When I first started using the term open source epidemiology to describe illness and disease surveillance systems that any one could contribute to, my focus was on wikis such as ProMED sponsored by the International Society for Infectious Diseases. Today, NYT coverage is focused on Google and their Flu Trends app [see also The Wall Street Journal].The idea is simple: Google scours their searches for entries like "flu symptoms" and then displays the results by state. The display page also has links to the CDC Home Page (bad idea, why not here?) and the Flu Shot Locator sponsored by the American Lung Association (great idea!). The reports today note that flu outbreaks using this search strategy on consumer-generated data may detect flu outbreaks 7-10 days before the CDC reports them using their traditional methods such as emergency room visits. In terms of timing and early warning systems think about that: monitor people searching for flu symptoms and how to treat them or wait until they show up at the already overburdened ERs when all else has failed. From Miguel Helft's reporting in the NYT.
Google Flu Trends avoids privacy pitfalls by relying only on aggregated data that cannot be traced to individual searchers. To develop the service, Google’s engineers devised a basket of keywords and phrases related to the flu, including thermometer, flu symptoms, muscle aches, chest congestion, and many others.
Google then dug into its database, extracted five years of data on those queries and mapped it onto the C.D.C.’s reports of influenzalike illness. Google found a strong correlation between its data and the reports from the agency, which advised it on the development of the new service.
As I said in the earlier piece on open source epidemiology, this type of innovation incursion into epidemiology opens a door for discussions about the roles of social media and the people formerly known as the audience in public health practice. You should also note that the CDC was an engaged partner in this effort - state and local health department folks will want to hear that. This work also underscores how social marketers and health communicators need to be thinking about search behaviors as a critical part of understanding the media habits and sources of information of many of their markets and audiences.
And to keep things interesting, The Wall Street Journal reports that Microsoft in willing to pay upwards of $650 million dollars to be the default search provider for Verizon Wireless customers. Why? Today there are 17.6 million (7.7% of cellphone users) people searching the internet through their mobile phone browsers and Google has about a 60% share; Microsoft comes in at 10%. If people are searching for why they feel bad and we can track that, doctors can use Google as a diagnostic aid, and I could google some symptoms to figure out why the car would not start this past weekend (and turned out to be correct btw), the on-demand need for information highlights the necessity for public health people to figure out how to utilize health information technologies as a communication strategy and not simply a tool. This means not just communicating to people when and where they are open to it, but engaging them to contribute to our collective knowledge base as well.
Try this analogy with your colleagues to make the point about social media and public health: the amber alert program for missing children is not created and acted upon by just law enforcement agents. They use citizen reports and all forms of media including cell phones and widgets, to mobilize communities to search for and safely recover missing children. Seems like an easy model for pandemic flu preparedness - though devilish in the details (they tell me. I am not convinced. Sometimes the issues lie in getting you to try and answer the wrong questions).
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