epi info™ mesh4x
TRANSCRIPT
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Data Synchronization of Epi InfoTM Using a Mesh4X Adapter
AMIA 2009 Annual SymposiumDemonstrations: Management of Populations
Taha A. Kass-Hout, MD, MSBioSense Program Manager and
Director (Acting), Division of Emergency Preparedness and Response
Disclaimer: The findings and conclusions in this presentation are those of the authors and do not necessarily represent the official position of The Centers for Disease Control and Prevention.
Presented November 17th, 2009
Innovative Support to Emergencies, Diseases, and Disasters
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DisclaimerDisclaimer: Any views or opinions expressed by the speaker do not necessarily represent the views of the CDC, HHS, or any other entity of the United States government. Furthermore, the use of any product names, trade names, images, or commercial sources is for identification purposes only, and does not imply endorsement or government sanction by the U.S. Department of Health and Human Services
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The Team
Eduardo (Ed) JezierskiJuan Marcelo TondatoNicolas di TadaDaniel CazzulinoPablo M. CibraroDennis Israelski, MDEric Rasmussen, MD,
MDMMary Jane (MJ) Marcus
Taha Kass-Hout, MD, MSLes Lenert, MD, MSDavid NitschkeRoger Mir Mark BerndtEnrique Nieves, Jr., MSAneel Advani, MD, MS
Innovative Support to Emergencies, Diseases, and Disasters
Saiful Islam RajuSharif UddinMohammad IklashNobel …
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Need for CollaborationWhen data needed to make decisions is trapped in
silos:Different organizations. Different networks. Different
applications. Different formats. Different devices.• How can I share what I know with others?• How can I use the data I have access to wherever
I am?• How can I get everyone on the same page
quickly?• How do I keep everyone in sync as the situation
changes?
Answer: Use a Mesh4X data synchronization adapter.
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Need for Collaboration
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Need for Collaboration
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What is Epi Info™ • Epi Info™ is a suite of tools to rapidly create
questionnaires, enter, and analyze outbreak investigation data
• Epi Info™ allows easy customized application development• Epidemiologic statistics, tables, graphs, and maps are
produced with simple commands such as READ, FREQ, LIST, TABLES, GRAPH, and MAP. Epi Map displays geographic maps with data from Epi Info™
• Epi Info™ used in outbreak investigations• Epi Info™ trainers sometimes use the classic 1940’s
Oswego Church Supper outbreak
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Oswego in the Cloud
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Outbreak of Gastrointestinal Illness Following A Church Supper in Oswego
Co. NY• Oswego County, New York: 1940
• 80 people attended a church supper on 4/18/1940• 75 people (ill and non-ill)
interviewed• 46 people who attended the
supper suffered from gastrointestinal illness beginning 4/18/1940 and ending 4/19/1940
• Investigation focus: church supper as source of infection
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Church Supper Outbreak Investigation Form
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What is Mesh4X?Protocol for seamless cross-boundary information sharing• Fuse diverse applications, data sources, and devices into a
seamless “mesh” of free-flowing information• Share your data selectively and securely with different
organizations using different applications• Synchronize data
automatically between databases, websites, spreadsheets, applications, phones, and PDAs
• Synchronize over the Internet or by Short Message Service (SMS) text messages
• Open source software based on open standards
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The Prototype: ArchitectureMesh4x Storage Server
(hosted by Google Cloud or Amazon EC2/S3, Jurisdiction*, or CDC*)
Peer-to-peer sync
“Cloud” sync
Epi Info™ Data
Epi Info™ (On MS-Access
or MySQL)
* Proposed
Map SyncWeb App
Oth
er D
ata
Sour
ces
Epi Info™ Data
KML
KML file on a USB
Drive
KML Sync UtilityKML
Sync Utility
KML Sync Utility
KML Sync Utility
Epi Info™ Data
KML
KML
KML
MS-Access, MySQL, MS Excel, Google
Spreadsheet, KML, Epi Info™, etc.
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EPI INFO™ ─ MESH4X SYNCHRONIZATION PROTOTYPE
The Demonstration…
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Outbreak Investigations Today
May …• Cross jurisdictional boundaries• Include a team of investigators
working independently and coordinated.
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Added fields for Address and County
Modified the Outbreak Investigation Form
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• Added addresses for all 75 interviewees• Expanded the scenario to
include 4 counties (in addition to Oswego)
COUNTY
Ill? Jefferson Lewis Oneida Osweg
o Wayne TOTAL
Yes 8 2 12 21 3 46No 1 3 16 8 1 29
TOTAL 9 5 28 29 4 75
Provided Mock Geo-referenced Information
0
5
10
15
20
25
Cou
nt
18 Apr 40 19 Apr 40Date of Onset
Epidemic Curve
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Analysis of Outbreak DataOneida County Only
In the Epi Info™ Analysis output window, frequencies of County and ILL are shown.
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Analysis of Outbreak DataOneida County Only
Epi Info™ Analysis 2 x 2 Tables of two exposure variables, Baked Ham and Vanilla Ice Cream.
Vanilla x ILLBaked Ham x ILL
Both BAKED HAM and VANILLA are significant at P = 0.05 level
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Each epidemiologist collects outbreak data, offline, for a given jurisdiction.All three then plug mobile phones into their laptops and click “Share my Data”
Data can be shared over the cloud, SMS, etc.Now they have each others’ latest data and can see it all in their systems or on
a map.
Epidemiologists Create Surveillance “Data Mesh”
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Create A Mesh
Go to: http://sync.staging.instedd.org/mesh4x
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Create A Mesh
Go to: http://sync.staging.instedd.org/mesh4x
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Epi Info™ Mesh4X AdapterTo share the data with selected team members:• Launch the Epi Info™ Mesh4X tool• Select the table to synchronize • Specify transmission method• Test the partner’s readiness• Click “Sync Now”
To gain a perspective of the cases, the adapter creates a KML file to be displayed in Google Earth (map layers).
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To show the map, the user opens the Google Earth file generated by the Epi Info™ Mesh4X tool.
Cases are marked with colored pins (e.g. Red pins show the ill patients and Yellow pins show the cases with no illness)
Generate Google Earth Map
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Synchronizing Data with OthersThe user may evaluate the data in the cloud
Before Synchronization: No data in the cloud
After Synchronization: the user verifies that the data is in the cloud
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Synchronizing to Update DataData synchronized as XML (RDF
Standard)
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Analysis of Synchronized DataThe user launches Epi Info™ Mesh4X tool on their laptops and
generates a local map including all synchronized data.
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Analysis of Synchronized DataThe user now has the data from other investigators. In this
example, the State’s Database in the cloud has the data from each county.
Epi Info™ Analysis frequency of County
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Analysis of Synchronized DataThe Epi Info Analysis 2 x 2 Tables of the two exposure variables,
Baked Ham and Vanilla. Baked Ham is not significant, but Vanilla is still significant at the P = 0.05 level
Vanilla x ILLBaked Ham x ILL
Only VANILLA is significant at P value = 0.05 level
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Benefits of Mesh4X• Database, device, application, and platform
independent• Make changes anywhere. See the changes everywhere.• Allows secure communications and encrypted data
storage to protect privacy• Socio-politically neutral architecture where no one
party controls the only copy of the data• Multiple, distributed copies of data mean no single
point of failure • Designed to keep working when Internet access is slow,
unreliable, or entirely unavailable
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The Tools
Mesh4X Projecthttp://code.google.com/p/mesh4x
Discussion Grouphttp://groups.google.com/group/mesh4x
Epi Info™http://www.cdc.gov/epiinfo
Discussion Grouphttp://cms.MyEpi.Info
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DataDat
aDataDat
aGeo
Names+ Google+ YahooData Stores
System Stores: Configuration, Versioning, Security, Ontologies, Schemas
Storage
Update APIsFeedSync HTTP
AtomPub*
JavaROSA Endpoint*
Format TransformersOntology Extraction
FilteringGeoChat Bridge*
Ontology Mapping
FrontlineSMS~
.NETJava
Python*Ruby~J2ME
MS AccessMS Excel
HTTP AdapterFile AdapterSMS Adapter
KML
MS Groove~C~ HibernateAmazon S3
GData~JavaScript*
Core Library Implementations
Storage AdaptersSplit Adapter Utils
Transports
Django~.NET CF
~ Proposed
KMLGeoRSS*
RDF (Native)XForms FormXForms Data
Scheduler~ GeoCoder*Utilities
Application – Specific Adapters & Clients
JavaROSAEpi Info™
OpenMRS*
EpiSurveyor~Martus~
Generic Sync Clients
Generic Sync Servers & ServicesInSTEDD Store (Mesh4x
Server on EC2 / S3)
AED Gather~
Mesh4x Server* (Hosted by CDC)
Mapping Service (Auto KML or GeoRSS)
Java*Zoho~Google
Spreadsheet
MySQL~ Other
* In Progress
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Thank You!
Taha A. Kass-Hout, MD, MSBioSense Program Manager andDirector (Acting), Division of Emergency Preparedness and ResponseCenters for Disease Control (CDC)[email protected]
David A. Nitschke, PMPProject Manager - Epi Info™ Centers for Disease Control (CDC)[email protected] http://www.CDC.gov/EpiInfo