A Global Infectious Disease Surveillance and Case-Tracking Model for COVID-19: An Implementation that is Designed on the Block-chain and HL7 FHIR International Patient Summary.
2020
Background The 2019 novel coronavirus (COVID-19) has affected more than 180 countries and territories around the world. On March 11, 2020, the World Health Organization (WHO) characterized the COVID-19 outbreak as a pandemic. This is the first pandemic known to be caused by a new virus. While the complete clinical picture regarding COVID-19 is not yet fully known, based on currently available information, older adults, and people of any age who have a serious underlying medical condition, might be at a higher risk of becoming severely ill with COVID-19. The emergence and rapid spread of COVID-19 is not only becoming a new public health crisis, but it is also wreaking havoc on the global economy and industries. However, investigations into the disease, patient-tracking mechanisms and the transmission of case reports seem to both labor-intensive and slow. Objective The ongoing pandemic is putting healthcare systems under strain worldwide and forcing hospitals and other medical facilities to scramble to make sure that data can be shared effectively. The primary aim of this study is to design a Global Infectious Disease Surveillance and Case-Tracking system that is capable of facilitating the detection and control of COVID-19 transmission. A block-chain-based architecture has been built to protect the security and guarantee the correctness of the International Patient Summary (IPS). The primary aim of this study is to design a Global Infectious Disease Surveillance and Case-Tracking system that is capable of facilitating the detection and control of COVID-19 transmission. We have designed an International Patient Summary (IPS) that is based on the HL7/FHIR standard and have used block-chain architecture to build a platform for protecting the security and guaranteeing the correctness of IPS. Methods An International Patient Summary (IPS), which is an electronic health record that contains essential healthcare information about a patient, is used in this study. IPS is designed to support the used case scenario for 'unplanned, cross-border care'. It is intended to be international, i.e., to provide generic solutions for global application beyond a region or country. The design, global scope, and utility of IPS for unplanned cross-border care, and its potential for re-use, make it suitable for a situation like COVID-19. The Fast Healthcare Interoperability Resources (FHIR) confirmed that IPS, which includes symptoms, therapies, medications, and laboratory data, can be efficiently transferred and exchanged on the system for easy access by physicians. Patient data are de-identified to protect their privacy. All systems are protected by block-chain architecture, including data encryption, validation, and exchange or transfer records. Members of the Center for Disease Control and Prevention (CDC) in various countries will be able to carry out risk control and track high-risk groups by using a tracking module in the system. Results This study designs an International Patient Summary (IPS) that complies with infectious disease surveillance and clinically-meaningful data, according to the IPS HL7-FHIR guidelines. In order to achieve the purpose of global COVID-19 surveillance and to enhance health resilience, a global infectious disease information exchange must be enacted. The COVID-19 surveillance system was built and designed, based on block-chain architecture. IPS is used to exchange case study information among physicians. When physicians pass the system verification, they can upload the case IPS and get the IPS data of other global cases from the system. The system includes a daily IPS uploading and enhancement plan, which covers real-time uploading through the interoperation of the clinic system with the module based on the Open API architecture. An authentic physician can use this system to share and exchange a patient's IPS, in order to provide international references. Through the treatment of different cases, drug treatments, and the exchange of patient treatment results, the disease spread can be controlled and treatment methods can be funded. From the establishment of the infectious disease case-tracking module, and according to the location information of the IPS, we can track the moving paths of infectious disease cases. The location information recorded in the block-chain is for all users to check the location information of different cases. The case-tracking module is established for CDC members to track cases and prevent the spread of a disease. Based on this module, CDC members can identify the moving paths of the cases and design a case-tracking plan. Conclusions This study has created an IPS of infectious diseases for physicians to access when treating COVID-19 patients. We have also established secure block-chain architecture for the protection of IPS and have completed the application of the moving path tracking of patients. The results of this research can help health authorities to respond quickly to the transmission and spread of any unknown disease and provide a good system for information retrieval on disease transmission. Another benefit of this system is that it can help public health researchers to form a study trial and analyze data from different countries. One of the effective means of fighting an unknown virus could be by means of a common forum to facilitate the mutual sharing of experiences, best practices, therapies for patients, possible useful medications and outcomes from clinical interventions being trailed in various countries in a secure, trustworthy manner. The system that is suggested by our study can become an effective tool for facilitating global collaboration, cooperation and collective evidence-based efforts to address the unprecedented situation created by COVID-19.
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