Web-Based Apps for Responding to Acute Infectious Disease Outbreaks in the Community: Systematic Review.

BACKGROUND: Web-based technology has dramatically improved our ability to detect communicable disease outbreaks, with the potential to reduce morbidity and mortality because of swift public health action. Apps accessible through the internet and on mobile devices create an opportunity to enhance our traditional indicator-based surveillance systems, which have high specificity but issues with timeliness. OBJECTIVE: The aim of this study is to describe the literature on web-based apps for indicator-based surveillance and response to acute communicable disease outbreaks in the community with regard to their design, implementation, and evaluation. METHODS: We conducted a systematic search of the published literature across four databases (MEDLINE via OVID, Web of Science Core Collection, ProQuest Science, and Google Scholar) for peer-reviewed journal papers from January 1998 to October 2019 using a keyword search. Papers with the full text available were extracted for review, and exclusion criteria were applied to identify eligible papers. RESULTS: Of the 6649 retrieved papers, 23 remained, describing 15 web-based apps. Apps were primarily designed to improve the early detection of disease outbreaks, targeted government settings, and comprised either complex algorithmic or statistical outbreak detection mechanisms or both. We identified a need for these apps to have more features to support secure information exchange and outbreak response actions, with a focus on outbreak verification processes and staff and resources to support app operations. Evaluation studies (6 out of 15 apps) were mostly cross-sectional, with some evidence of reduction in time to notification of outbreak; however, studies lacked user-based needs assessments and evaluation of implementation. CONCLUSIONS: Public health officials designing new or improving existing disease outbreak web-based apps should ensure that outbreak detection is automatic and signals are verified by users, the app is easy to use, and staff and resources are available to support the operations of the app and conduct rigorous and holistic evaluations.

Patient Privacy and Integrated Care: The Multidisciplinary Health Care Team.

This article explores legislative provisions in relation to patient privacy in the context of integrated health and social care and the development of multidisciplinary health care teams that include practitioners from private sector and government agencies in the health, education, child protection, family welfare, disability, aged-care, housing, local government and criminal justice sectors. The definition of a multidisciplinary health care team and the extent to which health information can be shared within the team is examined. Australian Commonwealth and State legislation provides for the sharing within a health care team of health information where that is for the primary purpose it was collected, and for a secondary purpose where that is directly related to the primary purpose, or might be reasonably expected by the patient for the provision of their care. For this purpose consent is not required.