collaboration in biosurveillance and disaster response problems, methods, and tools eric rasmussen,...
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Collaboration in
Biosurveillance and Disaster Response
Problems, Methods, and Tools
Eric Rasmussen, MD, MDM, FACP
We create free and open-source software
for collaboration toward collective action.
We then teach other people how to create it for themselves.
Questions in disaster response…
What information
isn’t getting to
those who need
it?
Which groups should be
making more decisions together?
What field reports and alerts
should come faster?
Which systems
need to share
information?
InSTEDD has several core principles
• Participatory, contextual design
• Agile development method
• Information flow in a mesh
• Internal capacity first
• Resilience by design
Innovation Lab
A few Alerting and Response problems we’ve found:
1. Cultural acceptance
2. Geo-referenced imagery
3. Languages and translation
4. Unreliable communications
5. Minimal Essential Data Sets
6. Complex System Assessments
7. Formal Decision Support
8. Rapid Assessment Consolidation
9. Emergent Strategic Collaboration
10. Consolidating Human-Animal-Environmental health impact
In our view, collaboration, in humanitarian action is THE critical task
Refugee management
Cholera outbreak
Katrina response
What we face in collaboration efforts…
• Harsh field conditions
• Slow, unreliable networks
• Stressed users
• Disincentives for cooperation
• Unsuitable platforms
• Slow and misleading data collection
• Lack of tools for information sharing
• Poorly designed applications
We think this is what collaboration requires in 2008…
Collaboration tools• Problem
– Agencies can’t (or won’t) communicate effectively in crisis
• Requirements– Effective, free, standards-based, easy to use, sustainable,
measurable, and thoroughly interoperable
• Specifications– Discussed with WHO, UNICEF, MoH, UCLA, OCHA, UNOSAT, ISDR,
many more…
• Development– Built four tools as prototypes for improved collaboration
• Implementation – In beta evaluation with all four
InSTEDD tools for collaboration
• GeoChat
– We need to move information to and from teams in the field, and we need to know where those teams are.
• Mesh4x
– We need to translate and share information between systems
• Riff
– We need to engage with our colleagues when threats appear
• RNA Analytics
– We need help thinking carefully about context and decisions
From a faint signal to collective action
Merge &
Analyze
- Collective understanding- Response initiation
Immediate analysis & decision support
Peer-to-peer information sharing and collaboration
Informed collectiveaction
Real-time exchange of information
GeoChat• Problem
– Need simple communication with teams in the field
• Requirements– Multi-modal, geo-locating, broadcast, triage, history
• Specifications– Established by users in Cambodia and US Search and Rescue Teams
• Development – In Argentina and Cambodia. Now v0.7, v1.0 scheduled for November
• Implementation– Small Beta during Hurricane Ike. Now reviewing results.
GeoChat
• SMS messages that put a location dot and a message on a map
• I can reply from the map on my laptop, and it becomes a chat
– By phone, person, location, specialty – any filter, single or groups
• I can see that dot from anywhere on the planet
– Just need a password and access to a web browser
Mesh4x• Problem
– Interoperability is a persistent impediment to collaboration
• Requirements
– Data schema mapping and application awareness, SMS sync
• Specifications
– Intuitive, secure, deep understanding, visible events
• Development
– Created at the IT level, but no simple user interface yet
• Implementation
– JavaROSA, OpenMRS, KML within HIV Clinics in Tanzania
Mesh4x• Imagine a public health event or system – many participants• Redundant information (very common)• Willingness to share (social issue…)• Now ability to share! (technical issue…)
– Excel– Access, Oracle, SQL, MySQL…– Google Earth, Virtual Earth, GeoRSS, ESRI, Google Maps…– Cell phones, PDA’s, laptops, whatever…
• I move my pushpin on Google Earth and your Excel spreadsheet changes.– And we can do it only through cell phones. A stream of SMS
messages.
Translation tool
Riff• Problem
– Teams can’t see an anomaly as a shared event. Fractured response.
• Requirements– Letting a team see an anomaly and contribute information about it
within a shared space
• Specifications– Intuitive, flexible, forgiving, inclusive, elegant, helpful, informative,
Web-based, with an offline client
• Development – Core development done and robust. Multiple modules for
contribution and analysis (31 considered, 12 implemented), weak UI
• Implementation– Internal use only for now.
Riff is a pure collaboration tool.
• Riff is a next-generation information browser
– GeoChat messages show up there, with ProMED, HealthMap, email…
• When something interesting appears, teams can join in
– Regional health officers, CDC, parasitologists, vets, HAZMAT teams
• Tools are included in Riff for letting teams enhance information
– Commentary, annotation, analysis, translation, mapping, sharing…
– Mathematics built in for collaborative decision support.
Riff
Cambodian National Hotline example• Problem
– One Cambodian phone receiving national health surveillance warnings– No history, process, depth, reproducibility, design, or interoperability
• Requirements– Develop a tool, process, structure, and backup, with flexibility,
feedback, and context
• Specifications– As designed by Cambodians to be effective for a hotline operator with
one arm, fully interoperable with health system, on local cell phone.
• Development– Prototype completed on the InSTEDD platform in thee days. Now
requested by the Mekong Regional Forum.
• Implementation– None yet.
Prototyping the Cambodian national hotline3 days, using InSTEDD platform and open source building blocks
EWARN (or any other event-based system)
Rapid Response Teams
Director and MOH Staff
National hotline operator
Provincial hotline operator / Avian influenza operator
Caller
Online Mesh store
Data Sync
SMS
Voice
Calls and weekly reports
ProMED
Google news
Tracker• Problem
– Many frustrating issues have possible solutions in the world but those options are invisible to health workers
• Requirements– A place to show an interesting range of possibilities in a familiar and
accessible format that breaches silos
• Specifications– Seductive, broad-ranging, professional, archived
• Development – Professionally designed; internal resource development now
• Implementation– Global release v1.0 on 09 October.
Houston EOC links here…
Ning social networking sites
Sahana Disaster Management System
