Twitter App Tracks Illness Outbreaks

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A new tool for tracking and analyzing health-related comments on Twitter may help public health departments identify emerging health issues and public health emergencies earlier than traditional surveillance methods do. The U.S. Department of Health and Human Services' Office of the Assistant Secretary for Preparedness and Response (ASPR) will make the Web-based application, called MappyHealth, available to state and local public health agencies within the next few weeks.

The application's developers--nursing informatics specialists Brian Norris and Charles Boicey and management information systems specialist Mark Silverberg--won the first prize of $21,000 in a contest sponsored by ASPR. Thirty-three developers entered the competition.

ASPR launched the contest after public health officials told the agency during a forum last fall that they needed a Web-based tool to monitor social media. According to ASPR, studies of the 2009 H1N1 flu pandemic and the Haiti cholera outbreak had demonstrated that social media trends could detect disease outbreaks earlier than conventional surveillance methods.

"What they found is that people start talking about these illnesses on social media in some cases up to two weeks before it starts showing up in traditional media," such as hospital reports and other public health surveillance tools, said Diana Kushner, ASPR's program lead, in an interview with InformationWeek Healthcare.

ASPR chose Twitter rather than Facebook for the public health application, she said, mainly because far fewer people use privacy settings on Twitter than on Facebook to restrict access to their posts. In addition, Twitter "puts out a public feed that anyone can access and download [to read tweets] for anyone who has not placed a privacy setting on their account."

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MappyHealth won the contest for three reasons, Kushner said. First, she noted, "they had really good filtering." Health discussions on social media contain a great deal of "noise" unrelated to participants' illnesses, she pointed out, but MappyHealth uses algorithms to spot terms related to current health conditions.

Second, she said, "They did a good job with geo-location [of tweets]. If a state or local health department uses this tool, they're going to be more interested in their own population than in the entire U.S." MappyHealth can filter tweets according to whether they originated in a particular county or state.

Third, MappyHealth displayed the information "in a very intuitive manner and multiple ways," including various graphical and text formats, she noted.

To date, MappyHealth has analyzed 71.6 million tweets around the world. Far and away the top condition that people tweet about everywhere is the common cold. Other top health conditions mentioned on Twitter this month include mosquito-borne diseases, sexually transmitted diseases, pertussis (whooping cough), tuberculosis, and influenza.

Some conditions that have turned up on MappyHealth's Twitter radar, such as Legionnaire's disease, are not the kind that people would know they had unless they had seen a doctor. But studies have shown that symptoms mentioned on social media can be used to determine what kind of illness people have, Kushner noted.

The principals of MappyHealth have formed a company called Social Health Insights, Kushner said. One of the new firm's first projects is an effort to use data analytics to create maps showing where in the U.S. various diseases are being tweeted about. The first such maps focus on West Nile virus.

Kushner is not sure how public health departments will use such maps or other MappyHealth tools. The feedback she and her colleagues have received from public health officials is that some want to use the application for epidemiological purposes and others would like to use it to increase public awareness and education about health issues. "So it's going to be used in a wide array of different ways in health departments," she said.

Still, she emphasized, the most important purpose of MappyHealth is to detect disease outbreaks early on so that public health departments can inform consumers and healthcare providers about them.

ASPR previously sponsored a contest for a Facebook application to help consumers share health information and get support from online friends during natural disasters and other public health emergencies. The winner of that competition, a widget called bReddi, has been available on Facebook since June 1.

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