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The Snow Agent System
Symptom based health surveillance
Health surveillance based on lab diagnosis has two potential weaknesses, it may take a long time before the diagnosis is ready, and testing is not done for all kinds of diseases. An example of the last case is the giardiasis outbreak in Bergen in 2004 where thousands of citizens where exposed to this organism through drinking source contamination, got ill, but were not tested for in the laboratory.
Today there is no system that makes it possible to exchange epidemiological data about incidences of infectious diseases between general practitioners in an area, or a system for automatic collection of data and quick alerts for the local primary health care service. A symptom based surveillance system could help remedy these weaknesses by obtaining information about the occurrence of a symptom pattern in a patient population at an earlier stage of a disease outbreak.
Goals
- Makes it possible to detect epidemics and outbreaks earlier
- Earlier diagnosis and intervention
- Contribute to a lower number of infected
- Reduced costs connected to outbreaks of infectious diseases
Method
The project wishes to examine if sharing of epidemiological data between general practitioners changes clinical practice for testing, diagnosis and treatment of infectious diseases. Our method for investigating this question is to develop and deploy a software system in the northern health region. We will divide the geographic areas where the system is deployed into two types. Areas where we only monitor the situation by collecting data and areas where the system is used to provide information about the epidemiological situation to the GPs. By comparing these areas we hope to be able to document a significant difference.
Project description
Main focus in the first year will be recruiting of general practitioners to the project and development of an open source and free software solution for general practice offices.
The system is planned to be deployed on as many medical offices as we can recruit in the project. The system will first be placed on a small number of pilot general practitioner offices. The first pilot will last for six months. The main deployment of the system for data collection will start after one year and six months, and will last until the end of the project.
Project period
03.2007-03.2010
Funding
- Northern Norway Regional Health Authority ‘s Telemedical Research Program
- Tromsø Telemedicine Laboratory
- Norwegian Centre for Telemedicine
- Norwegian Health Net
- University of Tromsø
Project partners
- University of Tromsø, Department for Computer Science and Department for Community Medicine
- Tromsø Telemedicine Laboratory
- Norwegian Centre for Telemedicine
- Norwegian Health Net
- ProfDoc
- Dips ASA
Contact person
Johan Gustav Bellika, johan.gustav.bellika@telemed.no
Norwegian Centre for Telemedicine
University Hospital of North-Norway
P.O. Box 35
N-9038 Tromsø
NORWAY
Peer reviewed papers
Johansen, M. A., Scholl, J., Aronsen, G., Hartvigsen, G. and Bellika, J. G. An exploratory study of disease surveillance systems in Norway. To appear in Journal of Telemedicine and Telecare (2008).
http://jtt.rsmjournals.com/cgi/content/abstract/14/7/368
Monika Alise Johansen, Jeremiah Scholl, Per Hasvold, Gunnar Ellingsen, Johan Gustav Bellika. “Garbage In, Garbage Out”- Extracting Disease Surveillance Data from EPR Systems in Primary Care. To appear in Proc. ACM conference on Computer Support Cooperative Work (2008).
http://portal.acm.org/citation.cfm?id=1460563.1460646&coll=ACM&dl=ACM&type=series&idx=SERIES296∂=series&WantType=Proceedings&title=CSCW&CFID=10564709&CFTOKEN=29201641
Johan Bellika, Monika Johansen, Per Hasvold, Johanna Nystad, Per-Atle Bakkevoll, Gunnar Hartvigsen. Eight Challenges for Developing Telemedicine Applications. The Journal on Information Technology in Healthcare 2008; 6 (4): 295-302
http://www.hl7.org.tw/jith/title.php?no=329
Gunnar Hartvigsen, Eirik Årsand, Taxiarchis Botsis, Klaske van Vuurden, Monika Johansen, Johan Gustav Bellika. Improved patient empowerment and continuity of care through electronic disease surveillance. To appear in the Journal on Information Technology in Healthcare (2008).
Granberg O, Bellika JG, Arsand E, Hartvigsen G. Automatic infection detection system. Medinfo 2007;12(Pt 1):566-70. PMID: 17911780
http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=17911780
Bellika JG, Hasvold T, Hartvigsen G. Propagation of program control: a tool for distributed disease surveillance. Int J Med Inform 2007 Apr;76(4):313-29. Epub 2006 apr 19. PMID: 16621681
http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=16621681
Bellika JG, Sue H, Bird L, Goodchild A, Hasvold T, Hartvigsen G. Properties of a federated epidemiology query system. Int J Med Inform 2007 Sep;76(9):664-76. Epub 2006 sep 1. PMID: 16949338
http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=16949338
Bellika JG, Aronsen G, Johansen MA, Hartvigsen G, Simonsen SG. The Snow Agent System: A peer-to-peer system for disease surveillance and diagnostic assistance. Advances in Disease Surveillance 2007;4:42
http://www.isdsjournal.org/article/view/1955/1509
Johansen MA, Scholl J, Aronsen G, Hartvigsen G, Bellika JG. An exploratory study of disease surveillance systems in Norway. J Telemed Telecare. 2008;14(7):368-71. http://www.ncbi.nlm.nih.gov/pubmed/18852319?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum
Hartvigsen, G, Årsand, E., Botsis, T., van Vuurden, K., Johansen, M., Bellika, J.G. Reusing Patient Data to Enhance Patient Empowerment and Electronic Disease Surveillance. The Journal on Information Technology in Healthcare. 2009; 7(1): 4–12. http://www.hl7.org.tw/jith/pdf/JITH7(1)01_Hartvigsen.pdf
Conference publications / abstract /short papers
Bellika, J. G. Electronic health surveillance: from John Snow to a networked health information system. Proceedings of the 6th Scandinavian Conference on Health Informatics. Kalmar, Sweden. 26-28 August 2008.
Kristian Andreassen, Johan Gustav Bellika. THE RELIABILITY OF THE XMPP PROTOCOL EXTENSIONS AS FILE TRANSFER MECHANISM IN DEDICATED HEALTHCARE NETWORKS. Proceedings: ICICTH 2008 (Samos, Hellas, 11.-13. July 2008).
Bellika, J. G. Electronic health surveillance: from John Snow to a networked health information system. Proceedings of the 6th Scandinavian Conference on Health Informatics. Kalmar, Sweden. 26-28 August 2008.
Bellika J.G., Ilebrekke L., Bakkevoll P.A., Johansen H., Scholl J., Johansen M.A. Authentication and Encryption in the Snow Disease Surveillance Network. Accepted at the The Medical Informatics Europe (MIE) 2009 conference in Sarajevo.
Johansen M. A., Hartvigsen G., Ellingsen G., Bellika J.G., Bridging the gap between patients’ expectations and GPs’ knowledge through disease surveillance. Accepted at the The Medical Informatics Europe (MIE) 2009 conference in Sarajevo.
Henriksen E, Johansen M.A., Baardsgaard A, Bellika J.G. Threats to Information Security of Real-time Disease Surveillance Systems. Accepted at the The Medical Informatics Europe (MIE) 2009 conference in Sarajevo.
Johansen M. A., Scholl J., Hasvold P., Ellingsen G., Bellika J.G., Garbage In, Garbage Out-Extracting Disease Surveillance Data from EPR Systems in Primary Care, ACM conference on Computer Support Cooperative Work (2008). http://portal.acm.org/citation.cfm?id=1460563.1460646&coll=ACM&dl=ACM&type=series&idx=SERIES296∂=series&WantType=Proceedings&title=CSCW&CFID=10564709&CFTOKEN=29201641
Conference presentations
Johansen, M. A., Scholl, J., Aronsen, G., Hartvigsen, G. and Bellika, J. G. An exploratory study of disease surveillance systems in Norway. Tromsø Telemedicine and ehealth conference, Norway June 9-11, 2008
Bellika J. G. Electronic health surveillance: from John Snow to a networked health information system. Keynote speech at the Scandinavian Health Informatics and Terminology Conference 2008. Kalmar, Sweden. 26-28 August 2008.
Poster presentations
Monika A. JOHANSEN, Jeremiah SCHOLL, Gudleif ARONSEN, Gunnar HARTVIGSEN, Johan G. BELLIKA. A Qualitative Study of Current and Future Systems for Disease Surveillance. The 21st International Congress of the European Federation for Medical Informatics (MIE), Gøteborg, Sweden, May 25-28, 2008.
(Program at http://www.hst.aau.dk/%7Eska/MIE2008/PosterSessions/PostersV091.htm, Downloaded 22.08.08))
Botsis T, Bellika JG, Hartvigsen G. Disease surveillance systems for sensitive population groups. Advances in Disease Surveillance 2007;4:148 []Johansen MA, Aronsen G, Hartvigsen G, Bellika JG. What do GPs want in return from a Syndromic Surveillance system? Advances in Disease Surveillance 2007;4:168
Master thesis
Andreassen K. THE RELIABILITY OF XMPP FOR FILE TRANSFER. Master’s thesis in Telemedicine & E-health. University of Tromsø, Department of Computer Science. June 2008.
Aronsen G. Visualization of contagious disease outbreak information for primary care physicians. Thesis. Master of Telemedicine and eHealth. Department of Computer Science, University of Tromsø. July 2007
Dhakal S.B. Interactive disease maps for the Snow Agent System. Master’s thesis in Telemedicine & E-health. University of Tromsø, Department of Computer Science. June 2009. http://www.ub.uit.no/munin/handle/10037/2006?language=no
Reports
Henriksen E, Johansen M.A., Baardsgaard A, Bellika J.G. Threats to Information Security of Real-time Disease Surveillance Systems. Medical Informatics Europe (MIE) 2009. Appendix: Definition of likelihood, consequence and risk levels.
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