One by-product of this ongoing effort is that the information is appropriately tagged and geo-located. The A(H1N1) workspace allows you to subscribe to all the information or to a filter of your own. The tags include information beyond just a disease category, symptom, or syndrome, but we also tried to capture other important information; such as policy issues (e.g., vaccination, school closure, travel advisory, etc.). However, our primary goal is not to become another information source, rather to be able to provide a good situational awareness of the event in order to respond effectively. We are trying to address the following problems that are inherent in the current early detection systems:
Classic problem: too much data, not enough information. Why aren’t the key indicators noticed earlier?
Noisy data—low reliability—
Need to keep the human in the loop (a lot of this is still an art).
Sources not always obvious - we saw emerging sources of information, like the citizen reporting over a Google map (in the past much attention was paid to sources like Internet search queries (e.g., Eysenbach, Ginsberg, Polgreen, Hulth, and Cooper), over the counter medications sales (e.g., Wagner/RODS Lab), absenteeism (e.g., Wagner/RODS Lab), as opposed to ER chief complaints or routine disease surveillance hierarchical systems).
Threat profile keeps changing- is not known for something like a SARS/SARI (e.g., Swine Flu or other things like it).
Political and Organizational Boundaries (Note that we weren't able to perfectly communicate the first indications of SARS, or the outbreaks of H5N1 in China, and we saw that happen again with the H1N1 Swine outbreak).
Need to set up the need for shared collaboration spaces and geographic distribution. Not only do we need human experts in the loop, but they need to share the hunches and concerns. Discussion needs to identify communities of interest. Different specialists are involved based on the nature of the threat.
While all this is important, I'd like to emphasize the fact that the best data is still coming from old-fashioned shoe leather epidemiology. We have to be true to ourselves and remember that, with all the information, new tools, open networks of collaborators, etc., we still missed the early indication(s) of the A(H1N1) outbreak. I remember when I was in the trenches of SARS back in 2003, we didn't have the breadth and depth of the information nor the tools we currently have. This calls for an action to rethink our strategies around early detection especially for emerging infectious diseases...
I presented the following at the Mekong Basin Disease Surveillance (MBDS), Information Communication and Technology Forum which took place April 2nd–3rd, 2009 in Mukdahan Province, Thailand.
I. ICT Developments in Mobile Technology for Global Public Health: InSTEDD Collaboration Tools
At the end of the forum, Ed and I answered questions related to the utility and feasibility of GeoChat and Evolve in the various MBDS member countries.
These spaces offer a suite of collaborative features, including: commenting, tagging (adding your own keywords), mapping (user generated and automated), relating multiple alerts, searching and filtering, specifying a time window, adding attachments, subscribing (currently in the form of a web-friendly format also known as RSS, but in the very near future we will support email subscription), and more. The two spaces are also equipped with an intelligent process (referred to as machine-learning algorithm) that "learns" from inputs provided by the users (e.g., adding a keyword (tag), or correcting the mapping of an item). This intelligent process quickly and accurately learns from users inputs (with 95% confidence based on previous tests) and starts suggesting tags as well as correcting itself and offering even better results over time (by simply accepting or rejecting a suggested tag or an automatically mapped location).
Have you an alert or item you like to share with the community? You can easily contribute that alert by clicking the "Add Item" feature.
We invite you to try it and help us spread the good word by inviting others as well. We look forward to your feedback and comments in order to make this tool as useful as it can possibly be. If you have thoughts or questions you can contact us at info@instedd.org or email me directly at: kasshout@instedd.org.
On November 24th, Eric and I presented at the 2nd International Conference on Global Health Applications of Handheld Computing Devices, at US CDC in Atlanta, GA.
Several opening talks reflected on our presence and our tools, including:
2) Sally Stansfield, Executive Director, Health Metrics Network, WHO, Geneva:
3) Mark Landry, Health Informatics, Office of Global AIDS Coordinator, Department of State, who described InSTEDD as “the best out of the box thinking”
