Digital solutions for frontline impact
During the past year, state and local public health agencies were on the front lines of the response to a once-in-a-century Global Pandemic. Responsible for the health of their constituencies, these agencies needed a way to rapidly respond to the COVID-19 outbreak, stay in touch with COVID-19 positive cases, and direct exposed contacts to get tested and to quarantine to minimize future spread. Given the unprecedented nature of the disease, no off the shelf tools existed to support this complex workflow at such a massive scale. For nearly 20 years, Dimagi has been on the cutting edge of technology for public health emergencies and infectious disease response around the world, including work on Ebola response [https://www.dimagi.com/sectors/ebola-response/] in West Africa. In March of 2020, contacts at the Centers for Disease Control reached out to us requesting urgent support on COVID-19 response. They were seeking a software provider who could rapidly develop a case investigation and contact tracing system for Santa Clara County, CA. After launching a pilot system in 10 days on our open-source platform CommCare, neighboring San Francisco county asked us to develop their own system. The rapid launch of a system in San Francisco prompted interest from other regional governments in the US, including the States of Alaska, New York, New Jersey, and Colorado, as well as the Navajo Nation. Dimagi was able to localize and launch the solution with four US States and two local governments in a matter of months. [https://dimagi.com/covid-19/us-response].
Dimagi is the social enterprise behind CommCare, the world’s most widely-used open source data collection and service delivery platform relied upon by governments and NGOs in over 130 countries. The CommCare Outbreak Response System provides governments and public health agencies a comprehensive solution for every phase of an effective outbreak response. Built from CDC protocols to support frontline worker patient screening, case investigation and contact tracing, it has the following components: Case investigation: Track a suspected case through a full continuum of care including screening, testing, quarantine and follow up. Users begin by screening suspects and assessing risk of infection. Once lab results are available, the system kicks off automatic triaging and communication protocols, helping public health officials isolate cases and identifying those that need additional support or services. Individuals with confirmed cases receive information and instructions to prevent transmission. Contact tracing: Once lab-confirmed cases are identified, the system prompts users to collect information about these cases’ contacts. Registered contacts receive daily SMS text messages checking in on their symptoms throughout a 14-day monitoring period. They can self-report symptoms via text, immediately alerting public health officials that follow up or testing may be required. Data Analytics and Reporting: Data entered into the system is accessible for export and analysis. Access data and pre-built reports, easily see trends in case counts and spread, and track key metrics. Data can be aggregated across local health jurisdictions, analyzed in a BI tool, or viewed in custom reports at the client or population level.
The CommCare Outbreak Response System stands out in several ways: Demonstrated scale: Since March 2020, the system has been scaled across the United States in some of the earliest and largest COVID-19 contact tracing and case investigation government initiatives, tracking over 10 million COVID-19 cases and contacts in the past year. Rapid localization and deployment: CommCare’s no-code, modular platform allows states to quickly adapt the system to local contexts and scale up in a matter of weeks, not months. Equitable, inclusive workflows including SMS: The system’s success supporting COVID response has come in large part from Dimagi’s experience building technology that is effective at reaching the underserved and vulnerable communities that are critical to successful public health interventions. For example, scripting and digital workflows standardize care across population types and two way SMS makes it easy to be in touch even if you can't leave your job to make it to an appointment. Cost effective: The system is more affordable than enterprise offerings from large technology companies. In procuring their contact tracing technology, the State of Colorado underwent a comprehensive vendor selection process that involved piloting all systems. They chose CommCare over several big tech vendors, in part because they calculated it would save Colorado a minimum of $15 million over three years. [https://beeckcenter.georgetown.edu/wp-content/uploads/2021/02/CO-OIT-Case-Study.pdf] Open platform: CommCare is open source, has turnkey integrations with 3rd party SMS and BI platforms, and has open APIs for fast integration with external systems - including lab systems, electronic disease registries and health information systems.
Our ongoing contracts with state and local governments across the US are testament to the value provided. Here are quotes from a few of our partners: New Jersey Department of Public Health: “We selected Dimagi’s CommCare application for a variety of reasons, ranging from its configurability to it’s ease of scale and maintenance…It is not an overstatement to say that had we gone with another vendor we would not have succeeded in this effort.” New York State Department of Public Health: “The powerful combination of Dimagi’s public health expertise, coupled with cloud-based technology, has allowed us to regularly improve our contact tracing application” Philadelphia Department of Public Health: “In the midst of an unprecedented disease outbreak, experience matters…[we] benefited from the expertise Dimagi gained from developing COVID-19 data systems for public health agencies.” Additionally, a report by Johns Hopkins University named the CommCare Outbreak Response System as one of the two most useful platforms for COVID-19 response. [https://www.jhsph.edu/departments/international-health/news/johns-hopkins-researchers-publish-assessment-of-digital-solutions-for-covid-19-response-in-low-and-middle-income-countries.html] An article in TechCrunch advocates for CommCare over custom software: “There are already specialized, fit-for-purpose toolsets available for infectious disease outbreaks. CommCare by Dimagi, for example, is an open-source Android platform that has COVID-19-specific contact tracing applications and other toolsets ready to deploy. All parties seeking to obtain or deliver technology solutions should consult experts and seek off-the-shelf solutions BEFORE anyone writes a single line of code.” Source: [https://techcrunch.com/2020/03/24/coordinated-response-required-to-optimize-telehealth-during-covid-19-pandemic/ Lastly, a case study of our work in San Francisco speaks to the speed and value provided: https://drive.google.com/file/d/1Idm3FPO1rp1PK_1Av-rd2SQ9L4mR7xYa/view
Efficient, easy-to-use contact tracing can save lives. The CommCare Outbreak Response System provides state and local public health agencies the most cost-effective, user-friendly, and scalable solution for outbreak containment and response. To date, it has handled over 10 million COVID-19 cases and contacts, and is poised to support future outbreaks.