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 isnt 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 weve 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

Collaboration Directory Federation Social NetworkingVirtual Teaming Reliable Messaging Social Metadata Information Flow Forms DesignShared OntologiesSchema EvolutionTranslation Deep Field Collection Geocoding Analysis Data Fusion Anomaly Detection Complex Systems Network Analysis Text Mining Spatio-temporal Analysis Sensor Integration Decision Support Geospatial Visualization Autonomous Agents Predictive Modeling Distributed Workflow AlertingReport Generation Mesh Synchronization Storage Abstraction Offline Work Conflict Resolution SMS IntegrationSecurityIdentity Adapters & Transformers We think this is what collaboration requires in 2008…

Collaboration tools Problem – Agencies cant (or wont) 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 collective action 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, PDAs, 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 cant 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, … 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 hotline 3 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.

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