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ISDS 2012 Conference Abstracts

Biosurveillance Ecosystem (BSVE) Workflow Analysis
Timothy Dasey*1, Hayley Davison Reynolds1, Nancy Nurthen2, Christopher Kiley2 and John
Silva3

1Chemical and Biological Defense Systems, MIT Lincoln Laboratory, Lexington, MA, USA; 2DTRA Chemical & Biological
Technologies Directorate, Ft. Belvoir, VA, USA; 3Silva Consulting Services, LLC, Sykesville, MD, USA

Introduction
The Defense Threat Reduction Agency Chemical and Biological

Technologies Directorate (DTRA CB) has initiated the Biosurveil-
lance Ecosystem (BSVE) research and development program. Oper-
ational biosurveillance capability gaps were analyzed and the
required characteristics of new technology were outlined, the results
of which will be described in this contribution.

Methods
Work process flow diagrams, with associated explanations and his-

torical examples, were developed based on in-person, structured in-
terviews with public health and preventative medicine analysts from
a variety of Department of Defense (DoD) organizations, and with
one organization in the Department of Health and Human Services
(DHHS) and with a major U.S. city health department. The particu-
lar nuanced job characteristics of each organization were documented
and subsequently validated with the individual analysts. Addition-
ally, the commonalities across different organizations were described
in meta-workflow diagrams and descriptions.

Results
Two meta-workflows were evident from the analysis. In the first

type, epidemiologists identify and characterize health-impacting
events, determine their cause, and determine community-level re-
sponses to the event. Analysts of this type monitor information (pri-
marily statistical case information) from syndromic or disease
reporting system or other sources to determine whether there are any
unusual diseases or clusters of disease outbreaks in the jurisdiction.
This workflow involved three consecutive processes: triage, analysis
and reporting. Investigation and response processes to disease out-
breaks are both parallel and overlapping in many circumstances. In
the second meta-workflow type, analysts monitor for a potential
health event through text-based sources and data reports within their
particular area of responsibility. This surveillance activity is often in-
terspersed with other activities required of their job. They may gen-
erate a daily/weekly/monthly report or only report when an event is
detected that requires notification/response. There are similar triage,
analysis and reporting workflow stages to the first meta-workflow
type, but in contrast these analysts are focused on informing leader-
ship and response in the form of policy modification. They are also
subject to answering leadership-driven biosurveillance queries.

Conclusions
In these interviews, analysts described the shortcomings of various

technologies that they use, or technology features that they wish were
available. These can be grouped into the following feature categories:

Data: Analysts want rapid access to all relevant data sources, ad-
visories for data that may be relevant to their interests, and availabil-
ity of information at the appropriate level for their analysis (e.g.,
output of interpretations from expert analysts instead of raw data).

Enhanced search: Analysts would like customization of informa-
tion based on relevance, selective filtering of sources, prioritization
of search topics, and the ability to view other analysts searches.

Verification: Analysts want indications of information that has
been verified or discarded by other analysts, a trail of information
history and uses, and automatic verification (e.g., data quality editing)
if possible. 

Analytics: Analysts want access to forecasting models, services to
suggest analysis methods, pointers to other analysts’ expertise, meth-
ods, and reports, and tools for “big data” exploitation.

Collaboration and communication: Analysts want assistance iden-
tifying people who may have needed information, real-time chat, the
ability to compare analyses with colleagues, and the ability to shield
data, results, or collaborations from selected others.

Archival: Analysts want automation to provide lessons learned,
methods and outcomes for related events, the ability to automatically
improve baselines with analyzed data, and assistance with reporting
on interim analytic decisions.

The current understanding of the biosurveillance analyst’s func-
tions and processes, based on the results of these interviews, will con-
tinue to evolve as further dialog with analysts are combined with
results of evaluations during subsequent phases of the new BSVE
program.

Keywords
biosurveillance; workflow; collaboration; operations

Acknowledgments

This work is sponsored by the Defense Threat Reduction Agency under
Air Force Contract #FA8721-05-C-0002. Opinions, interpretations, rec-
ommendations and conclusions are those of the authors and are not nec-
essarily endorsed by the United States Government.

*Timothy Dasey
E-mail: TimD@LL.mit.edu

Online Journal of Public Health Informatics * ISSN 1947-2579 * http://ojphi.org * 5(1):e86, 2013