Twitter app takes on disease tracking

By Erin McCann
10:09 AM

Twitter, the much beloved social networking site, is set to take on disease outbreaks, after the collaborative efforts of three informaticists yielded a new Web-based application tool available to public health officials.

Officials at HHS' Office of the Assistant Secretary for Preparedness and Response (ASPR) announced in September the arrival of MappyHealth, the winning submission in a developers' challenge sponsored by the ASPR.

The triumvirate was awarded $21,000 for developing the application in response to a request made by local health officials for help developing a Web-based tool that could make social media monitoring more accessible to local health departments. 

According to public health officials, studies of the 2009 H1N1 pandemic and the Haiti cholera outbreak demonstrated that social media trends could indicate disease outbreaks earlier than conventional surveillance methods. However, many Web-based apps are retrospective, looking back on a disease outbreak, as opposed to attempting to identify health trends as they emerge in real time.

Brian Norris, co-creator of MappyHealth, says what started out as a fun project turned into a mission to utilize data analytics to improve health. 

"I think what we found as we've gone through this is there are a lot of different ways you can see information." For Norris, the challenge really transformed into building a platform that could be leveraged in healthcare to solve other analytical problems via social media platforms.

When the data analytics portion of the project began, Norris recalls what the group initially observed. 

As the World Health Organization issued health reports, for example on Coronavirus or West Nile Virus, "We were able to see how those reports sort of moved around the social media Twittersphere, and that's valuable information, because it also gives information as to how far out their reports have gone, how long people are actually talking about it." 

Mark Silverberg, another co-creator of MappyHealth, explains how the data analytics portion works. First, the group requests the tweets they're interested in. "Prior to the contest, they gave us a list of key words, but we've filtered it down and added our own." Some of these key terms include a variety of illnesses, such as influenza and malaria. 

Once they're connected to the servers, the health tweets start streaming in, often millions within an hour, Silverberg says. "Right when we receive [the tweets], we do some quick analysis, look to see what condition they're talking about. We apply those qualifier terms," which Silverberg says are things like "I have," or "death," or "I'm going to go see a doctor."

"When the tweet gets to us," he adds, "We apply those algorithms to make fields in the data base, and they all go into a huge database where we currently have about 70 million tweets that we can look at." 

After that, he says, comes the difficult part of processing the data. "We've really only touched the tip of the iceberg." 

The result? Health officials say they can use data gained through the app to complement other health surveillance systems in identifying emerging health issues and as an early warning of possible public health emergencies in a community. 

Silverberg recalls back when the CDC published statistics on the high number of West Nile Virus cases and mortality rates in Texas, particularly Dallas: "Dallas lights up like a light bulb." This real-time data is huge, he says. "Historically, in healthcare, it's days, if not weeks, before that kind of information gets released to the public." 

Early identification allows health officials to respond quickly, including advising people on how to protect their health and minimize the spread of the disease. Officials say these strategies can help the community recover quickly from an outbreak or a public health emergency  -  potentially even heading off a pandemic.

"Having real-time information available in the public domain through social media like Twitter could be revolutionary for health officials watching out for the first clues to new, emerging infectious diseases in our communities and for modernizing our public health system," says Nicole Lurie, MD, assistant secretary for preparedness and response and a rear admiral in the U.S. Public Health Service. 

Currently, the top diseases being tracked by MappyHealth are STIs, pertussis, the common cold, influenza and gastroenteritis. Moreover, among the most frequent locations for these disease-tracking tweets include Orlando, Los Angeles, Johor Bahru and Chicago.

Norris says the collaborative efforts between Silverberg and other MappyHealth colleague Charles Boicey won't stop here. The group is in the process of helping the Department of Health and Human Services replicate the data system into the HHS system for the benefit of its own constituents and public health groups. 

"If we help save lives, or if we help impact healthcare positively," Norris adds, "I think it's a huge win."