InSTEDD Tools for Outbreak Epidemiology
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Transcript of InSTEDD Tools for Outbreak Epidemiology
Presentation prepared for the 2nd International Conference on
Global Health Applications of Handheld Computing Devices Atlanta, Georgia, USA – November 24-25, 2008
InSTEDD Tools for Outbreak Epidemiology
Taha Kass-Hout, MD, MSand
Eric Rasmussen, MD, MDM, FACP
2nd International Conference on Mobile Computing Devices November 24-25, 2008, Atlanta, Georgia, USA501c3 NGO
2nd International Conference on Mobile Computing Devices November 24-25, 2008, Atlanta, Georgia, USA
Slide 3
We create (or find) free and open-source software
for collaboration toward collective action.
We then teach other people how to create it for themselves
2nd International Conference on Mobile Computing Devices November 24-25, 2008, Atlanta, Georgia, USA
Slide 4
Questions in outbreak epidemiology
What information
isn’t getting to
those who need it?
What information
isn’t getting to
those who need it?
Which groups should be making more decisions
together?
Which groups should be making more decisions
together?
What field reports and broadcast alerts should come faster?
What field reports and broadcast alerts should come faster?
Which systems
need to share
information?
Which systems
need to share
information?
Collaboration…Collaboration…
How much can we learn from
what we already have?
How much can we learn from
what we already have?
2nd International Conference on Mobile Computing Devices November 24-25, 2008, Atlanta, Georgia, USA
Slide 5
Refugee trauma management
Cholera outbreak
Katrina response
In our view, collaboration in outbreak epidemiologyis THE critical task.
In our view, collaboration in outbreak epidemiologyis THE critical task.
2nd International Conference on Mobile Computing Devices November 24-25, 2008, Atlanta, Georgia, USA
Slide 6
1. Problem
– Agencies can’t (or won’t) communicate effectively in crisis
2. Requirements for the technical problem
– Software that is effective, free, standards-based, easy to use, sustainable, and thoroughly interoperable
3. Specifications
– Must have voices from WHO, US-CDC, UNICEF, MoH, OCHA, UNOSAT, ISDR, Relief Web, and many more involved in the design
4. Development
– We’ve built four free and open-source tools as prototypes for improved collaboration in crisis. They address the gaps we identified.
5. Implementation
– Field evaluation in progress with all four, plus a website now up
– Educational model for introducing disruptive technologies
Collaboration pathway
What we need to see… A young village health worker on her rounds finds a bleeding mother and
two children. The man is missing.
She sends an SMS with the location, an explanation, and the tag “bleeding”, then isolates the home
The SMS is received and triggers a cascade of events, including the dispatching of a Rapid Response Team and notification of both the Health Minister and the health worker’s nearest hospital.
The health worker receives an SMS telling her the message was received, and providing urgent management advice for suspected hemorrhagic viruses
The SMS from the health worker appears in a stream of messages that include recent monkey smuggling, and food insecurity leading to harvesting bushmeat. It is spotted by the surveillance software bots, combined with other information, and hypotheses are proposed.
A team of MDs, nurses, vets, logisticians, and others work together to plan and implement a response, entering information only once. Slide 7
2nd International Conference on Mobile Computing Devices November 24-25, 2008, Atlanta, Georgia, USA
The InSTEDD Collaboration Suite
1. GeoChat
2. Mesh4x
3. Riff
4. ( RNA )
5. www.TrackerNews.net
6. Innovation Lab
All free andopen-sourceAll free andopen-source(and working names…)
2nd International Conference on Mobile Computing Devices November 24-25, 2008, Atlanta, Georgia, USA
When that village health worker finds a bleeding family…
• (GeoChat) She has to notify someone
– And others need to learn of the problem
– The health worker needs to know she’s been heard
• (Mesh4x) Spreadsheets, maps, and databases need the information
– Synchronized as changes are made to ensure a common picture
• (Riff) A team needs to evaluate the significance, and they need context to sort it out
– They need to see each other and what else is known
• (RNA) Decision-makers need tools for event detection, hypothesis testing and planning
– Human and machine based decision support
2nd International Conference on Mobile Computing Devices November 24-25, 2008, Atlanta, Georgia, USA
GeoChat
Mobile-based reporting with (some) language support
Web-based mapping, mining, and chat
Vertical and horizontal alerts
– Multiple levels, multiple groups
Geo-tagging and topic tagging
Any cell phone that can use SMS
96% of the world’s ISPs now supported
Slide 10
Joining a GeoChat group in Cambodia
2nd International Conference on Mobile Computing Devices November 24-25, 2008, Atlanta, Georgia, USA
GeoChatGeoChat
2nd International Conference on Mobile Computing Devices November 24-25, 2008, Atlanta, Georgia, USA
GeoChatmessages
GeoChatmessages
2nd International Conference on Mobile Computing Devices November 24-25, 2008, Atlanta, Georgia, USA
Mesh4x:Imagine an outbreak response in the field…
Lots of information collected, working with many partners
Political and collegial will to share, but
– Different software applications between agencies
– Little or no internet connectivity (many modes, very flexible)
Mesh4x lets you:
– Choose the information to share
– Identify the various applications holding it
– Identify the various computers holding it
– Synchronize it all, over multiple modes (even just SMS!)
Excel, Google Earth, Access, ESRI ArcX, MySQL, etc.
Over to Taha…
2nd International Conference on Mobile Computing Devices November 24-25, 2008, Atlanta, Georgia, USA
Hybrid Disease Surveillance
Surveillance Systems
CaptureFilterVerify
Identified risksMandatory notification
Laboratory surveillanceEmerging risks
Syndromic surveillanceMortality monitoring
Healthcare activity monitoring
Prescription monitoringNon healthcare based
Veterinary surveillanceBehavioral surveillance
Environmental surveillance
Poison centersFood safety/water supply
…
Domestic, NGOsField ReportsOpen Media SurveillanceInt’l Distribution lists
ProMed (Regular, MBDS, Spanish, Russian, etc.)
International agencies WHO, OIE, CDCNASA (e.g., remote sensing, weather, population migration, bird migration, population density, plant, animal)
Confidential/LimitedProMed (e.g., MBDS)International health regulation agencies (WHO, OIE, CDC, NASA)Threat bulletin (EWARN, ECDC)
Public disseminationNews, blogs, articles, Health ministry press releases websitesWeekly releases (Eurosurveillance)
Event MonitoringIndicator Based Event Based
CollectAnalyze
Interpret
Signal
Assess
Control
Disseminate
Alert
Investigate
2nd International Conference on Mobile Computing Devices November 24-25, 2008, Atlanta, Georgia, USA
Hybrid Disease Surveillance
Surveillance Systems
CaptureFilterVerify
Event MonitoringIndicator Based Event Based
CollectAnalyzeInterpret
Signal
Control
Alert
Feedback
Feedback D
ete
ctio
nR
esp
on
se
2nd International Conference on Mobile Computing Devices November 24-25, 2008, Atlanta, Georgia, USA
• Riff is a next-generation information browser
• GeoChat messages show up there, with HealthMap (ProMED), Google News, email…
• When a concerning message appears, teams can join in
• Regional health officers, CDC, parasitologists, vets, HAZMAT teams
• Tools are included in Riff for letting teams enhance information
• Commentary, annotation, analysis, tagging, geocoding, reliability…
• Cognitive analytics built in for collaborative decision support. (RNA)
RiffRiff is a collaboration browser
2nd International Conference on Mobile Computing Devices November 24-25, 2008, Atlanta, Georgia, USA
Slide 17
Information streams……with collaborativespaces…and cognitiveanalytics
Seven syndromes and 10 transmission modes> 100 infectious diseases> 180 micro-organisms> 140 symptoms> 50 chemicals
Slide 18Timeliness, Representativeness, Completeness, Predictive Value, Quality, …
Machine learning methods:
• Support Vector Machines
• Clustering
• Entity extraction
• Neo-Bayesian analysis
• Satisficing
• Hypothesis testing (HMM)
• Relationship suggestions
2nd International Conference on Mobile Computing Devices November 24-25, 2008, Atlanta, Georgia, USA
Slide 19
In Southeast Asia
Invited by Mekong Basin Disease Surveillance Network (MBDS) to support technology for surveillance and response
Started in Cambodia with CDC because Cambodia is the technology lead.
Supporting the entire region.
2nd International Conference on Mobile Computing Devices November 24-25, 2008, Atlanta, Georgia, USA
Innovation Lab( Physical space in Cambodia )
400 hour workplan
125 hour curriculum
Curriculum for ownership of InSTEDD tools and beyond
Neutral space for academia, Ministry, local NGOs, more
Dissolving silos – teaching as cross-functional teams
Capacity enhancement for IHRs and MDGs
Back to Eric…
2nd International Conference on Mobile Computing Devices November 24-25, 2008, Atlanta, Georgia, USA
TrackerNews.net
2nd International Conference on Mobile Computing Devices November 24-25, 2008, Atlanta, Georgia, USA
2nd International Conference on Mobile Computing Devices November 24-25, 2008, Atlanta, Georgia, USA
Open Mobile Consortium
South Africa
UNICEF
Robert Kirkpatrick is Chair
– InSTEDD CTO
~35 organizations
Standards and agreements
Slide 23
2nd International Conference on Mobile Computing Devices November 24-25, 2008, Atlanta, Georgia, USA
Slide 24
Further Information
+1-650-353-4440www.TrackerNews.net
taha.instedd.org