Propagation of program control: a tool for distributed disease surveillance

Area of Science:

• Public Health Informatics
• Epidemiology
• Health Systems Engineering

Background:

• Recent outbreaks like SARS and anthrax highlight the need for robust disease surveillance.
• Existing systems often rely on centralized data, posing privacy risks and limiting real-time information.
• Decentralized approaches are crucial for effective public health monitoring.

Purpose of the Study:

• To define requirements for advanced syndromic and disease surveillance systems.
• To develop a system meeting these requirements, focusing on privacy and decentralized data.
• To enable communicable disease diffusion tracking without central patient data.

Main Methods:

• Engineering paradigm: analysis, specification, design, implementation, and testing.
• Requirements derived from prior projects and outbreak analyses.
• Validation through literature review and testing on simulated electronic health record (EHR) databases.

Main Results:

• Developed a comprehensive requirements list for surveillance systems.
• Created "The Snow Agent system," an open-source, distributed surveillance tool.
• The system extracts epidemiological data directly from EHRs in a geographic area.

Conclusions:

• Syndromic surveillance tools must be scalable, interoperable across health systems and borders.
• Systems should prioritize patient privacy by avoiding identifiable data transfer.
• The Snow Agent system demonstrates scalability for national-level public health surveillance.