epis3: a semantically interoperable social network for syndromic surveillance and disease control

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EpiS3: a semantically interoperable social network for syndromic surveillance and disease control Luciana Tricai Cavalini and Timothy Wayne Cook National Institute of Science and Technology – Medicine Assisted by Scientific Computing

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EpiS3: a semantically interoperable social network for syndromic surveillance and disease control. Luciana Tricai Cavalini and Timothy Wayne Cook National Institute of Science and Technology – Medicine Assisted by Scientific Computing. Summary. The problem The current solution - PowerPoint PPT Presentation

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Page 1: EpiS3: a semantically interoperable social network for syndromic surveillance and disease control

EpiS3: a semantically interoperable social network for syndromic surveillance and disease control

Luciana Tricai Cavalini and Timothy Wayne CookNational Institute of Science and Technology – Medicine Assisted by Scientific Computing

Page 2: EpiS3: a semantically interoperable social network for syndromic surveillance and disease control

Summary

• The problem• The current solution• Remaining challenges• A new approach• Implementation• Future steps

Page 3: EpiS3: a semantically interoperable social network for syndromic surveillance and disease control

THE PROBLEMSyndromic Surveillance:

Page 4: EpiS3: a semantically interoperable social network for syndromic surveillance and disease control

First cases detectedIndex case

Problem 1: Detecting Cases

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Fever?Bleeding? Jaundice?

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Problem 2: Decision Making

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Page 8: EpiS3: a semantically interoperable social network for syndromic surveillance and disease control
Page 9: EpiS3: a semantically interoperable social network for syndromic surveillance and disease control
Page 10: EpiS3: a semantically interoperable social network for syndromic surveillance and disease control

THE CURRENT SOLUTIONSyndromic Surveillance:

Page 11: EpiS3: a semantically interoperable social network for syndromic surveillance and disease control

Current solution: Standardize the data model

Page 12: EpiS3: a semantically interoperable social network for syndromic surveillance and disease control
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The Current Solution: Issues

• Top-down data models– Risk of inaccurate or incomplete data

• Hospital/clinic centered applications– No records from uncovered populations

• Incipient Decision Support Systems (DSS)– Mostly academic projects in internal medicine

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REMAINING ISSUESSyndromic Surveillance:

Page 16: EpiS3: a semantically interoperable social network for syndromic surveillance and disease control

Problem is: Accuracy or Utility?Problem is: Accuracy or Utility?

Page 17: EpiS3: a semantically interoperable social network for syndromic surveillance and disease control
Page 18: EpiS3: a semantically interoperable social network for syndromic surveillance and disease control

Remaining Questions• How to collect data in the most opportune

moment?– At the point of care– In the household

• How to get data with proper…– ...accuracy...– ...granularity...

• ...that will allow implementation of useful DSS for syndromic surveillance?

Page 19: EpiS3: a semantically interoperable social network for syndromic surveillance and disease control

Dr. Cool

Your patient: Jane

Updated her problem liston Apr 29, 2014 5:33pm- Fever: YES- Bleeding: YES- Location: Nose

Suspicious case of Acute Febrile

Hemorrhagic Syndrome

What to do

How to get...

...without creating another

data silo?

Page 20: EpiS3: a semantically interoperable social network for syndromic surveillance and disease control

A NEW APPROACHSyndromic Surveillance:

Page 21: EpiS3: a semantically interoperable social network for syndromic surveillance and disease control

Fever?Bleeding? Jaundice?

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Harmonization

Multilevel Model-Driven Approach

Minimalistic,XML-based

MMD technology

MLHIM-based implementation

MedWeb 3.0 Plugin Suite

AFJHS appRabies

prophylaxis app

Hospital infection control

appBioterrorism

appPoisonous

animals appAnd so on…

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IMPLEMENTATIONEpidemiological Surveillance Support System (EpiS3):

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Acute Febrile Jaundice Hemorrhagic Syndrome (AFJHS) App

> 1 y/oFever 0-3 wks

Jaundice

AFJS

> 1 y/oFever 0-3 wksBleeding signs

AFHS

> 1 y/oFever 0-3 wks

Jaundice and Bleeding

AFJHS

Malaria blood smear test

Positive Negative

Treat malaria

Evaluate current epidemiological profile of the territory

HepatitisYellow FeverLeptospirosis

SepsisTyphoid Fever

AFJSDengueSepsis

MeningococcemiaTyphoid Fever

HantavirusOther Arbovirosis

AFHSHepatitis

Yellow FeverLeptospirosis

SepsisTyphoid Fever

AFJHS

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ConceptConstraintDefinition

ReferenceModel

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Concept Constraint Definition Generator (CCD-Gen)

www.ccdgen.com

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CCD Library on CCD-Gen

www.ccdgen.com/ccdlib

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AFJHS App Form on CCD-Gen

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AFJHS App: CCD Schema

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AFJHS App: Sample Data Instances

AFHS with spontaneous

bleeding

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AFJHS App: Sample Data Instances

AFHS with tourniquet test

positive

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AFJHS App: Sample Data Instances

AFJS with mucosa jaundice

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Already Implemented:16 AFJHS simulated cases (all possible classifications)AFHS

- Spontaneous bleeding

- Tourniquet test +

AFJHS

- Mucosa- Skin- Both

AFJS - Spontaneous + mucosa

- Spontaneous + skin- Spontaneous +

both- Tourniquet +

mucosa- Tourniquet + skin- Tourniquet + both- Malaria

Negative

- Age- Fever- Fever duration- No signs + a R library that converts

the XML data instances into R data frames

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FUTURE STEPSEpidemiological Surveillance Support System (EpiS3):

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EpiS3: Future Steps

• App User Interface– Desktop and mHealth versions

• DSS Algorithms– Clinical evaluation– Messaging– Reporting

• EpiInfo Form Builder for MLHIM data

Page 37: EpiS3: a semantically interoperable social network for syndromic surveillance and disease control

Thank you!

[email protected]

[email protected]

google.com/+MedWeb30