Accelerating National Responses to COVID-19 with Big Data and Advanced Analytics

1. Background

Zenysis is a Silicon Valley big data and artificial intelligence company with active projects in more than 10 countries. These countries rely on Zenysis software to improve their delivery of healthcare and to coordinate their response to public health emergencies.

Zenysis is already working with governments in Africa and Asia to actively support their national efforts to contain COVID-19. Zenysis also has strategic partnerships with the Global Fund, the GAVI Alliance and major financial institutions in private capital markets.

This document is a summary of the critical information management infrastructure and capacity that Zenysis can rapidly deploy to affected countries to help national actors contain the COVID-19 outbreak as quickly and effectively as possible. Zenysis will also provide vital project management support, user support and hosting for the duration of the COVID-19 response.

2. Zenysis COVID-19 capabilities

Zenysis can move quickly to help countries contain the transmission of COVID-19 and manage health system capacity by rapidly deploying the following suite of powerful information management capabilities. These capabilities can be deployed individually, as an integrated end-to-end package, or in any combination required based on country needs.

Virtual Control Room for COVID-19

Zenysis software can be used to integrate structured data from every available and relevant source, both within and beyond the health sector, into a single unified workspace for decision makers.

These workspaces, or “Virtual Control Rooms”, can help significantly enhance situational awareness and disease surveillance and provide decision makers the actionable analytics they need to coordinate containment efforts in a data-driven way. In most circumstances, we can establish these Virtual Control Rooms within a day.

Within the virtual Control Room, decision-makers have access to near real-time, high-resolution analytics that help them take and coordinate effective action. These analytics are available through easy-to-use visualizations and dashboards that can also be shared to keep the public and partner organizations informed of developments.

Virtual Control Rooms integrate and visualize any structured data source including:

• routine public health data (e.g. DHIS2 data);
• sentinel surveillance data;
• EMR and patient-level data;
• logistics and supply chain data;
• ride-hailing data;
• cellular network data;
• human resources data;
• environmental data;
• labor and employment data;
• airline manifest data;
• customs and immigration data;
• and more.

Automated Alerting

The Zenysis software includes customizable alerts that expedite crucial outbreak workflows. These alerts are commonly used to manage stockouts and prompt health professionals when an infected patient seeks medical care at a health facility.

To manage stockouts, alerts are created to flag when health facilities start reporting low stock. Using the Zenysis platform, emergency managers can view inventory levels, traditionally managed in separate health facility equipment databases, and make quick decisions to move lifesaving health commodities and medical equipment from low burden to high burden facilities and geographies.

Automated alerts on the inventory levels of the following commodities and equipment could help to reduce the incidence of stockouts and strengthen the cascade of care for confirmed cases:

• Diagnostic tests;
• Personal protective equipment (PPE) such as masks, googles, gloves;
• Ventilators;
• Sanitization equipment and more.

Zenysis was recently asked by a partner in East Africa to create alerts around malaria stockout data. They then used this feature to ensure that analysts could follow up on each stockout alert and monitor numbers of stockouts per facility. This management tool enabled central level health authorities to find gaps in their logistics model that directly affect treatment of malaria.

Cohort Tracking

The Zenysis cohort tool enables public health professionals to conduct both cohort and cascade analyses on groups of patients by various dimensions over time. These types of analyses are key to understanding the key risk factors for transmission and the medical outcomes of subsets of the affected population.

Sub-populations in the COVID-19 cascade of care can be constructed using any combination of the following attributes:

• Gender
• Comorbidities:
• HIV
• TB
• Malaria
• Vaccine preventable illnesses
• NCDs such as diabetes, heart disease etc
• Key and Vulnerable Population Disaggregations
• Age
• Pregnancy status
• IDUs, Sex Worker, MSM etc
• Quarantine location
• Travel history
• Medical history including including COVID-19 treatment history

These customized cohorts can then be monitored and compared to other sub-populations to gain insights into transmission, infection control, treatment outcomes etc.

Currently the cohort tool is being used in South Africa to: (i) monitor retention in HIV prevention programs; (ii) monitor adherence to HIV prevention and treatment cascades; and (iii) analyze outcomes for at-risk cohorts across different grant periods.

Geospatial Layering

The Zenysis platform powers a flexible geospatial tool which enables users to visualize their geospatial data using map layers that can be combined to enrich their understanding of the outbreak and the response.

This functionality can be used to:

• Monitor outbreak hotspots: with high-resolution data, users can map the location of new outbreaks as a first step to understanding where authorities need to prevent further community transmission;
• Map gaps in availability of key services: using maps, stakeholders can quickly detect geographical areas where high disease burden has unmet needs for equipment like diagnostic kits;
• Plan the location of new services: based on disease burden, population data, and presence of other services, stakeholders can make better decisions about where to locate drive-through testing services and where there may be a need to convert private facilities into public facilities etc.

Facility Readiness Scores

As many governments prepare for a significant increase in severe COVID-19 cases, it is essential that decision makers understand which health facilities are adequately prepared to respond to the expected surge in demand for healthcare and which are not.

Zenysis is able to rapidly integrate and harmonize different versions of master facility registries (MFRs) to create a single source of truth for decision makers. This involves harmonizing and integrating data coming from previously mismatched sources such as surveys, assessments and routine data collection tools.

These tools include health facility readiness data from a variety of routine sources such as stockout information, facility based surveys, Service Availability and Readiness Assessment (SARA) surveys, the Service Provision Assessment (SPA) tool and the Demographic and Health Survey (DHS).

Using this data Zenysis can calculate composite “COVID-19 readiness” scores that reflect the relative preparedness of a given facility and visualize these on private and/or public dashboards.

Contact Tracing

Zenysis can help countries rapidly enhance their capacity to effectively trace the contacts of people who test positive for COVID-19 and minimize the number of new infections. Countries can use our advanced data integration and visualization software to integrate and analyze a diverse range of data sources. For example, countries can use Zenysis to:

• integrate patient-level testing data with immigration and customs data to identify contacts who travelled on planes or who transited through immigration arrival halls with people who have positive for COVID-19; and
• integrate patient-level testing data with ride-hailing app data to identify which drivers transported riders who tested positive for COVID-19.

Examples of other data sources Zenysis can integrate to enable effective contact tracing include: SMS cellular and geolocational data, airline manifests, EMR systems and hospital data, DHIS2 case trackers, patient data captured via mobile collection apps and other contact tracing services (e.g., CommCare, Medic Mobile, ODK, etc.), credit card transaction data, as well as other more rudimentary data sources such as patient records maintained in Excel files by health clinics, NGOs, and other partners.

Most countries that already have contact tracing tools can also benefit from these capabilities. In these circumstances, Zenysis can help integrate data sources like flight manifests into third-party contact tracing applications to avoid the need for slow, error prone and non-scalable data entry.

Case Management

Users can explore their integrated data via the Zenysis Case Management Tool (right). For each patient or individual record, platform users can:

• visualize whom they were in contact with (derived from integrated sources);
• centralize information on each case (e.g. confirmed/ suspected/exposed); and
• track each person’s journey through the cascade of diagnosis, isolation and/or care and treatment to monitor compliance and the need for follow up.

By integrating facility-level data (e.g. surveys, supply chain data) decision-makers will also be able to use the case management tool to understand the full picture of capacity at the facility level. This includes information such as the number of active cases at a facility, available medical stock and equipment, and current health workforce numbers and distribution by cadre.

If you are aware of a government agency that needs support in any of these areas, or you are interested in working together to respond to COVID-19, we would like to hear from you.

Please contact us by writing to covid19response@zenysis.com