The IEEE-RIVF – Research, Innovation, and Vision for the Future – International Conference on Computing and Communication Technology took place in Hanoi, Vietnam at the Vietnam National University, Nov 02-04, 2010. The plannery sessions were on applied operations research, software engineering, human machine interface & imaging technology, computational Intelligence, information & knowledge management, communication & networking, and modeling & computer simulations. I presented out paper titled: T-Cube Web Interface as a Tool for detecting disease outbreaks in real-time: a pilot in India and Sri Lanka. This paper discusses the results from the pilot in India and Sri Lanka, namely the Real-Time Biosurveillance Program (RTBP). While may discussed the science behind their solutions, we had surpassed that and were able to discuss the challenges in practically working the solutions in the real world.
Not just eHealth but in any national innovation, finding a champion to own, operate, and promote the new intervention is crucial. We found ours in Sri Lanka to take the Real-Time Biosurveillance Program (RTBP) to the next level; our champion is Dr. R.M.S.
The Real-Time Biosurveillance Program (RTBP) held a news conference in Colombo, Sri Lanka on September 14, 2010 at the Cinnamon Lake Side Hotel. This is list of the articles published in the News papers:
The Director of Carnegie Mellon University’s Auton Lab – Prof Artur Dubrawski – delivered a keynote speech at the Health Informatics Society of Sri Lanka organized eHealth Sri Lanka 2010 conference, 15-16 September, 2010. His talk titled – Detection of Informative Disjunctive Patterns in Support of Clinical Informatics (click to view slides) – has synergies with the Real-Time Biosurveillance Program (RTBP) we are piloting in India and Sri Lanka. RTBP specifically integrates a data mining and probability testing tool called the T-Cube Web Interface. In addition to the keynote, Chamindu Sampath, LIRNEasia Research Assistant, presented a paper titled the “T-Cube web tool for rapid detection of disease outbreaks in India and Sri Lanka” (click to view the slides) and a poster. Several interesting issues regarding data quality needed for event monitoring was discussed by the audience during the session: public health informatics.
The International Telecommunications Union – Development (ITU-D) has published the “Evaluating a Real-Time Biosurveillance Program” (RTBP) in their newest eHealth case study: “Land Scape of Tele-Health Infrastructure at points-of-service in India“. ITU discusses only the component of the study taking place in Southern Tamil Nadu, India; while identical work is being carried out in North Western Province of Sri Lanka. This is a two country comparative study, made possible through a grant from the International Development Research Center of Canada. The RTBP introduced affordable mobile technology and fast responding statistical data mining algorithms to increase the efficiencies in the present day sluggish disease surveillance and mitigation systems in the respective countries.
The key take home from the workshop were: the Regional Epidemiologist – Dr. P. Hemachandra – stressing the need for Syndromic surveillance; especially, the ability to monitor escalating fever like disease and geographic clusters of increase in common symptoms. Dr. Lakshman Edirisinghe (Deputy Director Planning) emphasized the need for comprehensive patient clinical data for becoming a data driven organization that can optimize the resources opposed to speculative expert opinion.
I was in Lyon, France presenting our mHealth paper – Real-Time Biosurveillance pilot in India and Sri Lanka – at the IEEE-HealthCom conference, which took place 01-03, July 2010 (click to view the slides). I spent an extra day in France to travel down to Grenoble, accompanied by my friend and research partner – Artur Dubrawski – an ex-scholar from Grenoble, in search of a Joseph Fourier’s statue for a photo opportunity. Why? Jean Baptist Joseph Fourier (21 Mar 1768 to 16 May 1830) was a French mathematician and physicist best known for the “Fourier series” – a way of writing a function as a sum of frequency components; i.e.
The “Evaluating a Real-Time Biosurveillance Program” (RTBP) research team meet in Chennai, July 6 – 7, 2010 to discuss the interim findings of the evaluation work (click to read workshop report) carried out in Tamil Nadu India. In addition to the workshop a news conference was organized to disseminate the pilot project findings. The links below are some of the news prints (click on the thumbnails to view news clippings) :: – Mobiles on Health Calls, The Hindu Business Line, September 13, 2010 – Pilot study in using mobile technology for disease reporting shows promise, Thehindu.com, July 07, 2010 – Pilot study on epidemiological early disease warning system, Chennaionline.com, July 07, 2010 – New tech to keep tab on diseases, timesofindia.
I was recently invited by the United Nations System Influenza Coordination (UNSIC), regional office in Bangkok, to present our findings from the Real-Time Biosurveillance (RTBP) Pilot. UNSIC has appointed Dr. David Nabarro, the founder of Flu-Tracker to develop and implement a comprehensive unified strategy for UN system on pandemic influenza prevention, preparedness and response and increase the effort to control avian influenza. Given the nature of LIRNEasia researchers to speak the evidence as it is and not be superficial as in marketing products, the public and private stakeholders in Bangkok were intrigued to learn of the real intricacies of implementing a systems such the RTBP in India and Sri Lanka. We will continue to collaborate with UNSIC in feeding our extremely rich experiences and implications with possible contributions to their regional good practices documentation due in June 2011.
The present day disease surveillance and notification system in Sri Lanka, confined to a handful of diseases, known as Notifiable disease, and reporting large numbers of common cases, is what the British introduced in 1897 as part of the quarantine and prevention of diseases ordinance. This paper based surveillance and reporting system has its shortcomings that the health professionals themselves have voiced. The Real-Time Biosurveillance Program (RTBP) pilot, during the first week of April, interviewed health workers and health officials in Kurunegala District to study the notification and response policy and procedures. These interviews revealed that in some occasions by the time health officials receive the notification to inspect the patient, with the infectious disease, at the patient’s residence, the patient had already died; health workers literally pull their hair trying to decipher the illegible handwriting on the paper forms; they also mentioned that they have to travel long distance from their villages to the Medical Officer of Health (MOH) office to pickup the paper forms with the patient’s information. These inefficiencies and excessive costs can be drastically reduced with ICT; with a technique as simple as a communicating the information via SMS text messages that costs Rupees 0.
Recently I presented a paper titled – Robustness of the mHealthSurvey Midlet for a Real-Time Biosurveillance program at the 2010 International Symposium on Medical Informatics and Communications Technology – in Taipei, Taiwan. The main focus was on mobile computing; especially surrounding Body Area Networks (BAN) that is in the working mills of the IEEE 802 standardization process under the auspices of Task Group 6. The present day challenges that countries like Taiwan and Japan face, also propagating in to other Asian countries, are increase in chronic illnesses, aging population, and need for convenience. Within this frame, researchers are realizing the growing need for remote sensing and maintenance of health; such remote maintenance ICT based services would reduce patient admissions (or inward patients), which countries like India, Sri Lanka, Taiwan, etc, fully subsidize and can be drastically reduced. The mHealthSurvey has proven the capability to transport digitized data compressed to ~ 2KB over GPRS-10 and higher networks in rural India and Sri Lanka.
The Canadian Broadcasting Corporation’s show – The National “Lifelines” – did a news program on the Real-Time Biosurveillance Program carried out in India and Sri Lanka; watch the clip here.
The literarcy rate in Tamil Nadu is above that of the national average. Health workers assisting in the Real-Time Biosurveillance Program (RTBP) in Tamil Nadu, all of whom are female, 68% have 10 years of education and the rest only 12 years of education. They have more than 10 years experience working in the field providing primary health care and reporting on relevant health statistics to the government. These health workers (few of them are in the photo with their backs to you) were given training and mobilized with the mHealthSurvey, mobile phone application, for submitting patient disease/syndrome data for the surveillance of epidemiological events. Data that used to take over 15 days to relay up to the paper chain, but was not subject to any detection analysis (i.
The Sivagangai District (Tamil Nadu, India) Deputy Director of Health Services (DDHS), Dr. Raghupathy, compared the Real-Time Biosurveillance Program (RTBP) to a comprehensive machine with multiple flavors that can give the required surveillance results with the touch of a button. Kurunegala RE (Region Epidemiologist, Sri Lanka), Dr. Hemachandra’s words were “RTBP will give a booster to surveillance in our region”. Evaluation planning workshops took place in Karraikudi, Tamil Nadu and Kurunegala, Sri Lanka.
The document describes the Standard Operating Procedures (SOPs) for data collection, data processing, data reporting, and database/system administration. Data collection involves Setting up of the Biosurveillance Module (BSM) initial information (i.e. implement database) through the web application and direct Database Administration (DBA) functions Installing, configuring, and maintaining the m-HealthSurvey mobile application Health worker expected practices in submitting data Documenting and reporting problems associated with the BSM and m-HealthSurvey Data processing involves Installing, configuring, and maintaining the T-Cube Web Interface (TCWI) analytical tool Installing, , configuring, and maintaining the detection algorithms Health Officials (epidemiologist) expected practices in analyzing the health data Defining priority levels for particular diseases Documenting events of interest Documenting and reporting problems associated with TCWI and detection algorithms Data reporting involves Installing, configuring, and maintaining the Sahana Alerting and Messaging Module (MAM) Initializing the MAM contact lists, jurisdictions, geographical areas, message templates Verification and Authorization procedures for issuing health alerts
Carnegie Mellon University’s Auton Lab, Professor Artur Dubrawski (RTBP research partner), was invited to a speak at the University of Peradeniya Computer Engineering Department. Doctrine on data mining and applications were presented focusing on the work related to the Real-Time Biosurveillance Program (RTBP) to an audience of faculty and students. Faculty members from the department Statistics and Computer Science were quite keen in the topic as they are working on similar applications. University of Peradeniya Department of Computer Engineering will be offering a course in statistical data mining beginning April/May 2010.