Collaboration Collaboration In DiseaseIn DiseaseSurveillance & Surveillance & ResponseResponse Dennis Israelski, M.D. Dir. of Programs Eduardo Jezierski, Dir. of Engineering
InSTEDD at a GlanceNon profit, based in Palo Alto, California, USA
Mission: Innovative application of technology to early detection and better response to diseases and disasters
Founded by Larry Brilliant in 2006, TED Prize
Funding: Google.org, Rockefeller Foundation and others
First implementation: Mekong Collaboration Program
Free and open source
After the tsunami in Banda Aceh: A city leveled, and only one bar of cell signal
In our view, collaboration, in outbreak containmentand humanitarian action, is THE critical task
Refugee management
Cholera outbreak
Katrina response
Economic Impact of Recent Epidemics(12 listed, and all but one zoonotic)
Avian Flu, EU$500m
1996 1997 1998 1999 2000 2001 2002 2003
$50bn
$40bn
$30bn
$20bn
$10bn
Estim
ated
cos
ts
BSE, UK $10-13bn Foot & Mouth Disease
Taiwan, $5-8bn
1992 1993 1994 1995
Foot-and-Mouth DiseaseUK
$30bn
Avian FluAsia, US, Canada
$10bn (2004-now)
2004
BSE, US $3.5bn
BSE, Canada$1.5bn
Lyme diseaseUS $2.5bn
SARSChina, Hong Kong,
Singapore, Canada…$50bn+
Nipah, Malaysia$350-400m
Swine Flu, Netherlands
$2.3bn
BSE, Japan 1.5bn
© Graphic from "SARS and the New Economics of Bio-Security", by James Newcomb, Managing Director, Research for Bio Economic Research Associates, LLC or bio-era in 2003.
Hybrid Disease SurveillanceSurveillance Systems
CaptureFilterVerify
Identified risksMandatory notificationLaboratory surveillance
Emerging risksSyndromic surveillance
Mortality monitoringHealthcare activity monitoring
Prescription monitoring
Non healthcare basedVeterinary surveillanceBehavioral surveillance
Environmental surveillancePoison centers
Food safety/water supply…
Domestic, NGOsField ReportsOpen Media SurveillanceVeratect (Argus) , GPHIN, etc
Int’l Distribution listsProMed (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
SignalAssess
Control measures
DisseminateAlert
Investigate
Steung Treng Province, northern CambodiaMay 2008
From a faint signal to collective action
Merge & AnalyzeMerge & Analyze
Media
Journals
ICS Operations
Collective understandingEvent CharacterizationResponse initiationRealtime feedback
Immediate analysis & Decision making capacity
Peer- to –peer information sharing and collaboration
Informed collective action
Realtime feedback and coordination
Proactive education & preparation
From a faint signal to collective action
Merge & AnalyzeMerge & Analyze
Media
Journals
ICS Operations
Collective understandingEvent CharacterizationResponse initiationRealtime feedback
Immediate analysis & Decision making capacity
Peer- to –peer information sharing and collaboration
Informed collective action
Realtime feedback and coordination
Proactive education & preparation
Human Human Sensor & Sensor & Actuator Actuator NetworkNetwork
GeoChatGeoChat•MessagesMessages•LocationLocation•MetadataMetadata•AlertsAlerts
Data Interop& Data Interop& Information Information
FlowFlow
Mesh4xMesh4x•2-way sync2-way sync•MapsMaps•DatabasesDatabases•DocumentsDocuments
Over Files, Web, Over Files, Web, SMSSMS
Group Group Decision Decision Making & Making & AnalyticsAnalytics
““Riff”Riff”•Info StreamsInfo Streams•Social MetadataSocial Metadata•VisualizationsVisualizations•AnalyticsAnalytics
From a faint signal to collective action
Merge & AnalyzeMerge & Analyze
Media
Journals
ICS Operations
Collective understandingEvent CharacterizationResponse initiationRealtime feedback
Immediate analysis & Decision making capacity
Peer- to –peer information sharing and collaboration
Informed collective action
Realtime feedback and coordination
Proactive education & preparation
Human Human Sensor & Sensor & Actuator Actuator NetworkNetwork
GeoChatGeoChat•MessagesMessages•LocationLocation•MetadataMetadata•AlertsAlerts
Data Interop Data Interop & Information & Information
FlowFlow
Mesh4xMesh4x•2-way sync2-way sync•MapsMaps•DatabasesDatabases•DocumentsDocuments
Over Files, Web, Over Files, Web, SMSSMS
Group Group Decision Decision Making & Making & AnalyticsAnalytics
““Riff”Riff”•Info StreamsInfo Streams•Social MetadataSocial Metadata•VisualizationsVisualizations•AnalyticsAnalytics
GeoChatSMS Messages on a mapMabvuku, Zimbabwe*Found 3 cases of watery
diarrhea*urgent Lat long, Geocoding, tags SMS, email, (VHF?) Open or closed groups Visualize, Analyze, Export data
• Interactive Reply, see conversation threads Group reply, with filterso Group chat channels (IRC over SMS)
• Built for austere settings Cell plugged in to PC, or scale up to SIP Simple extensibility of message botso Wiki-like base for geocoding gaps
• Integrate with your applicationo Sync with HR contact list, embed UIo Integrate client into J2ME or WinCE device
From a faint signal to collective action
Merge & AnalyzeMerge & Analyze
Media
Journals
ICS Operations
Collective understandingEvent CharacterizationResponse initiationRealtime feedback
Immediate analysis & Decision making capacity
Peer- to –peer information sharing and collaboration
Informed collective action
Realtime feedback and coordination
Proactive education & preparation
Human Human Sensor & Sensor & Actuator Actuator NetworkNetwork
GeoChatGeoChat•MessagesMessages•LocationLocation•MetadataMetadata•AlertsAlerts
Data Interop Data Interop & &
Information Information FlowFlow
Mesh4xMesh4x•2-way sync2-way sync•MapsMaps•DatabasesDatabases•DocumentsDocuments
Over Files, Web, Over Files, Web, SMSSMS
Group Group Decision Decision Making & Making & AnalyticsAnalytics
““Riff”Riff”•Info StreamsInfo Streams•Social MetadataSocial Metadata•VisualizationsVisualizations•AnalyticsAnalytics
Mesh4x: Simplify information flow• REST-based N-way sync
+ Reliable than SOAP messaging Feedsync- Creative Commons ATOM & RSS Extensions
• No ‘single master’• Server, Desktop & Mobile• Storage adapters
MySQL, Access, KML, …
• Transport adapters Http, File, SMS text messages,…
• Securityo Encryption & oAuth authN
• Mappingo Xforms, RDF support
1- abc2 - efg23 - xyz
1- abc2 - efg23 - xyz
1- abc2 - efg13 - ---
1- abc2 - efg13 - ---
1- abc2 - efg3 - xyz
1- abc2 - efg3 - xyz
1- abc2 - efg3 - xyz
1- abc2 - efg3 - xyz
1- abc2 - efg3 - ---
1- abc2 - efg3 - ---
1- abc2 - efg23 - xyz
1- abc2 - efg23 - xyz
SMS-based or IrDA sync
http or USB Drive sync
Sync over http
1- abc2 - efg23 - ---
1- abc2 - efg23 - ---
1- abc2 - efg23 - ---
1- abc2 - efg23 - ---
From a faint signal to collective action
Merge & AnalyzeMerge & Analyze
Media
Journals
ICS Operations
Collective understandingEvent CharacterizationResponse initiationRealtime feedback
Immediate analysis & Decision making capacity
Peer- to –peer information sharing and collaboration
Informed collective action
Realtime feedback and coordination
Proactive education & preparation
Group Group Decision Decision Making & Making & AnalyticsAnalytics
““Riff”Riff”•Info StreamsInfo Streams•Social Social MetadataMetadata•VisualizationsVisualizations•AnalyticsAnalytics
Journals
ICS Operations
Immediate analysis & Decision making capacity
Peer- to –peer information sharing and collaboration
Data Interop Data Interop & Information & Information
FlowFlow
Mesh4xMesh4x•2-way sync2-way sync•MapsMaps•DatabasesDatabases•DocumentsDocuments
Over Files, Web, Over Files, Web, SMSSMS
Human Human Sensor & Sensor & Actuator Actuator NetworkNetwork
GeoChatGeoChat•MessagesMessages•LocationLocation•MetadataMetadata•AlertsAlerts
Riff: Collaboration around streams
Field Report 12Field Report 12
Article 234Article 234
DiscussionsTagging
Tags: influenza, unconfirmedTags: influenza, unconfirmed
2 Comments2 Comments
Tags: maps, influenza, asiaTags: maps, influenza, asia
3 Comments3 CommentsFavoritesLocation
12
2
asia influenza maps outbreak, suspected,
unconfirmed
asia influenza maps outbreak, suspected,
unconfirmed
SE Asia Health Alerts
Alerts
SearchLast Update: 30 minutes ago
30 minutes ago
12 hours ago
…Extensible!-Language translation- Visualization of data –eg genetic sequences, health alerts, medical records- Cross-space search, aggregation.- Exporting as different data formats.- Spatiotemporal metadata- Autonomous agents scanning & applying heuristics continuously
Logged in as User567
News Item 345News Item 345 16 hours ago
Newest first
Latest comments30 min ago by User445 (link)“I don’t think this news is accurate as it omits to mention the ...”
Latest comments30 min ago by User445 (link)“I don’t think this news is accurate as it omits to mention the ...”
(3 other members logged in)
Current Alerts• Item 1 , 30 mins ago, by User123Current Alerts• Item 1 , 30 mins ago, by User123
List
Existing ModulesLorem ipsum dolor sit amet, consectetuer adipiscing elit. Proin a ante. Fusce magna arcu, tristique vitae, accumsan eget, tristique eu, tortor. Donec euismod leo vitae augue. Donec aliquet augue non eros. Nam
Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Proin a ante. Fusce magna arcu, tristique vitae, accumsan eget, tristique eu, tortor. Donec euismod leo vitae augue. Donec aliquet augue non eros. Nam condimentum. Donec
Private or Public Spaces
One or more source feeds
Security Management
From Stung Treng province
From ReliefWeb
Collaborative Analytics
Article feature extraction
TagsTags
Content – in Riff
Metadata
CommentsComments
LocationLocation
Flags/Alerts/BookmarksFlags/Alerts/Bookmarks
Environment FactorsEnvironment Factors
PhylogeneticsPhylogenetics
Remote SensingRemote Sensing
InSTEDD
Event Characterization & D
etection Bot
Event Classification and Detection
Event Classification and Detection
Previous Event Training DataPrevious Event Training Data
Previous Event Control DataPrevious Event Control Data
Metadataextraction
Other reference
informationMachine Learning
Show event characterizations
Social network acting on itemSocial network acting on item
Other information
Open MediaOpen Media
Professional network feedback
Professional Feedback
Anomaly Detection
Riff Spaces
InSTEDD Field LabParticipatory ethnography meets natural selection
We learn there by failing fast and failing often.
In the end, we hope the tools we select will be:
more robust, more reliable, and easier to use.
Know who’s driving
Release PlanRelease Plan
Iteration Plan
Iteration Plan
Iteration ReleaseIteration Release
Daily Standup
Daily Standup
Dev & Test
Dev & Test
SpikesSpikes
Release 1m•Quality•Requirements• Functional and non
•Priorities•Partners•Demo Script
Iteration 1 w•Priorities•Key Tasks•Deployments
“Day” 1d•Dev, Test, UX•Community
Month
Week
Day
ReleaseRelease
Don’t reinvent the wheel
Develop& share
Partner, influence & contribute
Integrate & extend existing components
Use & recommend Existing Solutions
ExamplesKML, Feedsync, Open Street Maps,
Integrate BT w21c SMS with Google Maps, SMSLib with Mesh4x, transformers & adapters
Contribute to SMSLib, javaROSA, etc
Platform componentsOSS project creation
Scout, search, integrate & extend, before building.
When building, share and actively involve adopters in the process
Beyond Local Sustainability….
…to Sustainable Local Innovation
Cross Discipline Experts
Unforeseen ideas
Cultural fit
Global Public Health experience
Human Factors & Design
Innovative tools & services
Epidemiologists
Anthropologists
Broader adoption
Better cross sector
coordination
Research
Developing Engineers Global
applicability
Innovation Lab in Phnom Penh
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