February 4, 2004—As today’s public and private health care systems are wrestling with how many and what kinds of resources to deploy towards bioterrorism preparedness in the face of limited finances, the University of Pittsburgh Medical Center (UPMC) has developed a roadmap that will make this decision making process easier and allow health officials to preplan crisis decision-making.
Known as the Pittsburgh Matrix, this emergency response application has the potential to be an effective method for quantifying survivorship, medical costs for response and options for treatment of specific bioterror agents, according to UPMC experts who developed the system.
The Pittsburgh Matrix works by identifying various bioterrorism scenarios and assessing them against hospital patient volume and timeline of detection.
Four levels of hospital patient volume are measured ranging from low, medium, high and above all capacity. The values given to the timeline of detection include the pre-release stage, the release stage, the symptom occurrence stage, the illness occurrence stage and the epidemic stage.
“Obviously, to save the most lives during a bioterrorism attack, the best scenario would be to identify a pathogen during the pre-release stage such as through syndromic surveillance, and within a hospital’s current capacity. Conversely, many lives would be lost if a bioterror attack is epidemic and a hospital is beyond capacity,” explained Dr. Allswede.
Pittsburgh Matrix methodology enables medical decision makers to assess a variety of scenarios in advance in order to deploy resources to save the most lives, and is designed to be flexible in order to fit each particular hospital facility, whether large or small. The Matrix might suggest one hospital to stockpile medications rather than invest in hospital surveillance detection systems, but offer different recommendations to another. A companion cost capture tool assists in these decisions.
In the Pittsburgh Matrix, bioterror agents are also numerically rated to characterize their severity. For any treatable disease, the ability to deliver lifesaving treatment depends on the nature of the bioterrorism agent, when it is detected, the complexity of treatment and hospital load. Bioterror agents recorded in the Pittsburgh Matrix are grouped into the following categories: communicability/quarantine needs, effectiveness of medical treatment and availability of medical treatment. The higher the score of a specific bioterrorism agent, the more complex and expensive the pathogen is to treat. The score for each bioterror agent is then added to the timeline-capacity boxes to express risk, complexity and expenses involved in management.
The project is funded through the Agency for Healthcare Research and Quality’s Integrated Delivery System Research Network (IDSRN). This work has been collaboratively conducted with researchers at RTI International.
For more information on UPMC’s bioterrorism preparedness programs, visit UPMC.
