Everything came together: Boaz Carmeli, spokesperson for the IBM Haifa Research Lab.Imagine this scenario: an astute doctor identifies a patient with a highly communicable infectious disease. Realizing that the illness could rapidly spread and potentially become a pandemic, the doctor quickly calls the local public health authority, which in turn, reports it to the national authority which, for its part, reports it to the international authorities.

International Health Regulations (IHR) requires all countries to report any infectious disease outbreak of international significance. If a pattern of disease outbreak is identified, an alert is issued.

Given that this is the 21st century, it’s shocking to learn that the entire system is still based on phone calls, faxes and spreadsheets – sometimes even handwritten records – with no interoperability, standards or uniform coding systems. When a disease pattern is identified, unwieldy low technology can delay the alert process by hours and even days.

But that’s all about to change. IBM Research, led by researchers at the IBM Haifa Research Lab and IBM’s Almaden Research Center, announced a new system that will allow public health officials in Israel, Jordan and the Palestinian Authority to share and exchange health data, (while protecting patient privacy) and to monitor and react to potential disease outbreaks across geographic and political boundaries.

Sharing information on global pandemics

“IBM began looking at global pandemic issues after the outbreak of SARs and the avian flu,” explains Boaz Carmeli, spokesperson for the IBM Haifa Research Lab. “The challenges came from two directions: how to collect and share information; and how to use the data for forecasting and planning.”

The result is a technology that standardizes the method of sharing health information and automates the task of analyzing for outbreaks. IBM created the secure, web-based portal system, called Public Health Information Affinity Domain (PHIAD), in collaboration with the global organization Nuclear Threat Initiative’s Global Health and Security Initiative (GHSI) and the regional organization Middle East Consortium on Infectious Disease Surveillance (MECIDS).

MECIDS, whose members include Israel, Jordan and the Palestinian Authority, will be an early adopter of the technology. Currently, MECIDS members exchange information mostly on paper. By moving to a standards-based model of secure electronic information exchange, members will now be able to share and exchange key data to monitor and respond to potential outbreaks.

“PHIAD has already been deployed in Israel and is in place with the Palestinian Authority. Shipping has been ordered for Jordan and it’s ready for them to use,” says Carmeli. Will other neighbors, like Egypt, join in the effort? “Technically, there’s no problem for other countries to be included,” Carmeli says.

Interestingly, PHIAD’s initial deployment in the Middle East is a direct result of IBM having a research lab in Haifa. “There are several initiatives of this kind around the world but MECIDS was the biggest, already in place and the need was clear – plus we are here in the region – so everything came together,” says Carmeli.

A multinational research development

He notes proudly that of IBM’s 3,000-strong research staff, 400 work in Haifa, making it IBM’s largest lab outside the US. “We have a small dedicated research group concentrating on this specific area of cross-boundary sharing of information,” he says, adding that, in fact, IBM’s Health Information Exchange solution started in 2004 as an electronic health records (EHR) project worked on jointly by the Haifa and Almaden labs.

Although part of a multinational development team, it was the experience of working with the neighbors next door that was most powerful for the Haifa team, says Carmeli.

“Going to these places, having face to face meetings, seeing how things come together when you sit in the same room and solve problems, seeing the interactions – that was truly amazing,” he explains. “Plus, it was great to feel that the value we’re bringing isn’t just for the business world but for society at large.” The NGO partners, too, “brought so much additional value to the project. They were really unique in terms of their goals.”

GHSI originally wanted to create a standardized means of dealing with biological threats, but regional political tensions made that goal too difficult, says Carmeli. “Instead, the decision was taken to build a generic infrastructure for PHIAD. We focused on models of common food-borne diseases, such as salmonella, shigella, and helicobacter, which are regional problems. But the underlying communications channels are the same for biological or other threats. We showed them, for instance, how easy it is to add avian flu into the system.”

Carmeli emphasizes that PHIAD “is a very open and generic system because we realized it should serve government and NGOs around the world, as well as the private sector.”

The international standard used was SNOMED CT (Systematized Nomenclature of Medicine-Clinical Terms), which provides a core terminology for electronic health records, and the International Health Terminology Standards Development Organization (IHTSDO) waived the license fees on humanitarian grounds. The partners are now pushing for PHIAD to be deployed in other regions around the world.