Tuesday, September 25, 2012

Guest Post: Anna Tomasulo On HealthMap

This week I am happy to be hosting a post on Science Decoded by guest blogger Anna Tomasulo, project coordinator for Healthmap and Editor-in-Chief of The Disease Daily. Please note that I am not personally promoting Healthmap as a service, I just think it is an interesting case-study of the way the internet can be harnessed to gather data in real-time so I asked Anna to give us some background.

I never focused too long on the myriad of ways that the Internet has changed our lives, until recently. This past February, The Atlantic published excerpts of Polish pundit Piotr Czerski’s “manifesto” titled, “We, the Web Kids.” The essay put my relationship to the Internet into a new light- particularly when compared to how my parents, for example, interact with the Web. “The Internet to us is not something external to reality but a part of it: an invisible yet constantly present layer intertwined with the physical environment. We do not use the Internet, we live on the Internet and along it,” writes Czerski. The Web kids rely on this shared memory drive; we extract information, contribute to it, and re-post it at our leisure. We learn about new scientific research at home and participate virtually in uprisings across the ocean. Geographic barriers dissolve. And we expect to do this all instantaneously; we want it “here and now, without waiting for the file to download.”

This essay also put my first post-graduate school job into a new light. Admittedly, I am not very tech savvy; I’ve always thought of myself more as a qualitative, literature-oriented person. But my international experience, French language skills, and recently acquired MPH landed me at HealthMap, a research group, co-founded by a software developer and an epidemiologist, that uses online media to track infectious diseases worldwide. And it does this in real time, in an almost completely automated manner.

The healthmap homepage

HealthMap was founded in 2006 by John Brownstein, PhD and Clark Freifeld, MS. Back then, Brownstein and Freifeld understood that there was a large gap between the beginning of an infectious disease outbreak and the public becoming aware of and responding to that outbreak. They attributed this lag to traditional public health reporting, which is often troubled by structural hierarchies and geographic and political barriers. For example, a typical public health worker in a small, remote village may take note of a strange syndrome that is surfacing in a handful of young kids. He or she might provide that information to medical professionals who will want to take samples for analysis. Well, the samples will need to be sent to laboratories miles away and it’s rainy season so the roads are washed out. Let’s say the samples did get to the lab. Once an infectious disease agent is confirmed, the report will then move on to district, national and then international officials. This whole process could take weeks. And during those weeks, infectious diseases can spread.

Brownstein and Freifeld recognized that there was a wealth of information available through the Internet that would fundamentally change the picture of global health. So, they created a freely available online platform that gave people access to this information.

Essentially, the system mines the Web for formal and informal sources of infectious disease news. Data is collected by carefully developed language specific search strings (HealthMap has news feeds in over a dozen languages) that sift through various news aggregators (Google News, Baidu, allAfrica), RSS feeds, mailing lists and chat rooms. The collected data is then automatically assigned a pathogen and location of the outbreak, based on information in the article (or chat room, mailing list, etc.). Then, the system determines the relevancy of each alert and filters it into one of six categories: Breaking, Context, Warning, Old News, Non-Disease Related, or International Significance. Any duplicate data is clustered together. The end product, http://healthmap.org, is a highly organized data set that allows public health officials, international travelers, government agencies and interested community members to access a real-time view of infectious disease outbreaks around the globe.

The HealthMap platform has been used to track public health threats in many contexts. Every year before the Hajj, we begin heightened disease surveillance on the countries that send the most pilgrims, and post all infectious disease news from these countries to a map created especially for Hajj. Similarly, we mine formal and informal sources for information regarding the wildlife trade because of its role in spreading zoonotic diseases.

The Internet has radically changed our way of life. It is no longer a tool that we use to perform a specific task or a tool that requires special training to use; it is an interactive system where people can deposit and build upon collected intelligence- an idea that Czerski hints at and with which Mike Kuniavsky, an entrepeneur who studies people’s relationships to digital technology, agrees. In 2008, Kuniavsky explained that all real world objects have “information shadows,” or digital representations, that exist on the Internet. These information shadows can be built upon and interacted with by other users. As a result, the Internet grows exponentially.

Arguably, HealthMap takes information shadows of disease outbreaks (local news reports, tweets, chat room questions, status updates, etc.) and augments official public health reports with real time information. But what makes HealthMap truly unique, is that it takes the informal information, or information shadows, and automatically makes it immediately useful to those who can act upon it.

Czerski differentiated our generation from others by pointing out that we are the first generation that exists not on paper, but on and through the Web. HealthMap is exemplary of the Web kid generation, as it has transported information disease tracking to the Web, and made it an immediate and global process. Not only is outbreak information available online and in real time, but it is also freely available. Czerski finishes the manifesto with: “What we value the most is freedom: freedom of speech, freedom of access to information and to culture. We feel that it is thanks to freedom that the Web is what it is.” As a freely available site, HealthMap provides international users with knowledge to make informed health-related decisions. A true product of the Web kids, HealthMap has leveraged the power of the Web, and our existence on it, to improve disease surveillance and timely responses.

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