Wednesday, March 2, 2011

Real-Time Biosurveillance Pilot - Technical Report

The Real-Time Biosurveillance Program (RTBP) was a multi-partner initiative to study the potential for new Information and Communication Technologies (ICTs) to improve early detection and notification of disease outbreaks in selected regions of Sri Lanka and India. Experts in the field of biosurveillance and health informatics have argued that improvements in disease detection and notification can be achieved by introducing more efficient means of gathering, analyzing, and reporting on data from multiple locations. New ICTs are regarded as an important means to achieve these efficiency gains. The primary research objective of RTBP was to examine these claims more closely by producing evidence to indicate in what ways and to what extent the introduction of new ICTs might achieve efficiency gains when integrated with existing disease surveillance and detection systems.

The project achieved a number of key objectives at the outset, including the development of a Java-based application for collecting patient data using low cost mobile phones; the successful implementation of Auton Lab’s analytic software and T-Cube Web Interface for analyzing patient records and near real-time prediction of disease outbreaks; and the adoption and implementation of Common Alerting Protocol for multi-channel health alerting. Moreover, the project team successfully integrated each of these three key components into an operational system that collected individual patient records, over 330,000 in Sri Lanka and over 130,000 in India, over a 15 month course of study. Over the life of the project, the system identified over a dozen instances of potential disease outbreaks, with four of those (Chicken Pox, Acute Diarrheal Disease, Respiratory Tract Infection, and Mumps) being confirmed by health authorities. The project demonstrated that new ICTs can dramatically reduce turnaround time for outbreak detection and alerting, from current period of weeks to a matter of days or even hours. The project also demonstrated the feasibility of using low cost mobile phones and existing commercial cellular infrastructure and services to enable affordable, real-time reporting of patient records from frontline health centers.

Overall results from our work demonstrate the feasibility of introducing an RTBP from a technical and operational standpoint. Initial findings show significant efficiency gains in terms of disease reporting, outbreak detection, and health alerting; with cost savings over 35% in both countries when compared to the existing systems. However, further research is needed to better understand the challenges associated with scaling such a system up to a regional or national level of implementation. In particular, further work needs to be done to optimize data entry over low cost mobile devices, to address usability and training requirements for the analytics platform, and to continue to enhance and integrate health alerting into national and regional systems and practices. Moreover, extensive stakeholder consultation will be necessary to ensure the various policy, legal, and operational implications of a national or regional RTBP are better understood, addressed, and effectively managed in the future.

It was a tiring and exciting experience but helped towards change adaptation whereby health professionals in the respective pilot countries were exposed to new ways of public health maintenance. I am delighted to have developed the proposal, gotten funding, and directed the project in achieving in terms of important empirical findings on the usefulness of this type of system, as well as achieving impressive outcomes around the greater adoption of the RTBP.

This project was made possible through a grant from the International Development Research Center of Canada. This project recently ended in December of 2010. This blog is to share the final technical report with researchers and practitioners.

Click to view the Real-Time Biosurveillance Program Final Technical Report.