InSTEDD: TED Prize Follow Up


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At TED, InSTEDD spoke about what has happened since Larry Brilliant's original TED prize with in 2006. You can catch up on the video here:

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  • World Health Organization October 26, 2010
  • Ability to get results is a function of your skills and who and how you work with others Most people –the social network of TEDsters may be a unique outlier in this sense – get the most help in unexpected situations out of the extended network One of the things we hope to contribute with our directory ‘who’s doing what where’ is use this fact and Help the health and disaster response communities Which is highly geographically mobile, and help them Be more effective and efficient by tightening their social network by location <<give example of someone arriving in SE asia or tsunami – looking for folks based on skills and finding ‘contact of a contact’, and requesting introductions.
  • Discuss” they do maps by hand and excel spreadsheets Potential Tags should include: I. one is at diary level - just to know which are the diaries devoted to news: the diaries tagged with "news"? II. and then there could be internal tagging as in "**new case**" III. we can have human correct the info on the map Types of Applicable Technologies Geospatial Visualization Biosurveillance Disease Spread Modeling Predictive (and Risk) Modeling Natural Language Processing Resource Allocation and Supply Chain Management Outbreak Management Mass Collaboration Situation Awareness and Decision Support
  • InSTEDD: TED Prize Follow Up

    1. 1. TED Wish Update: InSTEDD Eric Rasmussen, MD, MDM, FACP 2006 TED Wish CEO
    2. 2. <ul><li>Stanford BA 1987, MD 1990 </li></ul><ul><li>Former US Navy Commander </li></ul><ul><li>Former Fleet Surgeon, Third Fleet, US Navy </li></ul><ul><li>Master’s in Disaster Medicine, WHO </li></ul><ul><li>Director, Strong Angel Demonstrations </li></ul><ul><li>Special Advisor, Humanitarian Informatics </li></ul><ul><ul><li>US Office of the Secretary of Defense </li></ul></ul><ul><li>DARPA Investigator of the Year - 2003 </li></ul><ul><li>Chairman, Department of Medicine, Seattle </li></ul><ul><li>President and CEO, InSTEDD </li></ul>Medical fieldwork in: Colombia, Korea, Iraq, Afghanistan, Bosnia, Zambia, Katrina, Kenya, Banda Aceh, Uganda, Turkey, Haiti… Eric Rasmussen, MD, MDM, FACP
    3. 4. Larry Brilliant’s PRIZE Wish: <ul><li>… that you will help build a global system to detect each new disease or disaster as quickly as it emerges… </li></ul>
    5. 6. <ul><ul><li>Offer help to those with existing responsibilities </li></ul></ul><ul><ul><li>Make useful tools freely available to anyone </li></ul></ul><ul><ul><li>Be available in as many languages as necessary </li></ul></ul><ul><ul><li>Be outside of any government </li></ul></ul><ul><ul><li>Be transparent in purpose and partnerships </li></ul></ul><ul><ul><li>Be international in scope and practice </li></ul></ul>was asked to:
    6. 7. We’ve talked with a lot of people United Nations Humanitarian Information Symposium Geneva, November, 2007
    7. 8. A few disease reporting problems we’ve found: <ul><li>Cultural acceptance </li></ul><ul><li>Geo-referenced imagery </li></ul><ul><li>Languages and translation </li></ul><ul><li>Unreliable communications </li></ul><ul><li>Minimal Essential Data Sets </li></ul><ul><li>Complex System Assessments </li></ul><ul><li>Epidemiology Decision Support </li></ul><ul><li>Rapid Assessment Consolidation </li></ul><ul><li>Emergent Strategic Collaboration </li></ul><ul><li>Consolidating Human-Animal-Environmental health impact </li></ul>
    8. 9. We’ve thought about it… <ul><li>Commercial models rely on competition to drive innovation. </li></ul><ul><li>Their tools fail at the edge where there is no market to drive success. </li></ul><ul><li>Non-profits know the “edge” challenges, but lack the resources for technical innovation </li></ul><ul><li>We recognize our success will be measured by effective adoption at both the edge and the center. And it has to be open-source and free. </li></ul><ul><li>We’ve decided to rely on environmental forces (rather than a market) to drive innovation. And it works. </li></ul>
    9. 10. Laptop from LTC Susanna Roughton, RAMC Physician-Epidemiologist British Royal Army Az Zubair, Iraq - 2003 Our environments are harsh . Tough environments drive innovation.
    10. 11. Not just harsh. Also REALLY disconnected… Savanakhet village, Laos, 2008
    11. 12. A related question for you…
    12. 13. The Greatest Foreseeable Threat to Global Security? (based on a recent NIC report) <ul><li>Cancer radiotherapy </li></ul><ul><li>Car antennas </li></ul><ul><li>Peanut rust </li></ul><ul><li>Lawns </li></ul><ul><li>Glaciers </li></ul><ul><li>Orphans </li></ul><ul><li>Silurian phytoplankton </li></ul><ul><li>Chickens </li></ul><ul><li>Myanmar hookers </li></ul><ul><li>Baywatch </li></ul><ul><li>Groove, PGP, VSee and Skype </li></ul>US National Intelligence Council 2020 Project: Mapping the Global Future
    13. 14. Chickens. Domestic fowl are the carriers of H 5 N 1 avian influenza. 120 million chickens died or were slaughtered in Asia in early 2004 to halt the spread of that virus. There have now been tens of millions more culled through 2007. It hasn’t worked. 147 out of 418 tigers now have died in Thai zoos from bird flu. The Cambodian human case fatality rate is 100%
    14. 15. From the US National Intelligence Council Report, 2003 “ A global pandemic is the greatest single threat to the global economy… … and so to global security”
    15. 16. Emerging Infectious Diseases (EID) 1940 – 2004 Nature 451, 990 - 993 (21 Feb 2008)
    16. 17. Hong Kong: A single person with SARS arriving in Toronto infected 483 people, killed 43, and cost Canada $763m.
    17. 18. Economic Impact of Recent Epidemics (12 listed, and all but one zoonotic) Avian Flu, EU $500m 1996 1997 1998 1999 2000 2001 2002 2003 $50bn $40bn $30bn $20bn $10bn Estimated costs BSE, UK $10-13bn Foot & Mouth Disease Taiwan, $5-8bn 1992 1993 1994 1995 Foot-and-Mouth Disease UK $30bn Avian Flu Asia, US, Canada $10bn (2004-now) 2004 BSE, US $3.5bn BSE, Canada $1.5bn Lyme disease US $2.5bn SARS China, Hong Kong, Singapore, Canada… $50bn+ Nipah, Malaysia $350-400m Swine Flu, Netherlands $2.3bn BSE, Japan 1.5bn
    18. 19. <ul><li>Predict and Prevent </li></ul><ul><ul><li>developing the science </li></ul></ul><ul><ul><li>regional networks as springboards </li></ul></ul><ul><ul><li>awareness and mitigation </li></ul></ul><ul><ul><li>multiple continents </li></ul></ul><ul><ul><ul><li>southeast Asia and Africa this year </li></ul></ul></ul>
    19. 20. If you don’t go, you don’t know. A core thought for us…
    20. 21. The airfield in Banda Aceh: Infectious bacteria in the mud “off the scale”
    21. 22. After the tsunami in Banda Aceh: A city leveled, and no way to communicate the needs
    22. 23. Collaboration, in outbreak containment and humanitarian action, is THE critical task
    23. 24. InSTEDD Field Lab Participatory ethnography meets natural selection <ul><li>Our customers work in extreme conditions. </li></ul><ul><li>Our tools have to work where they work. </li></ul><ul><li>So…we go to the field. </li></ul>We learn by failing fast and failing often . In the end, our tools will be: more robust, more reliable, and easier to use.
    24. 25. California Urban Search and Rescue Task Force – 3 Collaboration Testing in the field
    25. 26. Thirsty? Here’s a firehose… Using agile design and early validation for linking people to help GeoBlogging SMS Geo-Chat Emergency Command Center GeoChat GeoForms
    26. 27. Platform Development Strategy Innovate only where we must <ul><li>Gather requirements in the field. </li></ul><ul><li>Solicit ideas from a wide audience. </li></ul><ul><li>Repurpose existing tools with potential for humanitarian use. </li></ul><ul><li>Partner with key public and private sector organizations. </li></ul><ul><li>Build wherever gaps remain. </li></ul><ul><li>Integrate into the InSTEDD Platform. </li></ul><ul><li>Iterate… </li></ul>Agile Development Process
    27. 28. Field Lab and Platform Synergy Learning at the edge, building for the future Emerging Requirements Component Integration Design Validation New Features & Services
    28. 29. Collaboration everywhere “Who’s doing what where” – January 2008
    29. 30. The Mekong Basin Disease Surveillance Consortium Serious infectious disease hotspot.
    30. 31. Requirements from our MBDS countries <ul><li>Reliable </li></ul><ul><li>Effective </li></ul><ul><li>Sustainable </li></ul><ul><li>Local relevance </li></ul><ul><ul><li>The method of reporting is locally appropriate </li></ul></ul><ul><ul><li>The local population derives benefit </li></ul></ul><ul><li>Regional Partnerships </li></ul><ul><ul><li>shared technical capacity acceptable in MBDS </li></ul></ul>Cambodia
    31. 32. <ul><li>Cambodia and Lao encompass the set of problems we want to help address: </li></ul><ul><li>Challenging languages </li></ul><ul><li>Early stage of technical development </li></ul><ul><li>Reportable diseases are present, difficult, and worrisome </li></ul><ul><li>Helpful Ministry involvement </li></ul><ul><li>Strong relationships with both international agencies and neighboring countries </li></ul>
    32. 33. Health Information Flow in Lao and Cambodia <ul><li>Overland travel </li></ul><ul><li>Some HF Radio </li></ul><ul><li>More mobile phones </li></ul><ul><li>Some land lines </li></ul><ul><li>Few mobile phones </li></ul><ul><li>HF radio </li></ul><ul><li>Overland travel </li></ul><ul><li>Some dial-up Internet </li></ul><ul><li>Land lines & Fax </li></ul><ul><li>Broadband Internet </li></ul><ul><li>Broadband Internet </li></ul>Upward: slow and difficult Downward: slow and rare Horizontal: only ad hoc observed from the District level down
    33. 34. Some helpful methods are out there, waiting… Some we’ll have to build
    34. 35. <ul><li>Compact </li></ul><ul><li>Reliable </li></ul><ul><li>NGO discovery </li></ul><ul><li>In use in Afghanistan </li></ul>GATR Inflatable Satellite Communications
    35. 36. <ul><li>Simultaneous IM translation </li></ul><ul><li>Instant messaging </li></ul><ul><li>17 languages </li></ul><ul><li>Accuracy “modest”, but improving. </li></ul><ul><li>In use in Iraq and Afghanistan </li></ul>
    36. 38. Solid science is developing around indicators <ul><li>200+ social disruption parameters developed by subject matter experts in: </li></ul><ul><ul><li>Infectious diseases </li></ul></ul><ul><ul><li>Medicine </li></ul></ul><ul><ul><li>Public Health </li></ul></ul><ul><ul><li>Sociology </li></ul></ul><ul><ul><li>Cultural Anthropology </li></ul></ul><ul><ul><li>Disease History </li></ul></ul><ul><ul><li>Disease Modeling </li></ul></ul>Palantir Analytics Corp. Proprietary and Confidential. No distribution without prior PAC written authorization
    37. 39. And around sensemaking in large data sets
    38. 40. <ul><li>Cell phone SMS messages show up on Google Earth </li></ul><ul><li>Time, date, person, location, text </li></ul><ul><li>Reply directly from your laptop </li></ul><ul><li>See movements as paths over time </li></ul><ul><li>The status display ages </li></ul>SMS Microblogging (cell phone + Google Earth) GeoChat
    39. 41. So, after learning all of that, what would REAL antiviral software look like?
    40. 42. InSTEDD Platform Open source applications, services, and frameworks
    41. 43. Big project. Worthy goal. And there is a good start already underway.
    42. 44. World Health Organization’s EWARN An Early Warning and Response Network <ul><li>23 countries </li></ul><ul><li>WHO international standard </li></ul><ul><li>Paper ledgers to Microsoft Access. </li></ul><ul><li>Good reporting from a limited base </li></ul><ul><li>Excellent effort from very limited resources. </li></ul><ul><li>Well-accepted globally </li></ul><ul><li>Used in Cambodia and Lao PDR </li></ul><ul><li>But…. </li></ul><ul><li>It is a stand-alone system with no network layer. </li></ul><ul><li>It has no collaboration or communication capacity. </li></ul><ul><li>WHO has asked for our help. </li></ul>
    43. 45. WHO-EWARN partnership with InSTEDD <ul><li>Collaboration </li></ul><ul><li>Improved Analytics </li></ul><ul><li>Enhanced Visualization </li></ul><ul><li>Mesh Architecture </li></ul><ul><li>Bidirectional data flow </li></ul><ul><li>Horizontal data flow </li></ul><ul><li>SMS Reporting </li></ul><ul><li>SMS Alerting </li></ul><ul><li>SMS Synchronization </li></ul><ul><li>Standards-based interoperability </li></ul><ul><li>Multi-feed data fusion </li></ul><ul><li>Improved Usability </li></ul>Riff
    44. 46. Siam Peng District in Steung Treng Province, Cambodia No internet access, and a computer with EWARN only in the district capital <ul><li>Community health center workers routinely submit reports into the District EWARN via SMS </li></ul><ul><li>EWARN, watching, detects an outbreak in progress </li></ul><ul><li>EWARN broadcasts SMS alerts to all district community health workers </li></ul><ul><li>Community health workers coordinate a response using group SMS </li></ul>OUTBREAK Siam Pang District Northern Cambodia
    45. 47. Steung Treng Province, Cambodia District EWARN Sites, Diagnostics Lab in Provincial Capital <ul><li>EWARN database SYNCHRONIZES via SMS. </li></ul><ul><li>Cell phones to laptops. </li></ul><ul><li>The outbreak, the lab confirmation, and the contact tracking, can all be done over SMS. </li></ul>Steung Treng Province Northern Cambodia
    46. 48. <ul><li>Moderated Lists, News Feeds, Articles, Blogs, Emails, wikis, Videos </li></ul><ul><li>Human health, animal health, plant health, water quality, Internet traffic, utilities, intelligence, etc. </li></ul><ul><li>SMS, SMS Geo-Chat </li></ul>Risk Visualization and Simulation User Alerts Contact Tracing and Network Modeling Time Series Visualization Multiple data streams (structured and unstructured) Data Visualization Alert and Health Events Board Asset Status and Readiness Spatio-Temporal Analysis Remote Sensing Response Signal
    47. 49. Early technical partners in our platform development <ul><li>Research Triangle International </li></ul><ul><li>Harvard MIT – HealthMap </li></ul><ul><li>NASA Goddard Space Flight Center </li></ul><ul><li>IBM: Public Health Information Affinity Domain (PHIAD) </li></ul><ul><li>ProMed Infectious Disease Reports </li></ul><ul><li>, </li></ul>
    48. 50. Obvious risks <ul><li>Ignorance </li></ul><ul><li>Arrogance </li></ul><ul><li>Stupidity </li></ul><ul><li>Seduction </li></ul><ul><li>Distraction </li></ul><ul><li>Complacency </li></ul><ul><li>Passivity </li></ul><ul><li>Misplaced Trust </li></ul><ul><li>Evil, knowing or unknowing </li></ul>
    49. 51. John Francis, PhD UN Goodwill Ambassador on the Environment Planetwalker, and here at Unusual consultant: An Ethics Advisor, helping the focus <ul><li>Minimizing Agendas </li></ul><ul><li>Political </li></ul><ul><li>Personal </li></ul><ul><li>Academic </li></ul><ul><li>Religious </li></ul><ul><li>Corporate </li></ul><ul><li>Social </li></ul>
    50. 52. You must take responsibility for what you know. John F. Kennedy, 1962 Humanitarian Technology Review This doesn’t exist yet. We think it needs to. We’re looking for sponsors.
    51. 53. There is a lot to do. And much at risk.
    52. 54. We’d love to tap the energy! See us at our display in the Simulcast Lounge