Surveillance and Outbreak Response Management System (SORMAS) to support the control of the Ebola virus disease outbreak in West Africa

Abstract

In the context of controlling the current outbreak of Ebola virus disease (EVD), the World Health Organization claimed that 'critical determinant of epidemic size appears to be the speed of implementation of rigorous control measures', i.e. immediate followup of contact persons during 21 days after exposure, isolation and treatment of cases, decontamination, and safe burials. We developed the Surveillance and Outbreak Response Management System (SORMAS) to improve efficiency and timeliness of these measures. We used the Design Thinking methodology to systematically analyse experiences from field workers and the Ebola Emergency Operations Centre (EOC) after successful control of the EVD outbreak in Nigeria. We developed a process model with seven personas representing the procedures of EVD outbreak control. The SORMAS system architecture combines latest In-Memory Database (IMDB) technology via SAP HANA (in-memory, relational database management system), enabling interactive data analyses, and established SAP cloud tools, such as SAP Afaria (a mobile device management software). The user interface consists of specific front-ends for smartphones and tablet devices, which are independent from physical configurations. SORMAS allows real-time, bidirectional information exchange between field workers and the EOC, ensures supervision of contact follow-up, automated status reports, and GPS tracking. SORMAS may become a platform for outbreak management and improved routine surveillance of any infectious disease. Furthermore, the SORMAS process model may serve as framework for EVD outbreak modelling.

Ebola Outbreak Containment: Real-Time Task and Resource Coordination With SORMAS

“…We limit the number of process models shown here to the overall process and the contact tracing; all other process models are accessible via the project website (Helmholtz Centre for Infection Research, 2016). While the detailed persona descriptions and requirements related to SORMAS have been published in previous work, we limit explanations to a minimum here to provide a rough understanding of an outbreak control process for the reader (Fähnrich et al, 2015). The overall process model in Figure 1 depicts pools for the different management teams, each working in their corresponding responsibility areas:…”

“…In the first version of the architecture, we planned on using matured software for a remote device management, e.g., for automated software updates and locking of lost devices (Fähnrich et al, 2015). It turned out, however, that the software came along with an overhead of functionality that made it rather complex for us to maintain.…”

“…While a first version of the architecture showed dedicated desktop and mobile applications for each persona, the final prototype splits up into a desktop application and two mobile applications (Fähnrich et al, 2015). The former is meant for Surveillance, Case, and Contact Supervisors, while the latter are dedicated to Informants, Surveillance Officers, and Contact Officers.…”

“…As a first step, we defined personas and an interaction model to get a rough understanding of the system and the required components, e.g., mobile and desktop applications (Fähnrich et al, 2015). As a second step, we derived detailed process models that map the procedures of Nigerian Ebola outbreak control.…”

“…While the overall system idea, personas, and requirements have been presented prior, we here concentrate on the technical realization of the system (Fähnrich et al, 2015). This includes (a) the presentation of the final process models that served as blueprint for the system, (b) the underlying data model for storing and accessing surveillance data, (c) the final system architecture, and (d) the implementation details of the central part of the system: the contact tracing app.…”