A Picture Worth About 16,000 Intense Flu Cases

First in a three-part series on the SureScripts Technology Challenge-winning team from Arcadia.

The flu outbreak of November 2013 struck like a meteor, knocking out dozens, then hundreds of individuals along the East Coast of the United States. Initial cases spread like wildfire out of Boston, Florida, the Carolinas, rippling up and down the Northeast in a matter of days. The symptoms were intense, far stronger than the typical achy chest and head; painful breathing, even respiratory distress, and very high temperatures plagued the sufferers of this influenza outbreak. And those sufferers weren’t drawn from the ‘usual suspects’, the very young, the very old, the immune-compromised. No, this was a wide cross-section of humanity, healthy individuals contracting serious cases of the flu. Serious enough to require antiviral medication.

You don’t remember that outbreak? It’s still happening, you know… in simulation. This outbreak came, not from the brew of influenza virii that emerge every year to plague humanity, but instead from the 2013 SureScripts Technology Challenge. The widespread November epidemic – and the pinpoint impacts of the December 2013 outbreaks that followed – came to life in simulation on the award-winning FluFender application, developed by a team from Arcadia Healthcare Solutions (with A/V expertise on loan from Honorary Arcadian Ned Brown).

FluFender Example Screen (Florida, mid November)

FluFender – A prototype epidemic tracker and analysis tool from Arcadia Solutions

The FluFender Team, led by Arcadian Kathleen Palinski, developed the FluFender application for the SureScripts Technology Challenge, which had the novel aim of tracking and predicting the flu using prescription data on influenza antivirals like Tamiflu and Relenza rather than tracking specific clinical reports (which typically lag the outbreak by weeks) or reports of symptoms at doctors offices or on social media (which are rapid but imprecise). FluFender was designed to meet three requirements. First, it should provide useful visual information about the flu outbreak for the public; second, it should provide useful analytic information about the infected population for public health purposes; and, third, it should provide some basic forecasting functionality to assist those who ensure that drugs combating the worst effects of the flu are ready and positioned where they’ll be needed. The latter two will be discussed in upcoming posts, but the first point deserves some attention right off the top.

FluFender visualizations over multiple locations and over time

FluFender screens used to visualize multiple clusters of activity over time. (Circles added for emphasis.)

As discussed in my previous post, visualization tells a story in a way that often cannot be achieved with numbers alone. A table of dates, locations, and rug names describing the movement of an influenza outbreak can be reshaped and mined to provide as much useful information as possible, but there is only so much that can be done. In contrast, FluFender’s UI is designed to highlight the most important elements to the user – Is there a flu outbreak near me? Is it likely to spread? What are the vaccination rates in my community? How is that likely to affect the impact? Visual cues of this information help address the truly important question: What should I do?

This sort of UI design, while exciting and novel for Arcadia due to its specificity to an epidemic, is not new to Arcadia in terms of our use of visuals. So common as to be cliche, the “dashboard” view still provides a profoundly powerful mechanism to gain insight into organizational structure, activity, and processes. When you see that the cost of care has gone up in a specific department, you want to answer some of those basic “journalistic W’s” right away. What costs are increasing, specifically? Whose (which patients) costs increased? When did this start? Where (or for which providers) is this happening? And Why? Visualizations highlight the answers most clearly, allowing one to see what the change is, compare populations and providers to identify where the increases are focused, and examine temporal trends to begin to narrow down on when things changed. Putting all this together, our clients can then use their own expertise and experience to focus in on the Why? and address the matters at hand.

Additional examples of Arcadia visualizationsDashboards and summary visualizations make all the difference in understanding changes and identifying actions needed.

We had first-hand experience of this at the SureScripts Technology Challenge Finals. We had never used FluFender in a full-blown field test, and wondered whether the components would work. Not only did FluFender work; it was essential to telling the story of the Great Flu Epidemic of November-December 2013. We had a moment of profound gratitude for our UI designers for giving us a tool that not only showed off the epidemic with pretty heat maps and graphs, but also provided actionable information to craft the narrative.

In this case, FluFender was worth more than thousand words. It was worth over 16,000 severe cases of the flu… and a path toward readiness for the future.

December 2, 2013