When a disease outbreak strikes, it’s often the fear of the unknown that causes panic — rather than any sense of the actual risk of falling ill. Just ask people who were in Dallas or New York City when cases of Ebola were discovered there.
Yet the unknown is a real threat to containing an outbreak, as health officials kick into detective mode to track down and account for anyone who might have been exposed to the afflicted. That’s where data analysis can help turn traditional “shoe-leather epidemiology” into less of a guessing game — and more of a science.
“If you have 20 contacts and only one of them becomes infectious, you want to make sure someone doesn’t forget to follow up with that person because of a misplaced record,” says Joy Alamgir, vice president and chief strategy officer at Consilience Software. The Xerox-owned company deployed its Maven outbreak management software, which enables monitoring of more than 90 communicable diseases, in New York City to assist public health officials to help respond to the recent Ebola case.
“You need to have a system to manage that process, especially when there’s a large number of people who could potentially be exposed,” he explained, noting that 100 or so people had been monitored in relation to the Dallas and New York cases.
Alamgir spoke with Ideas Lab about the important role data plays in helping health officials contain an outbreak, where the technology is headed, and how keeping Ebola out of the U.S. is more of a marathon than a sprint:
How big of a role does technology play in containing outbreaks of diseases like Ebola?
Technology definitely plays a key role, but at the end of the day the public health doctors and workers, they’re the ones saving lives.
On the technology side, if you do have an outbreak of a disease like Ebola, you need to be able to react quickly and adapt to the threats to make sure the various public health departments and health providers can mobilize effectively.
Once you have an outbreak, how is data used for containment?
Technology is a pretty significant part of managing and tracking outbreaks, especially for something like Ebola. Once you have a confirmed case, you have to trace through all of the people who have been in contact with the person during the infectious period. That’s where technology plays a substantial role.
The process begins with contact tracing — trying to trace every single person that the Ebola patient may have been in contact with. Then triaging the contacts — determining whether they’re a high or low risk. Finally, monitoring contacts for signs of symptoms and potentially quarantining them.
You need to have a system to manage that process, especially when there’s a large number of people who could potentially be exposed. More than 100 people were monitored in some fashion in Dallas, and New York was looking at a similar number.
You have to manage a large amount of information and — most important — establish an electronic workflow to ensure things don’t fall through the cracks. For example, if you have 20 contacts and only one of them becomes infectious, you want to make sure someone doesn’t forget to follow up with that person because of a misplaced record.
As in any data-based approach, is human error one of the biggest threats to disease containment?
Yes, that’s why having a system that is easy to learn and use is so important. Medical professionals are primarily trained in health — not information technology. So you want to make it so the technology doesn’t become a barrier.
The system has to be easy to use and access, yet secure, so you can deploy a distributed workforce that’s collaborating to contain an outbreak. One of the things we’ve done with Maven, our outbreak management software, is take feedback from our user community to make it easier to use. The easier it is, the more people will use it. And the more people that use it, the better visibility you’ll have into a potential outbreak.
Where do you see this technology heading over the next five years or so?
You’ll definitely see more interoperability so that it’s easier to take in data feeds — whether from a lab or a flight manifest. You need to have a platform that’s able to take in such data in a flexible manner, because the data quality may not be very high, especially in an emergency situation.
You’ll get more mobile activity, so people can access and track through their mobile phones and tablets. Maven enables that capability to some extent, but there’s more to do in terms of incorporating different platforms and jurisdictions.
You’ll also see more direct engagement by the citizenry. Most of the information on potential cases comes from providers or laboratories, but this could be expanded to enable the population to report something causing a concern.
Finally, Big Data will play a greater role. More data allows more researchers to slice and dice information in a way that makes containment more targeted and efficient, without compromising people’s privacy.
With the latest Ebola patient in America, Dr. Craig Spencer, having made a full recovery, what’s the prognosis for keeping the country disease-free?
This is not a sprint. It’s more of a marathon. There is a chance that you might get more imported cases here in the U.S. and elsewhere. You must be able to contain these cases through proper contact tracing and treatment, and try to prevent the disease from spreading.
Joy Alamgir is Vice President and Chief Strategy Officer at Consilience Software, A Xerox Company.