Contact tracing gets a digital makeover, thanks to a unique tech partnership
Earlier this year, a trio of leading technology companies reached out to the U.S. Centers for Disease Control to ask a question: What can we do to help with the pandemic?
The CDC had a ready answer: Find a better way to do contact tracing, that laborious process of tracking down and interviewing people who are infected or may have been exposed to infection, in order to slow down disease spread.
The three companies--Intel, Dell, and Leidos--got straight to work. The result is MicrobeTrace Next, a fully digital upgrade to contact tracing that makes the process easier, faster, and more effective. “This is a way of allowing for economic reopening, while at the same time preventing transmission of the infection through precision data,” says Leidos Chief Scientist Ryan Weil.
Contact tracing, notes Weil, has been public health’s main weapon against epidemics and pandemics since the birth of modern epidemiology during a mid-19th century cholera epidemic, and that’s still the case. But there are some real challenges to implementing contact tracing, he notes, including the need to train an army of people how to ask exactly the right questions of the right people, the time and effort required to aggregate the resulting flood of data, and the difficulty of analyzing the vast pools of data quickly enough to shut down hot spots and get ahead of other trends in disease spreads. Coordinating contact-tracing efforts across the different approaches taken by different jurisdictions can be tricky, too, making it harder for counties and states to respond to disease trends with fast public-health policy decisions and resource allocation.
Those are among the problems the three technology partners set out to solve. The project’s roots go back to March, when the pandemic first hit the U.S. At the time, Intel contacted Dell and Leidos to propose a technological-best-of-breed pandemic-fighting partnership that could take advantage of First Genesis’ unique BpaaS solution, Intel’s processing power, Dell’s integrated computer systems, and Leidos’ deep experience in developing healthcare software solutions. After the partners were aimed by the CDC at contact tracing, Leidos determined the project could get a running start by adapting the CDC’s MicrobeTrace, an open-source online tool designed to find infection patterns in multiple databases of patient data.
, Leidos Chief Scientist
Contact tracing has been public health’s main weapon against epidemics and pandemics since the birth of modern epidemiology during a mid-19th century cholera epidemic, and that’s still the case.
The goal then became to expand and modify MicrobeTrace to quickly produce a digital solution that could support all the COVID-19-focused best practices in contact tracing that had been developed by public health experts at Johns Hopkins University. Those practices spell out the process of determining who contact tracers need to interview, what information to get during the interviews, and how to use that information. “Contact tracing is a hard job that has a lot of complex science behind it,” says Weil. “We wanted to use technology to make it as easy as possible to get good results from such a tough job.”
The first step was developing a mobile app that could walk a newly hired contact tracer through the many steps needed to conduct a full interview, without requiring a lot of training. The interviews, which are usually conducted by contact tracers over the phone with people who may have been exposed to COVID-19, involve asking a series of questions that change on the fly with each response. Has the person been tested? Do they have certain symptoms? Have they been near other people? Were they wearing a mask? And on and on, with each “yes” or “no” calling for different follow-up questions.
Getting contact tracers to correctly navigate that shifting landscape of questions has always required a fair amount of training. But the MicrobeTrace Next mobile app reduces that training burden by prompting the contact tracer to enter in the response to a question, at which point the app pulls up the appropriate next question. “The app makes someone with no public-health experience an effective interviewer,” says Weil. “If someone who is infected says they were in a grocery store, the app will prompt them to ask for information from their receipt, so that the store’s purchase data can help identify other people who were shopping there at the time.”
Instead of leaving public-health workers with a batch of individual “trace forms” containing the different interviewees’ responses, as traditional tracing does, the MicrobeTrace Next app automatically uploads the resulting data to a database, where it’s integrated with the other tracing data coming in. Then the app supports the analysis of the data and feeds highlights of the integrated data to a dashboard, so public-health workers and officials can get a picture of what’s happening in real time, and zero in on potential spreading events to better contain the transmission. The software can even display a map showing confirmed and potential infection and exposure. “You can see at a glance that the probable center of an infection event was a picnic in the park, or a round of golf, or a church service,” says Weil.
MicrobeTrace Next can be enabled to automatically share the resulting information and insights with other jurisdictions, enabling public-health officials to spot trends at county, state or even national levels. “It gives you the precise, granular views needed to understand exactly what’s happening on the ground, as well as the high-level views that tell you where things have been heading, and where you need to focus more attention,” says Weil. He adds that the system can also tie into state infection-alert systems, hospitals’ electronic health record databases, and other healthcare and public-health databases.
Security was another key concern of the project. To help protect privacy and comply with HIPAA, so that only authorized healthcare and public-health workers can see personally identifying information, MicrobeTrace Next uses state-of-the-art blockchain-based encryption technology.
The partners have made MicrobeTrace Next as accessible as possible to states and localities, offering the system as a complete packaged solution running on Dell Intel-powered hardware, along with the mobile app. For most public-health agencies, the cost of the system qualifies for funding under the federal CARES Act. “We’re targeting net zero costs for local jurisdictions,” says Weil.
With MicrobeTrace Next in place, getting control of the outbreak could suddenly become within reach of states and counties that have been overwhelmed by COVID-19 rapid spread. And that in turn should make it safer to move ahead with the process of opening more businesses, schools and other institutions. “Contact tracing is the fundamental unit of public health,” says Weil. “It’s a hard job, but we’ve worked to make it easier.”