InSTEDD HISA Conference

Collaboration Collaboration In DiseaseIn DiseaseSurveillance & Surveillance & ResponseResponse Dennis Israelski, M.D. Dir. of Programs Eduardo Jezierski, Dir. of Engineering

InSTEDD at a GlanceNon profit, based in Palo Alto, California, USA

Mission: Innovative application of technology to early detection and better response to diseases and disasters

Founded by Larry Brilliant in 2006, TED Prize

Funding: Google.org, Rockefeller Foundation and others

First implementation: Mekong Collaboration Program

Free and open source

http://creativecommons.org/licenses/by-nc-sa/3.0

After the tsunami in Banda Aceh: A city leveled, and only one bar of cell signal

In our view, collaboration, in outbreak containmentand humanitarian action, is THE critical task

Refugee management

Cholera outbreak

Katrina response

Economic Impact of Recent Epidemics(12 listed, and all but one zoonotic)

Avian Flu, EU$500m

1996 1997 1998 1999 2000 2001 2002 2003

$50bn

$40bn

$30bn

$20bn

$10bn

Estim

ated

cos

ts

BSE, UK $10-13bn Foot & Mouth Disease

Taiwan, $5-8bn

1992 1993 1994 1995

Foot-and-Mouth DiseaseUK

$30bn

Avian FluAsia, US, Canada

$10bn (2004-now)

2004

BSE, US $3.5bn

BSE, Canada$1.5bn

Lyme diseaseUS $2.5bn

SARSChina, Hong Kong,

Singapore, Canada…$50bn+

Nipah, Malaysia$350-400m

Swine Flu, Netherlands

$2.3bn

BSE, Japan 1.5bn

© Graphic from "SARS and the New Economics of Bio-Security", by James Newcomb, Managing Director, Research for Bio Economic Research Associates, LLC or bio-era in 2003.

Hybrid Disease SurveillanceSurveillance Systems

CaptureFilterVerify

Identified risksMandatory notificationLaboratory surveillance

Emerging risksSyndromic surveillance

Mortality monitoringHealthcare activity monitoring

Prescription monitoring

Non healthcare basedVeterinary surveillanceBehavioral surveillance

Environmental surveillancePoison centers

Food safety/water supply…

Domestic, NGOsField ReportsOpen Media SurveillanceVeratect (Argus) , GPHIN, etc

Int’l Distribution listsProMed (Regular, MBDS, Spanish,

Russian, etc.)

International agencies WHO, OIE, CDCNASA (e.g., remote sensing, weather,

population migration, bird migration, population density, plant, animal)

Confidential/LimitedProMed (e.g., MBDS)International health regulation

agencies (WHO, OIE, CDC, NASA)Threat bulletin (EWARN, ECDC)

Public disseminationNews, blogs, articles, Health ministry press releases websitesWeekly releases (Eurosurveillance)

Event MonitoringIndicator Based Event Based

CollectAnalyze

Interpret

SignalAssess

Control measures

DisseminateAlert

Investigate


Steung Treng Province, northern CambodiaMay 2008

From a faint signal to collective action

Merge & AnalyzeMerge & Analyze

Media

Journals

ICS Operations

Collective understandingEvent CharacterizationResponse initiationRealtime feedback

Immediate analysis & Decision making capacity

Peer- to –peer information sharing and collaboration

Informed collective action

Realtime feedback and coordination

Proactive education & preparation




Media

Journals

ICS Operations







Human Human Sensor & Sensor & Actuator Actuator NetworkNetwork

GeoChatGeoChat•MessagesMessages•LocationLocation•MetadataMetadata•AlertsAlerts

Data Interop& Data Interop& Information Information

FlowFlow

Mesh4xMesh4x•2-way sync2-way sync•MapsMaps•DatabasesDatabases•DocumentsDocuments

Over Files, Web, Over Files, Web, SMSSMS

Group Group Decision Decision Making & Making & AnalyticsAnalytics

““Riff”Riff”•Info StreamsInfo Streams•Social MetadataSocial Metadata•VisualizationsVisualizations•AnalyticsAnalytics




Media

Journals

ICS Operations









Data Interop Data Interop & Information & Information

FlowFlow






GeoChatSMS Messages on a mapMabvuku, Zimbabwe*Found 3 cases of watery

diarrhea*urgent Lat long, Geocoding, tags SMS, email, (VHF?) Open or closed groups Visualize, Analyze, Export data

• Interactive Reply, see conversation threads Group reply, with filterso Group chat channels (IRC over SMS)

• Built for austere settings Cell plugged in to PC, or scale up to SIP Simple extensibility of message botso Wiki-like base for geocoding gaps

• Integrate with your applicationo Sync with HR contact list, embed UIo Integrate client into J2ME or WinCE device




Media

Journals

ICS Operations









Data Interop Data Interop & &

Information Information FlowFlow






Mesh4x: Simplify information flow• REST-based N-way sync

+ Reliable than SOAP messaging Feedsync- Creative Commons ATOM & RSS Extensions

• No ‘single master’• Server, Desktop & Mobile• Storage adapters

MySQL, Access, KML, …

• Transport adapters Http, File, SMS text messages,…

• Securityo Encryption & oAuth authN

• Mappingo Xforms, RDF support

1- abc2 - efg23 - xyz


1- abc2 - efg13 - ---

1- abc2 - efg13 - ---





1- abc2 - efg3 - ---

1- abc2 - efg3 - ---



SMS-based or IrDA sync

http or USB Drive sync

Sync over http

1- abc2 - efg23 - ---

1- abc2 - efg23 - ---

1- abc2 - efg23 - ---

1- abc2 - efg23 - ---




Media

Journals

ICS Operations








““Riff”Riff”•Info StreamsInfo Streams•Social Social MetadataMetadata•VisualizationsVisualizations•AnalyticsAnalytics

Journals

ICS Operations



Data Interop Data Interop & Information & Information

FlowFlow






Riff: Collaboration around streams

Field Report 12Field Report 12

Article 234Article 234

DiscussionsTagging

Tags: influenza, unconfirmedTags: influenza, unconfirmed

2 Comments2 Comments

Tags: maps, influenza, asiaTags: maps, influenza, asia

3 Comments3 CommentsFavoritesLocation

12

2

asia influenza maps outbreak, suspected,

unconfirmed

asia influenza maps outbreak, suspected,

unconfirmed

SE Asia Health Alerts

Alerts

SearchLast Update: 30 minutes ago

30 minutes ago

12 hours ago

…Extensible!-Language translation- Visualization of data –eg genetic sequences, health alerts, medical records- Cross-space search, aggregation.- Exporting as different data formats.- Spatiotemporal metadata- Autonomous agents scanning & applying heuristics continuously

Logged in as User567

News Item 345News Item 345 16 hours ago

Newest first

Latest comments30 min ago by User445 (link)“I don’t think this news is accurate as it omits to mention the ...”

Latest comments30 min ago by User445 (link)“I don’t think this news is accurate as it omits to mention the ...”

(3 other members logged in)

Current Alerts• Item 1 , 30 mins ago, by User123Current Alerts• Item 1 , 30 mins ago, by User123

List

Existing ModulesLorem ipsum dolor sit amet, consectetuer adipiscing elit. Proin a ante. Fusce magna arcu, tristique vitae, accumsan eget, tristique eu, tortor. Donec euismod leo vitae augue. Donec aliquet augue non eros. Nam

Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Proin a ante. Fusce magna arcu, tristique vitae, accumsan eget, tristique eu, tortor. Donec euismod leo vitae augue. Donec aliquet augue non eros. Nam condimentum. Donec

Private or Public Spaces

One or more source feeds

Security Management

From Stung Treng province

From ReliefWeb


Collaborative Analytics

Article feature extraction

TagsTags

Content – in Riff

Metadata

CommentsComments

LocationLocation

Flags/Alerts/BookmarksFlags/Alerts/Bookmarks

Environment FactorsEnvironment Factors

PhylogeneticsPhylogenetics

Remote SensingRemote Sensing

InSTEDD

Event Characterization & D

etection Bot

Event Classification and Detection

Event Classification and Detection

Previous Event Training DataPrevious Event Training Data

Previous Event Control DataPrevious Event Control Data

Metadataextraction

Other reference

informationMachine Learning

Show event characterizations

Social network acting on itemSocial network acting on item

Other information

Open MediaOpen Media

Professional network feedback

Professional Feedback

Anomaly Detection

Riff Spaces


InSTEDD Field LabParticipatory ethnography meets natural selection

We learn there by failing fast and failing often.

In the end, we hope the tools we select will be:

more robust, more reliable, and easier to use.

Know who’s driving

Release PlanRelease Plan

Iteration Plan

Iteration Plan

Iteration ReleaseIteration Release

Daily Standup

Daily Standup

Dev & Test

Dev & Test

SpikesSpikes

Release 1m•Quality•Requirements• Functional and non

•Priorities•Partners•Demo Script

Iteration 1 w•Priorities•Key Tasks•Deployments

“Day” 1d•Dev, Test, UX•Community

Month

Week

Day

ReleaseRelease


http://creativecommons.org/licenses/by-nc-sa/3.0/

http://creativecommons.org/licenses/by-nc-sa/3.0/

Don’t reinvent the wheel

Develop& share

Partner, influence & contribute

Integrate & extend existing components

Use & recommend Existing Solutions

ExamplesKML, Feedsync, Open Street Maps,

Integrate BT w21c SMS with Google Maps, SMSLib with Mesh4x, transformers & adapters

Contribute to SMSLib, javaROSA, etc

Platform componentsOSS project creation

Scout, search, integrate & extend, before building.

When building, share and actively involve adopters in the process


Beyond Local Sustainability….

…to Sustainable Local Innovation

Cross Discipline Experts

Unforeseen ideas

Cultural fit

Global Public Health experience

Human Factors & Design

Innovative tools & services

Epidemiologists

Anthropologists

Broader adoption

Better cross sector

coordination

Research

Developing Engineers Global

applicability

Innovation Lab in Phnom Penh


Thank you!

http://[email protected]@instedd.org


Technology

InSTEDD HISA Conference