Wrap up from EpiHack

After three days of designing and hacking, the digital disease surveillance hack-a-thon we’ve been sponsoring in Cambodia, EpiHack, has come to a close. As newcomers to the hack-a-thon model, our team has been impressed with the overall productivity and the projects that emerged. We are honored and excited to have witnessed the transformation of these great systems that now incorporate participatory surveillance and are excited to see how they will be implemented!

On the third and final day of EpiHack, groups gave their final presentations and demoed their new systems. (In alphabetical order), the award for:

“Best Scientific System” goes to CoPanFlu
“Best User Interface” goes to DoctorMe
“Most Transformational” goes to ILI Surveillance (Bureau of Epidemiology, Thailand)
“Most Impressive System” goes to Mae Tao Clinic
“Best Overall Utility” goes to Verboice

Here are summaries of the “new” systems:

This project included home visits to collect blood samples from 807 homes and weekly follow-up phone calls to document occurrence of infectious respiratory symptoms. These visits and phone calls created disturbances to the participants. The new system uses SMS for users to report symptoms. Chart and map visualization of the data (with full case details) and a fieldwork tracking tool were developed to help the research team analyze and monitor data.

In addition to all of the popular features of DoctorMe (free health information for the general public), the tool now features a weekly survey for their users. The survey will ask participants to select whether they are experiencing any symptoms on a list of 11 total. After submitting, participants will be taken to a map visualization of all reports in their area. DoctorMe will launch the new tool by sending an email to current website users. They will then develop a promotion plan to grow the system.

ILI Surveillance, Bureau of Epidemiology Thailand
The old system was web-based and had no visual element. The new mobile application and website provide a map visualization for the reported cases of influenza-like illness (ILI) in Thailand. The map shows hospital ILI cases with color-coded pins to indicate the level of ILI and allows for simple analysis of the situation.

Mae Tao Clinic
The electronic records for this healthcare clinic were very basic. During EpiHack, the data was moved to the cloud and is now open-source. A data visualization dashboard was created to allow for map visualization of diagnoses. The staff at Mae Tao Clinic can now easily view and analyze the data to spot trends and send alerts. They plan to pilot this program at their clinic and, if successful, to replicate with other clinics.

The technology platform of Verboice is so user-friendly it doesn’t require technical developers to develop the systems. At EpiHack, project managers were able to design and create systems to address needs in their work completely on their own. In just 8 hours, four project managers each completed their own voice-based participatory surveillance systems to monitor the following: One Health in Kenya & Tanzania; early warning generation in South Sudan; animal health in Laos; unexploded ordinance in Laos; child trafficking in Cambodia. The project owners of these new systems will now take these back to their countries and develop implementation and sustainability plans.

Below is a 3-minute slide show from the event.


Hacking for Disease Surveillance in Southeast Asia

This week, the Skoll Global Threats Fund has been been sponsoring a three-day hackathon, “EpiHack,” in Phnom Penh, Cambodia. Along with local partners InSTEDD, Change Fusion, Opendream, and the Royal University of Phnom Penh, we have gathered 60 leading technical developers and global health experts to address the important, borderless issue of disease surveillance in Southeast Asia. We have been building out five prototype projects to incorporate participatory, or crowd-sourced, disease surveillance into the region.


During the first day of EpiHack, we broke out into smaller groups based on interests and skills and designed roadmaps for these five prototype projects. Then we moved on to real “hacking” to incorporate participatory surveillance into these existing systems. Below are descriptions of the five projects.

The Cohort for Pandemic Influenza in Laos (CoPanFlu Laos) is a laboratory-based system first implemented in Vientiane, Laos, in 2009 to investigate 2009 A(H1N1) influenza seroconversion rates and their determinants within an unvaccinated population. CoPanFlu Laos follows a general population cohort of 807 households and 4,072 participants that was established in March 2010. Sociodemographic data, epidemiological data, and capillary blood samples have been collected from all the household members on two occasions in the past.

DoctorMe is the first mobile application for health in Thailand on the IOS and Android systems. Initially, DoctorMe was created in 2011 to promote good health care and first aid for all people in Thailand. The original version was designed to be an electronic health manual with a database of more than 1,000 hospitals in Thailand for users to locate a nearby hospital when needed. The new version of DoctorMe includes an application designed to connect the user with the National Institute for Emergency Medicine (NIEM), offering free services by sending an ambulance instantly when you call 1669. Push notification is also being used in this version to keep people alert about health care issues.

ILI Surveillance – BOE
The Bureau of Epidemiology in Thailand set up web-based reporting for Influenza like Illness (ILI) with 987 government hospitals around the country. The project was established in 2009, with the hospitals submitting the number of ILIs weekly. A system analyst then sends back the results of national statistics coming into the ILI system to the hospital and other responsible people in the area via the Internet, email, and SMS for up-to-date information on the flu situation week by week.

Maetao Clinic
The Maetao Clinic is a health provider and training center based in Mae Sot, near the Myanmar-Thailand border. Maetao was established to contribute to and promote accessible, quality health care among displaced Burmese and other ethnic peoples in this border location. The Maetao Clinic provides health care to 100,000 patients per year. The group has developed an electronic medical record that could be a good data source for disease surveillance.

Voice to voice interaction remains the most effective and primary form of human communication for both health care service providers and vulnerable groups who live in rural Cambodia. Due to poor network connectivity and literacy barriers, rural Cambodians are inhibited from using many technologies. In September 2012, with funding from Spider (The Swedish Program for ICT in Developing Regions), the InSTEDD iLab Southeast Asia introduced and extended Verboice, an open-source tool developed by InSTEDD to support health, safety and sustainable development programs in Cambodia. Verboice makes it easy for anyone to create and run applications that interact via voice, allowing people to listen and record messages in their own language and dialect, or answer questions with a phone keypad.