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Information technology could be applied to assist the outbreak investigation process by
1. During the establishing the existence of an outbreak, IT can be used to detect the outbreak much earlier, e.g., Thailand Malaria Online Reporting System reduce the reporting time dramatically by use of IT
2.Verify the Dx – during this phase IT can be use to share pictures and other relevant data to subject matter expert quicker to get a verified Dx
3.Prepare for fieldwork – during this phase, IT can help reduce the amount of paper to be carried, e.g., a tablet can be use to collect data
4.During the description of outbreak phase (i.e., case-definition) IT can be use to pull in various experts across the globe (Zoom call)
5.During hypothesis and testing phase IT software can be use for efficient productivity (e.g., STATA for data analysis)
6.During response and action phase – IT can also be used to communicate with the relevant stakeholders and the publicIT can be used throughout the outbreak investigation process to assist and if the systems are design well, it can help improve efficiency and effectiveness.
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I classify the stages of outbreak investigation into 4 parts in which the information technology can play:
1. Verifying outbreaks: Various data analytics packages such as Ms. Excel, R software, and Phyton were invented and these would help analyze early warning surveillance data to situate the excess of normal expectancy of the case.
2. Describing severity and distribution: Playing with the power of dashboard, information technology is beneficial to visualize the outbreak’s magnitude (using epi curve), severity, and distribution in order to determine how does the outbreak look like.
3. Testing hypothesis: To identify the source of transmission, spread trajectory, and risk factors, the investigator usually uses tools such as drone, GPS system, and web-based epidemic intelligence tools.
4. Delivering response and action: A smartwatch and smartphone are representing the Internet of Things (IoT) in a sedentary society and comes as a shortcut to help detect diseases and acquire health information.
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Good job mapping the technology with specific tasks in an outbreak investigation!
I like the fact that you also mentioned the use of unmanned aerial vehicles and global positioning systems in the process. Those could also be applied to the work, not just the data pipeline and software!Keep up the good work!
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I would like to mention about integration of information technology (IT) with outbreak investigation process according to steps of an outbreak investigation that were mentioned in the lecture.
1. Verification and preparation
In this step, we can use health information system and health information exchange to monitor the outbreak. Online case report will send information to the central server, then analyze and report the outbreak if the number of cases meets established criteria. For the step of diagnosis, natural language processing will help us extract data from paper based system.
2. Describe the outbreak
For the step of systematically identification of case and record information, IT such as GIS, online record form can help us collect data while we are doing field work. The overview of the outbreak can be presented by epidemic curve which we can approximate the outbreak onset. Moreover, statistic programs can assist the epidemiologist in analyze the collected data
3. Hypothesis and testing
We can use statistical program to test and confirm the hypotheses. Moreover, the IT will reduce workload in part of laboratory testing that can link the laboratory result to our case record form.
4. Response and action
Implementation to control the infection, case identification using IT and tracking technology can help us monitor the infected case. Finally, the summary of outbreak report will be made by existing information in the database.Thank you.
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From my point of view, there are many ways to apply information technology in the outbreak investigation process.
1) Verification & Preparation: In the process of confirming the diagnosis, if we could automatically link data from hospital databases to surveillance centers using ICD-10 of the disease being monitored, it would speed up the response time.
2) Describe the Outbreak: We can use well-developed web applications to increase the efficiency of work instead of the traditional epidemiological data collection model such as OpenClinica, REDCap, Epicollect5, etc.
3) Hypothesis & Testing: If we could aggregate high-quality data and store ready-to-use data in a secure cloud database, we will be able to provide opportunities for talented researchers across the country to access data for maximum efficiency. For example, Data Archival for Maximum Utilization System (DAMUS) is a project that allows researchers access to Thailand’s diabetes and hypertension care database to develop research that benefits the country.
4) Response & Action: We can respond more quickly and communicate more easily through real-time dashboard visualization such as Tableau, Power BI, Looker studio, etc.
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1. Verification and Preparation: IT could help in data aggregation and sharing. For example, if we retrieve patient’s definite diagnosis from hospital or health facilities databases. In addition, for the diagnosis verification, laboratory result is not only sent in a form of paper- based but email or through a software.
2. Describe the Outbreak: By defining a definition for cases, we may create an electronic form by having three components; time, place, and person, step by step. This will help defining and identifying cases through defined criteria. In addition, GIS and data visualization could help in describing the outbreak. People can understand the outbreak easier when it shows in pictures.
3. Hypothesis and Testing: Having a statistical program could help in analyzing the precision of hypothesis we assumed. Moreover, IT could help in finding or linking the cause of outbreak from the laboratory confirmation.
4. Response and Action: By having IT as part of the response, it could facilitate staff in contacting patients and tracing the disease. In addition, for example, Zoom/Skype/Line call could ease communication not only between physicians and patients but also other stakeholders.
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According to steps of an outbreak investigation, there are several information technologies that could assist in each particular steps
1.Verification and preparation
The existing electronic reporting tools which its dashboard show information can help in early detect the new wave of disease outbreak. Starting from passive cases in the hospital, when the laboratory confirmed and report, with the HIE linked between stakeholders, we can early detect the outbreak in timeliness. Various IT hardware, software and networks such as Laptops, WebEx/Zoom meeting, can be used in communication and preparation a rapid response team for field work.
2.Describe the outbreak
Online communication application can be used in every meeting for particular issues. Mobile application can be used in active case finding process. Instead of paper-based, electronic systematically data collection form is more reliable with higher quality of data. Data visualization technology such as dashboard, Epi curve, Map and also statistic software can be used for data analysis.
3.Hypothesis and testing
We can use statistical analysis software in this part. Then if we have to investigate more on laboratory testing, online search engine or consultant for the proper specimen type and reporting tool for the results notification will be useful.
4.Response and action
Again, various IT hardware, software and networks can be used in (1) communication between stakeholders during implementation the control measure, (2) data collection during follow up the event (3) data sharing using dashboard visualization program throughout all the steps (4) process of evaluation the performance and (5) writing the report. -
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**1. Verification and preparation**
Now that there is the advancement in telecommunication and information technology, most countries have implemented their own health information system and all of which are being regulated and compliant with the central government standard. In most cases, ICD-10 are the preferred standard of sharing diagnosis between health care institutions. Whenever there is any unusual surge in specific symptoms or syndrome, we can easily recognise them beforehand.
**2.Describe the outbreak**
Data visualisation can be implemented alongside with the local hospital database. We can select the specific code for some ICDs and collect insight by reviewing the case if possible. There are many tools which help us deal with numerous data such as Python or R.
**3.Hypothesis and testing**
Simple statistical methods such as risk factors determination, odd ratio, etc. can be easily applied by simple statistic software provided that we have collected enough data.
**4.Response and action**
After we have identified and declared an outbreak, we can quickly set up a response team by a meeting. We have online telecommunication platform such as Zoom, Google Meet, Skype and many others as an alternative to the old-fashioned way. Any decision will be made in a real-time manner and across region, no matter how far they are.
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Information technology(IT) is the used of technology to manage health data. Every step of outbreak investigations involved with data and information, therefore IT could assist better outbreak management.
Verification and preparation, this would delay the outbreak confirmation and team building without technology for data communication. The infected cases could happen in different hospitals and health professionals might not work in the same building. Software applications such as Line, email applications and Zoom could make communication faster. Infections could be notified early to estimate infected numbers and areas. Healthcare professionals could have effective distant communication.
Describe the outbreak, interoperability for healthcare information exchange would be very helpful to search more infected and suspected cases. Even if the system couldn’t have health data standards, structural interoperability such as data formatting via Excel would help to arrange, record and further analyze data. Generating data hypotheses by transforming data to graphics such as pie chart, bar chart, GIS mapping and contact tracing map would assist the investigator to understand the situation. Software applications for managing, analyzing and visualizing data such as Power BI could be used.
Hypotheses and testing, statistical applications such as STATA or SPSS could be used to test hypotheses.
Responses and actions, communicate to public health on control measures and reporting the situation have to be quick, efficient and reach the overall population. Official web applications to inform knowledge could be generated. Media presentation and other visual content have to be precise, attractive and suit different background knowledge, therefore designing applications ,such as Canva, Microsoft Power Point, might help generate effective media for communication. -
Information technology (IT) can be used in various ways during the outbreak investigation processes.
Verification and preparation: The used of data analysis could help identify the true outbreak from the noise. By filtering data from onset date and other attribute, it may give clearer picture before determining that this signal is the true outbreak or not. The outbreak could also be detected in event based. We can pull the data from social media/news to analyze and see the trend also.Describe the outbreak: The outbreak could be visualized in various way using data visualization technique including the pivot table, GIS mapping, Interactive chart and so on. Nowadays the use of online dashboard, for example Tableau, power BI, is quite popular. These tools could help readers/policy maker understand more on the outbreak pattern and ensure all members in the team is on the same page. The dashboard could be updated in real time manner with little to no manual support.
Hypotheses and testing: This step could be done in using the data we use for visualization. The statistics could be used. The advance technique for example, data mining and machine learning could be used to get the “insight” (descriptive analysis) and also “predict” what we need to do next. I think we also could use the data-driven decision making in public health field.
Responses and actions: Lastly once we gathered and analyzed the data appropriately. It’s time to action. The IT support could be used in various way, for example the mobile application development for education program, outbreak area alert. Disease investigation team could develop working platform like project management tools, for example Asana, to ensure that tasks were delegated and managed appropriately.
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The information technology could assist in every step of an outbreak investigation. The steps include the following.
1. Verification and Preparation: To establish the existence of an outbreak, we start with passive cases, the data of diagnostic and laboratory results could be collected from the report generated from the electronic medical records system. The collaboration of interoperability from different locations would require IT support to report data to a central system.
2. Describe the outbreak: To construct a working case definition, an IT system could be utilized to identify a clear criterion and standardize the investigation. The map showing the disease outbreak could be represented using Geographic Information System (GIS) that obtained geographic data to manage, analyze, and visualize data in the map. Active case finding could be performed using IT to collect data via an electronic system and data can transfer to the central system. Then, the data will be arranged using IT system to be in line-listing for reviewing quickly. Consequently, data could be analyzed by presentation in Epi curve and see the case distribution
3. Hypothesis & Testing: At this step, the hypothesis and testing could be done by using collected data and testing via statistical software.
4. Response & Action: We can use applications to track, monitor and follow-up the event. The visualization of data could be implemented to show the outbreak report. The report can be used to communicate with all stakeholders and raise awareness a person.
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