Thoughtful Technology Solutions for Real-Time Disease Surveillance

September 15, 2021:

Disease surveillance — collecting, analyzing, and interpreting disease-related data — is the key to public health. Depending on the disease being tracked, its effects and infectivity, the public health department regularly provides information such as demographics, symptoms, exposure, contact history, progress, care received, and other epidemiological characteristics. Collect Then use this information to design appropriate interventions and implement them on a large scale.

The strategic combination of active, passive, and sentry surveillance is the backbone of any country’s health information system. An ongoing pandemic shows that accurate, real-time disease monitoring can act as an early warning system and play a fundamental role in infection prevention and timely care delivery.

However, while both governments and leaders understand the importance of disease surveillance, there are still many requests for its implementation.

In the first place, much of India’s disease surveillance today relies heavily on human resources conducted by Certified Social Health Activists (ASHA). ASHA workers carry an overwhelming amount of workload. In addition to regular field visits and public interaction, you only need to check the 24 registers or logbooks of the various programs to get ideas.

This administrative and administrative workload leaves room for errors such as unreported / missed incidents, delays in reporting, and even data manipulation. For example, Kumar et.al. In 2014, we found that 93% of health center workers were unaware of the concept and practice of zero reporting. This is simply the process of recording the absence of a monitored case to make sure you haven’t forgotten to report it. Researchers also found that none of the centers they surveyed practiced zero reporting.

In addition, the program-based approach to monitoring creates vertical silos and exacerbates the workload. For example, the National Tuberculosis Eradication Program and the National AIDS Control Program are being implemented in parallel. Both programs are needed and there is no doubt that they have demonstrated their value in reducing the transmission of the disease. However, because HIV-positive patients are more susceptible to tuberculosis, both of these programs command individual infrastructures to work, even if the majority of patients tracked are duplicated.

In addition, the Indian Medical Research Council (ICMR) Virus Research and Diagnosis Institute (VRDL) Network, National Vector-Mediated Disease Control Program (NVBDCP), and Integrated Disease Surveillance Program (IDSP). All three organizations collect similar data, but there is no data sharing mechanism.

These challenges can be effectively addressed with technology solutions that provide continuous support for active, passive, and sentry monitoring.

Active monitoring requires staff / community health workers (CHWs) to actively search for information. This is a resource-intensive activity that frequently involves field visits. Applications such as DHIS2, CommCare, and Avni have had a significant impact by reducing the work associated with data collection and reporting.

These applications can be run on mobile phones and tablets. Healthcare professionals can take these apps to the field and collect data on the go. These apps can collect and store data even in areas where there is no connection and sync seamlessly when the connection is resumed. This reduces reporting delays and margins for human error.

In passive surveillance, medical professionals should report to authorities if they encounter patients with symptoms associated with 34 symptomatic disorders, 12 L-type and 22 P-type disorders. Electronic health records (EHR) can be the backbone of such passive surveillance systems.

With the rollout of the National Digital Health Mission (NDHM), the adoption of EHRs may increase, and more medical facilities are participating as nodes for sentinel monitoring. By linking it with Geographic Information Systems (GIS) and visualization systems, researchers and decision makers can identify correlations that are not apparent in tabular form.

As the pandemic continues and national public health initiatives become more important, technology solutions are the basis for building strong disease surveillance. You can combine various digital health applications that collect data for specific purposes to provide clear, real-time visibility into your country’s public health attitudes.

A comprehensive national digital health mission to be launched in India for active, passive, and sentry surveillance that governments can leverage to build more informed and responsive public health systems. There is an important opportunity to develop a unified system in India.

Thoughtworks Healthcare, Domain Specialist, Akhil Malhotra

ET Health