeasures and tracking last mile distribution.

Medical Logistics in Washington State: Moving Faster to Save Lives

The Washington State Medical Logistics Center plays a pivotal role in emergency response, supporting WA DOH’s ability to quickly distribute vital supplies and medical countermeasures before and during major incidents.

Through the COVID-19 response, the WA DOH medical logistics effort expanded to include vehicles, systems, and a 198,000 sq. ft., temperature-controlled warehouse. This effort ultimately supported WA DOH’s ability to distribute over 150 million gloves, 66 million surgical masks, 30 million N95 respirators, and other vital supplies throughout the COVID-19 emergency response.

This increased logistical capacity has allowed WA DOH to respond to many other events. In 2023, in response to wildfire smoke, WA DOH distributed 850 air cleaners across the state in just two days to support points of dispensing (PODs) in tribal communities. The Yakima Fire Department experienced an opioid overdose outbreak in September 2023 and WA DOH coordinated statewide to identify supply of naloxone and support mutual aid. Finally, in May 2024, WA DOH distributed 96 portable air cleaners and pallets of N95 respirators to the Benton Franklin Health District to support POD operations for communities with air quality impacted by the Lineage Cold-Storage Fire.

Receiving, storing, and distributing medical countermeasures and other supplies requires strong data management systems and practices. WA DOH strives for a collaborative approach to enhance data management for logistics. By facilitating bidirectional data sharing among healthcare, emergency management, public health, and tribal partners, WA DOH aims to enhance its ability to track assets and “last mile” logistics. To this end, WA DOH conducted a series of in-person tabletop exercises (TTXs) with each region of the state. These TTX discussions focused on the logistical considerations of requesting, receiving, and distributing PPE and medical countermeasures using a scenario of a novel influenza outbreak.

Leveraging TTX Discussions to Understand Local Logistics

Washington Department of Health staff
Washington Department of Health staff gathered for a tabletop exercise with ASTHO staff.

The tabletop discussions were organized into two modules: Medical Logistics Requesting, and Medical Countermeasures Planning and Last-Mile Distribution. The tabletop discussions focused on understanding how local jurisdictions source, receive, and distribute supplies. Cory Portner, director of WA DOH’s Office of Emergency Medical Logistics, praised the discussions: “The HELLO-TTX series highlighted the power of collaboration and gave us actionable insights into refining our response strategies and logistics operations. Effective communication across agencies is key. As always, at the end of the day it comes down to relationships and knowing who to call.”

Many jurisdictions indicated they do not have the space or staff to manage more than a small stockpile of supplies. Once requested from the state, local jurisdictions coordinate with local partners—such as libraries, foodbanks, fire departments, and immigrant assistance centers—to get materials distributed to the community, often using either PODs or using trusted partners to distribute to the population they serve.

Space came up as an issue repeatedly, with some jurisdictions utilizing creative solutions such as leveraging storage available at fairgrounds, a county-owned airport, and even an old jail (a solution that raised some unique challenges for receiving).

Last mile tracking depended on the type of asset. For example, tracking for PPE typically ended at the community partner level (the agency or site that received the supplies), while tracking for vaccines could show more data on number of vaccines administered by a provider. The focus of last mile tracking for local jurisdictions centered around using last mile information to ensure that the requestors received what was needed. Looking ahead, additional last mile tracking could shed light on equity and a better sense of whether community needs were met, rather than just whether orders were filled.

Portner reflected, “HELLO TTX showcased that local partnerships vary widely: larger urban areas typically focus on healthcare and emergency management organizations, while smaller rural areas engage a broader range of local sectors like fire departments and veterinary services. Medical logistics operations also differ, with urban areas having greater storage capacity and more advanced data tracking, while rural areas face limitations in both. Additionally, local prioritization of PPE and medical countermeasures affects how each area tracks logistics and manages storage.”

Looking Ahead

Washington Department of Health's Medical Logistics Center
This 198,000 sq. ft., temperature-controlled warehouse serves as the Medical Logistics Center for WADOH, housing PPE, medical countermeasures, and other supplies.

Effective public health response requires an understanding of what supplies are needed, where they are needed, and to track whether those needs were met. To achieve this, coordination and communication across multiple levels of public health is critical. "Next up, we’re focusing on asset tagging and improving supply chain visibility through enhanced data readiness. Our goal is to create a more transparent and responsive logistics system, to make sure that we’re fully prepared for any future emergencies in support of communities in Washington state and beyond,” explained Portner. The strategies explored by these data readiness pilot sites can improve critical processes and demonstrate sustainable methods to meet the demand of bidirectional information sharing for public health agencies and their partners.