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HealthMap: The Online Disease Tracker

Tracking emerging health threats through online database on HealthMap

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By Dr Sanjeev Sood

Innovative technologies such as digital marketplaces, health 2.0 and cloud computing are becoming more ubiquitous in our everyday lives

eHealth is more than just application of information and communication technologies in healthcare. eHealth should be envisaged as a new way of working which integrates complex networks of people, processes and technologies to provide a more consumer-centric and user friendly healthcare system where information is accessible, relevant and reliable. As the commercial world continues to push the boundaries of innovation with ubiquitous technologies, health informaticians also explore new ways to achieve the vision of universal healthcare.

The growing digital economy has seen innovative technologies such as digital marketplaces, mobile communication, health 2.0, cloud computing, next generation games consoles and social networking becoming more ubiquitous in our everyday lives. The ‘mashing up’ of data across the World Wide Web through web services has given healthcare providers greater edge over all kinds of information.

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What is HealthMap?

Information travels fast – especially online – and a group of scientists from US are putting this fact to good use by monitoring and trying to prevent infectious diseases in their tracks. HealthMap is one such innovation that is a freely accessible, automated electronic data-mining project for monitoring, organising, and visualising reports of global disease outbreaks according to geography, time, and infectious disease agent. In operation since September 2006, and created by John Brownstein, PhD and Clark Freifeld of Children’s Hospital Boston and Harvard Medical School, HealthMap acquires data from a variety of freely available electronic media sources such as ProMED-mail, Euro surveillance, Wildlife Disease Information Node, to obtain a comprehensive view of the current global state of infectious diseases. Thus, HealthMap is a public website bringing together disparate data sources to achieve a unified view of the current global state of infectious diseases.

Users of HealthMap come from various organisations including state and local public health agencies, the WHO, the US Centers for Disease Control and Prevention (CDC), and the European Centre for Disease Prevention and Control. HealthMap is used both as an early detection system and supports situational awareness by providing real time, regional information about outbreaks, even from areas relatively invisible to traditional global public health efforts. Currently, HealthMap monitors information sources in English, Chinese, Spanish, Russian, and French and reports not only infectious diseases affecting mankind, but also animals and plants.

By doing so, HealthMap provides an overview of potential disease outbreaks in local pockets, often before government and other health agencies such as the WHO and the CDC realise they are threats. The program is tracking in over 200 countries currently, and this helps to monitor the global impact of infectious diseases.

Once the news is in, HealthMap tracks and compiles all the latest reports, from government warnings to blogosphere buzz, and makes them available on its site free of charge. HealthMap uses a colour-coded reference system overlaid on a world map to highlight where disease news is being generated. For instance, ‘red’ or ‘hot’ icons designate areas in which there are multiple reports of illness.

The programme continues to scan progress once public health agencies declare an outbreak or epidemic to keep both researchers and consumerism the loop and on top of the latest news about any particular event.

Another such initiative is the Bio Sense Real-Time Clinical Connections Program developed by the US Federal Centers for Disease control and prevention. The Bio Sense program, initiated in 2004, is an innovative biosurveillance programme designed to increase the nation’s emergency preparedness through the development of a national network for real time disease detection, monitoring, and health situational awareness. Bio Sense sits atop a hospital’s existing information systems, continually gathering and analyzing their data in real time. It is a Federal Program that monitors the outbreaks from early stages, while HealthMap is an informal reporting and early warning information system available on public domain.

The underlying technology

HealthMap uses a colour-coded reference system to highlight where disease news is being generated. ‘Red’ or ‘hot’ icons designate areas in which there are multiple reports of illness

HealthMap uses a number of different algorithms to sort through all the information online. This automated system scours news services and online discussion forums and data warehouses pooling information about emerging health threats worldwide. This allows rooting out duplicative reports and determining where and when something is happening. Thus, HealthMap is essentially a disease mining information system. Data mining is the process of extracting patterns from data and to transform these data into meaningful information.

According to Clark Freifeld, co-founder of the HealthMap, the website is continuously updated on the front as well as back-end. HealthMap is now tracking 50,000 websites. It offers customized data viewing, is interactive and physicians can upload information on any outbreaks in real-time.

A recent example of HealthMap’s abilities is the salmonella outbreak generating headlines and concern across the US and the cholera outbreak in Haiti. By clicking on the red, square-topped icon over the US (indicating a countrywide threat), a site visitor is linked to recent news reports, government estimates of sickened individuals, and so forth. HealthMap founders informed author that they spotted the emerging outbreak days before the CDC by homing in on reports of salmonella-related gastrointestinal distress in New Mexico.

Indian initiative

The India’s answer to HealthMap and BioSense Programme is Integrated Disease Surveillance Project (IDSP), launched by MoHFW in 2004. It is a decentralised, state-based surveillance pogramme in the country, intended to detect early warning signals of impending outbreaks and help initiate an effective response in a timely manner. Major components of the project include integrating and decentralising surveillance activities; strengthening of public health laboratories; human resource development and training of state surveillance officers, district surveillance officers, rapid response team, other medical and paramedical staff; and using IT collection, collation, compilation, analysis and dissemination of data. Currently linkages are being established with all state head quarters, district head quarters and all government medical colleges on a satellite broadband hybrid network. The network on completion will enable 800 sites on a broadband network. This network enables enhanced speedy data transfer, video conferencing, discussions, training, communication and in future e-learning for outbreaks and programme monitoring under IDSP. A 24X7 call center with toll free telephone no 1075 accessible from BSNL/MTNL telephone from all states is in operation since February 2008. This receives disease alerts from anywhere in the country and diverges the information to the respective state/district surveillance units for verification and initiating appropriate actions wherever required. IDSP is supporting activities related to H1N1 virus under IDSP with total outlay of `20.85 crores for three years (2006-09) for Human Component.

Conclusion

HealthMap affords excellent example of application of informatics to strengthen public health system to effectively monitor and respond better to a public health crisis situation like one being currently faced by India in face dengue epidemic by collating and integrating all data from diverse sources. Effective surveillance shall enable keeping track of all cases, avoid panic, encourage knowledge sharing and mount coordinated response to public health crisis.

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