Real-Time Biosurveillance Program for India and Sri Lanka
Nuwan Waidyanatha
First to introduce myself I will provide a link to my profile -- Nuwan Waidyanatha. I'm in the process of finalizing a proposal to conduct an e-Health comparative study between India and Sri Lanka; specifically piloting a Real-Time Biosurveillance Program (RTBP). My past pilot (research) was evaluating a Community-based Last-Mile Hazard Information Dissemination system; namely the "Last-Mile Hazard Warning System" (a.k.a HazInfo project). The project evaluated 5 wireless ICTs and use of Common Alerting Protocol (CAP) as an internetworking standard for localized content delivery. The ICTs were tested in 32 tsunami effected villages along the coast of Sri Lanka. To learn more about the project and the research findings search on key terms: Disaster, HazInfo, Last-Mile Warning, CAP, Alerting. The proposed RTBP will also be examined in a Community-based setting. The difference of the RTBP from the HazInfo is that the RTBP is surveillance system opposed to an alerting system. The paragraphs below will explain the concept of the RTBP.
Problem faced by the Epidemiology Unit Officials in India and Sri Lanka is receiving health information in a timely manner in order to prevent diseases reaching epidemic states as it has with the case of the Chicken Gunya viral fever in the past. The current Communicable Disease Notification Paper System for "situational awareness" does not provide the much needed "real-time" information flow and analysis. The real-time communication shortcomings can be easily overcome with reliable and robust Information Communication Technologies (ICTs) and Intelligent Software.
Proposed Surveillance System will provide for the execution of decision analysis of the assessment and response problem faced by the Epidemiology Units. Government Public Health Official (PHO) based sensor system and deployment of advanced detection algorithms such as Spatial and Temporal Scanning, Bayesian modeling and multi-stream real-time monitoring of the collected surveillance data will provide the Epidemiology Units with the tools to combat the real-time detection and communication dilemma. Moreover, the unique project will couple governance and civil society through Mobile Phones.
An important aim for the study is to set up a prototype information system to timely collect relevant health surveillance data and to process this data in order to reliably and quickly detect possible outbreaks of diseases. We will evaluate the technical and organizational abilities of the RTBP and test it in a pilot deployment. Thereafter, summarize the results of the comparative study in the form appropriate for a wider scale deployment.
In each country the project will enroll 4 Districts in the study. The RTBP will be deployed in 2 Districts where the remaining 2 Districts will not be exposed to the RTBP and shall be used as control groups. 16 PHO (8 exposed to RTBP and 8 unexposed) will participate in the pilot. The 8 PHOs in the two Districts, exposed to the RTBP, will receive a mobile handheld with a built in application as well as have access to other modes to communicate health information. The District level Epidemiology Units belonging to the group exposed to the RTBP (i.e. 2 Districts) will be provided with a computer to visualize the data and perform the analytics for their respective Districts. Each PHO Area covers at least 4 villages (communities). Therefore, the pilot will employ a total of 64 communities covering the 4 Districts (i.e. 16 PHO Areas). These communities will predominantly participate in the evaluation process; especially in the mock-drills. The selected communities will act as the "public" in this research. Half (32) of the selected communities will be required to have a formal Community-based Healthcare program. This divide of communities with organized healthcare and absence of community healthcare will be use to compare the contribution of community organizational level to local and national healthcare; in this case mainly on prevention of disease outbreaks.
Research design will allow us to compare the performance
(reliability and effectiveness) of mobile handheld devices and
analytics algorithms as well as assess the outcome of introducing an
ICT based RTBP. The control groups will shed light on the extent to
which having dedicated ICTs contribute to an effective data retrieval
and detection system. Specific objectives of the project focus on
scrutinizing the possibility of:
1)Introducing an effective and sustainable real-time eHealth RTBP for detecting outbreak
2)Minimizing the latencies of communicating disease information from remote areas
3)Using the eHealth RTBP to identify new research areas to focus on prevention
4)Sharing disease information between regional Epidemiology Units (i.e. Interoperability)
5)Devising an evaluation framework to measure eHealth based RTBPs
The project will conduct mock drills (simulations) to evaluate the performance and outcomes of the proposed surveillance and analysis system. The 64 Community Members, 16 PHOs, and the Epidemiology Unit Staff will be actors in the exercises. Simulated drills will be conducted over a 1 year period. The criteria for evaluation will include the rapidity at which an action is taken, the organizational efficiency in coordinating collective action, and the proper functioning of the ICT and related technologies among others, and the acceptability of the RTBP in the respective Health systems for surveillance and notification.
The partners in this project are --
1) Epidemiology Unit of Tamil Nadu, Ministry of Health and Family Welfare, Tamil Nadu, India
2) Epidemiology Unit, Ministry of Health and Nutrition, Sri Lanka
3) Indian Institute of Technology – Madras, Rural Technology and Business Incubator, India
4) Carnegie Mellon University Auton Lab, USA
5) University of Alberta, Canada
6) Lanka Software Foundation, Sri Lanka
7) Sarvodaya Shramadhana Society, Sri Lanka
8) LIRNEasia, Sri Lanka
The project is applying for funding from the International Development Research Center of Canada under the PANACeA e-Health initiative