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2011-06-09

Are we selling soda?

Our team is having an interesting discussion about how we provide value to our customers. Views are all over the place and sometimes conflict with each other. As Elwood P. Dowd once remarked, "Well, an element of conflict in any discussion's a very good thing. It means everybody is taking part and nobody left out." Believe me, no one is left out.

When complete and operational, our system will support biosurveillance as defined by the federal government in Homeland Security Presidential Directive 21, as "the process of active data-gathering with appropriate analysis and interpretation of biosphere data that might relate to disease activity and threats to human or animal health – whether infectious, toxic, metabolic, or otherwise, and regardless of intentional or natural origin – in order to achieve early warning of health threats, early detection of health events, and overall situational awareness of disease activity." Okaaay, how do we do that? How do we deliver it? How do people engage with those analyses and interpretations?

One metaphor that may be helpful is making and selling soda. It's a liquid that comes in bottles made of glass, bottles made of plastic, and aluminum cans--at least when you think of the finished product. It also comes in containers of syrup used by soda fountains to blend their own soft drink by adding carbonated water at the moment of mixing. That lowers the cost of transportation and delivery radically, provides a fresh product, and avoids all the disposal issues of the cans or bottles. (I began my professional career as a busboy in a restaurant where I picked up such arcane knowledge.) But putting the soda in a glass can only be part of the path to the customer. Depending on the place, the soda can be added to ice cream for a fun, if fattening, experience. It can also have rum as its other active ingredient--equally fun although more immediately risky. Some people have even used it in cooking to sweeten dishes or add flavors they hope will delight the palate. So, the ubiquitous soda may be delivered in a wide variety of ways, mixed in with other things, and enjoyed by a person throughout a lifetime as their tastes evolve.

Our commodity is information derived from many sources across the biosphere. We divide it into the following data domains:

These are meant to represent the variety of sources of data we use. These can all tell us about the potential for threats to our health. The physical domain is the most basic since it involves data about such things as the weather, air quality, and water safety. The biological domain means all living things that are not human beings or non-human animals--such as bacteria and viruses that may infect us and make us sick. It also includes all foods that are plants or derived from plants. The clinical (non-human) domain includes veterinary data on companion animals who live with us, other animals for food production, or wildlife. The clinical (human) data is what most of us think of when we mention data relating to human health, but often is not seen in this type of spectrum. The organizational data domain brings in government agencies, businesses, and other groups that may have data of interest. These can touch the other domains--none of them are meant to be exclusive--and may include data coming from economic activity such as purchasing prescription drugs or over-the-counter medications. Finally, everyone's current favorite, social media. These sources include household names like Facebook and Twitter, but also other esoteric sources as MPHISE.

This construct is only meant to suggest the variety of data that are useful for biosurveillance. Our approach is to be inclusive in the variety of data we use, but recognize that not all data is of equal utility. Therefore, our approach is to evaluate a data source on what it can tell us about emergent health threats. Some of these are only background to other data the help us develop our information. Some are significant on their own in their ability to inform us of these threats.

The data are only the raw materials, however. We use them with a set of analytics tools to derive information from the data. That information, itself, is still only a part of the full value we can provide. Information needs a context for interpretation and meaning. Taken all together we can decide what is going on and act--or not--as the situation requires.

I think that we can look at soda as a metaphorical product. Like our information, it's delivered in a variety of ways, sometimes served by itself, sometimes mixed in with other things. It can stand on its own in its own container or be put into another person's container that suits their purposes. Getting the formula right is a necessary prerequisite for satisfaction but may not stop there. We should also enable people's use of our "soda" in their own containers and concoctions. Therefore, we need to develop our product so it can be used by everyone in every way possible. Easily said, not so easily done. More later.

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