Thursday, May 21, 2009

New Web Technology for H1N1 Surveillance?

An excerpt from the NEJM regarding the uses of technology for surveillance, monitoring, and mobilizing global response for outbreaks, such as the current H1N1 epidemics.

"Data about diseases and outbreaks are disseminated not only through online announcements by government agencies but also through informal channels, ranging from press reports to blogs to chat rooms to analyses of Web searches (see Digital Resources for Disease Detection) ... The Internet is also providing new opportunities for connecting experts who identify and report outbreaks. Information technologies such as wikis, social networks, and Web-based portals can facilitate communication and collaboration to accelerate the dissemination of reports of infectious diseases and aid in mobilizing a response ..."

Some scientific societies are leveraging technologies for data exchange, analysis, and visualization:
Distributed Surveillance Taskforce for Real-Time Influenza Burden Tracking and Evaluation (DiSTRIBuTE): a group of state and local health departments that use the Web to share, integrate, and analyze health data across large regions.

GeoSentinel project (CDC & International Society of Travel Medicine): brings together travel and tropical-medicine clinics in an electronic network for surveillance of travel-related illnesses.

Emerging Infections Network (CDC & Infectious Diseases Society of America): a Web-based network of more than 1000 infectious disease specialists that is geared toward finding cases during outbreaks and detecting new or unusual clinical events.

Electronic Health Records, Cell Phones & Texting: Useful for Surveillance?
Broader Web-based networks are also proving useful for surveillance. Social-networking sites for clinicians, patients, and the general public hold potential for harnessing the collective wisdom of the masses for disease detection. Given the continued deployment of personally controlled electronic health records, we expect that patients' contributions to disease surveillance will increase. Eventually, mobile-phone technology, enabled by global positioning systems and coupled with short-message-service messaging (texting) and "microblogging" (with Twitter), might also come into play. For instance, an organization called Innovative Support to Emergencies, Diseases, and Disasters (InSTEDD) has developed open-source technology to permit seamless cross-border communication between mobile devices for early warning and response in resource-constrained settings."

Potential Drawbacks that may limit the realization of their potential for public health practice and clinical decision making.

  • Information overload
  • false reports
  • lack of specificity of signals
  • sensitivity to external forces such as media interest
  • difficulties with verification and follow-up.

Sample Web-based data sources:
Global Public Health Intelligence Network (GPHIN), www.phac-aspc.gc.ca/media/nr-rp/2004/2004_gphin-rmispbk-eng.php
DiSTRIBuTE, www.syndromic.org/projects/DiSTRIBuTE.htm
GeoSentinel, www.istm.org/geosentinel/main.html
Emerging Infections Network, http://ein.idsociety.org

Full article: http://content.nejm.org/cgi/content/full/360/21/2153

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