Development of ClickClinica: a novel smartphone application to generate real-time global disease surveillance and clinical practice data

Abstract

BackgroundIdentification and tracking of important communicable diseases is pivotal to our understanding of the geographical distribution of disease, the emergence and spread of novel and resistant infections, and are of particular importance for public health policy planning. Moreover, understanding of current clinical practice norms is essential to audit clinical care, identify areas of concern, and develop interventions to improve care quality.However, there are several barriers to obtaining these research data. For example current disease surveillance mechanisms make it difficult for the busy doctor to know which diseases to notify, to whom and how, and are also time consuming. Consequently, many cases go un-notified. In addition assessments of current clinical practice are typically limited to small retrospective audits in individual hospitals.Therefore, we developed a free smartphone application to try to increase the identification of major infectious diseases and other acute medical presentations and improve our understanding of clinical practice.DescriptionWithin the first month there were over 1000 downloads and over 600 specific disease notifications, coming from a broad range of specialities, grades and from all across the globe, including some resource poor settings.Notifications have already provided important information, such as new cases of TB meningitis, resistant HIV and rabies, and important clinical information, such as where patient with myocardial infarctions are and are not receiving potentially life-saving therapy.The database generated can also answer new, dynamic and targeted questions. When a new guideline is released, for example for a new pandemic infection, we can track, in real-time, the global usage of the guideline and whether the recommendations are being followed. In addition this allows identification of where cases with key markers of severe disease are occurring. This is a potential resource for guideline-producing bodies, clinical governance and public health institutions and also for patient recruitment into ongoing studies.ConclusionsFurther parallel studies are needed to assess the clinical and epidemiological utility of novel disease surveillance applications, such as this, with direct comparisons made to data collected through routine surveillance routes.Nevertheless, current disease surveillance mechanisms do not always comprehensively and accurately reflect disease distribution for many conditions. Smartphone applications, such as ClickClinica, are a novel approach with the potential to generate real-time disease surveillance data that may augment current methods.

Technology for trauma: testing the validity of a smartphone app for pre-hospital clinicians

“…There are additional possibilities to enhance further versions of the Major Trauma Triage Tool app, such as data collection. This has been utilised successfully by other apps, in order to build a database that can provide information to assist in understanding epidemiology of disease (Michael and Geleta, 2013). There are potential applications in injury prevention and pre-hospital resourcing that could benefit from accurate information on location and severity of trauma incidents such as road traffic collisions and assaults.…”

The evaluation of a tailored intervention to improve the management of suspected viral encephalitis: protocol for a cluster randomised controlled trial

“…This online tool can be accessed at any time and all participants can download a certificate of completion An online multiple choice educational survey was developed. A certificate of completion was awarded with additional checklists and action planning tools Site PIs were able to circulate this online link to all junior doctors The trainee would only complete the survey once with a certificate of completion This could take place during a teaching session or during private study Two surveys were available with questions tailored for doctors and nursing staff ClickClinica [ 27 ] (optional component) An app containing all current guidelines was developed. This has been promoted within our package both within the education and also within the personalised invitation letter as a useful tool An app has been developed for use with iPhones whereby all guidelines are available in one place This app was promoted through local clinical leaders The link to download the app was within the educational sessions and contained within the direct mail letter Guidelines can be checked and downloaded on the ward or within private study None available for this component Encephalitis Society leaflets and video (optional component) The Encephalitis Society YouTube channel was included as a resource which could be incorporated into the education.…”

Lesionia: a digital data management system for epidemiological and clinical data collected from patients suspected for cutaneous leishmaniasis

“…Introducing DSDM was assessed on different types of studies ranging from geo-spatial mapping of dengue fever spread in Sri-Lanka (Lwin et al, 2019) to disease outbreaks surveillance in Germany (Krause et al, 2007). The positive impact of such systems on the management of chronic diseases was also assessed (Roshanov et al, 2011;Michael et al, 2013). For the specific context of epidemiological studies of parasitic diseases, Gray et al (2009) presented a DSDM designed to process data collected during field-based surveillance of the transmission of bovine Schistosoma japonicum in China (Gray et al, 2009).…”