Monday, December 22, 2008

Epi Info™ and Mesh4x Prototype Demonstration with US CDC

On Thursday, December 18th, 2008, we gave a joint theater-style demonstration of synchronizing Epi Info™ Data using Mesh4x with the Division of Integrated Surveillance Systems and Services (NCPHI/DISSS) at US CDC.

[The Epi Info™ team: David Nitschke (lead) (left), Roger Mir (middle) and Mark Berndt (right). According to our imaginary scenario (where we extended the sample Oswego outbreak from 1940), David is the NY State epidemiologist, Roger is the Oneida county Medical Officer, and Mark is the CDC epidemiologist]

Here is a presentation and script scenario which walks you through the scenario step-by-step. You can download the latest Mesh4x tool from here, which also includes the sample data. [If you do not already have a copy of Epi Info™, you can download it from here]

Oswego in the Cloud: Scenario Script
View more documents from Taha Kass-Hout.

During this proof-of-concept, we showed the utility of a Mesh4x tool for synchronizing Epi Info™ data over the cloud (web) and SMS (Please see my previous blog in which I introduced this effort: "Empowering Epidemiologists to Share Information, Anytime, Anywhere: Epi Info™ and Mesh4x"). Epi Info™ is now available as an Open Source project (Please see Official US CDC MMWR release notice and the most recent Government Health IT article: CDC takes its epidemiological software open source).

[The Epi Info™ ─ Mesh4x Synchronization Tool]

[Synchronization over over the Amazon EC2/S3 cloud (State’s available online data in the scenario)]

The Synchronization over SMS using cell phones provides great potential for sharing data among field epidemiologists conducting investigations in areas with limited resources and infrastructure, especially in austere conditions (e.g., during or after disasters).

[Synchronization over SMS]

As part of the scenario, we showed how to share maps across various investigators (in the scenario Oneida county and the neighboring counties). This is especially true as the epidemiologic investigation in underway, that data is shared in aggregate forms; such as a map with a few pins, before further collaboration. During the demonstration, we used Google Earth as the viualization tool to show the various cases (Ill) and no cases are distributed across space (accurately geocodesd) and time (through a time slider). We integrated Google geocoder with the Mesh4x tool to automatically geocode the sample physical addresses and we provided means in the Mesh4x tool to automatically generate and synchronize the maps across the various counties.

Here I show the maps before synchronization of data (one map for Oneida county (highlighted in pink) on the left and the rest of the counties on the right). After the synchronization was completed, both maps were identical as the counties now have similar data.

After the demonstration, we identified with US CDC a high priority list for next steps, including:
  1. Preview/Accept/Reject or "Undo" & Conflict Resolution
  2. Schema/view update and propagation
  3. Mesh-based authentication & authorization
  4. Specify multiple tables to sync
  5. SMS-to-cloud and back
  6. Client to define mesh, feeds, mappings
  7. Privacy & Signatures
[Brainstorming priorities with the Epi Info™ team (from left to right): Roger, Mark and David. Ed facilitated the discussion as you see him going through the projected list]

DISSS is currently seeking a project to continue development of this functionality pending the availability of resources. I'll keep you posted!

We are very grateful for the time and expertise US CDC offered us during this exercise and we wish to further enhance our tools and platform as a result of this effort. I want to personally thank the Epi Info™ team: David Nitschke (lead), Roger Mir and Mark Berndt, and US CDC National Center for Public Health Informatics (or NCPHI) leadership team: Dr. Leslie (Les) Lenert (Director) and Enrique Nieves (DISSS Division Director (Acting)).

[The NCPHI leadership team: Les (left) and Enrique (right)]

I also want to acknowledge my colleagues at InSTEDD who worked really hard over the past six weeks to put this together and to see it succeed, including work done at very early odd morning hours: Juan Marcelo Tondato, Daniel Cazzulino, Pablo M. Cibraro, and Eduardo (Ed) Jezierski.

Finally, on Behalf of InSTEDDers, I want to wish you Happy Holidays and a Happy New Year!

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