The CDC recently released its guidance on Minimum and Preferred Capabilities of Digital Contact Tracing Tools. One of the most exciting aspects of this is how closely it parallels the capabilities we have in our Contact Tracing Accelerator. We went through the document (here) and were happy to find that we meet all of the guidance requirements for the capabilities of a digital contact tracing tool.
|Contact Tracing Task||ExAM Capability|
|Patient Identification / Follow-up||ExAM enables easy imports of data, supports open APIs and has an existing feature set enabling the rapid mapping of our form inputs into document exchange formats for third party systems. All contact on boarding, daily follow up and self reporting forms exist as pre-built templates that can easily be extended by localities using the ExAM Command Console. Contacts have an explicit daily lifecycle and communications can be pre-planned and automated in order to support the tracing and isolation process.|
|Contact Elicitation / Identification||ExAM enables all parties to enter data into a single source of the truth, including PHAs and contacts. Contacts can elect to share location data and we enable index patients to easily add contacts they have had in order to facilitate tracing efforts. Each manually added contact can fire automation to support further contact tracing efforts and this recursive action can continue as needed to enable rapid gathering of contact data within the community at large.|
|ExAM enables automated notifications to known contacts including tailored messages based on scoring of the inputs conveyed in the contact intake form in order to assign relative risks, if desired by the locality. Messaging can be multi-channel with a focus on SMS and email as the primary modes of engagement with contacts.|
|Contact Follow-up||ExAM supports an explicit daily follow up model that is based on a daily Contact lifecycle. This can be extended beyond the current 14 day guidance, but it enables explicit messaging, notification and data collection based on an extensible criteria including daily status, confirmation of case status or other criteria. These notifications are not limited to contacts but can extend to other stakeholders in the system in order to drive real time situational awareness.|
|Platform Support||We move seamlessly between the web, Android and iOS apps enabling a fully offline experience and the ability for contacts and stakeholders to move seamlessly across these environments.|
|Data Interoperability||ExAM really shines here as our support of many distributed and federated use cases in the federal space have led us to develop extensive data exchange capabilities beyond even the strengths the Salesforce platform that powers ExAM is capable of delivering. This includes extensive capabilities to support RESTful services, explicit exchange formats and extensive expertise in supporting complex exchanges.|
|Trustworthiness||Trust is a key value at Salesforce and it extends to their partners as well. We believe in open standards and our development is done in the context of Salesforce best practice while the ExAM package is subject to ongoing security reviews by the Salesforce team as are all AppExchange products. Our product has been reviewed and is in place in high security environments in hospitals, laboratories and within federal organizations that demand a focus on security and we have baked that into our processes and practices.|
|Users||ExAM enables secure access to data by all parties including tracers, contacts and extended stakeholders. This is a tried and true security model that we use extensively on behalf of our public sector customers. The ability to have communities that display data from a single source based on the user profile and permissions is baked into the Salesforce and ExAM security models and it enables secure access for PHA users to appropriate information for them as well as secure and appropriate access for patients and contacts.|
|Availability||ExAM is deployable in days to weeks depending on the level of customization required by the customer. This is because we have experience in deploying the app to dozens of hospitals as well as federal, state and local customers. We have well understood on boarding approaches and stepped processes to moving customers from purchase to Go Live.|
|Customizability||The “E” in ExAM stands for Extensible and we have focused on customer configuration at every step. This is in lockstep with the overarching approach to configuration not code that Salesforce promotes and lives by. We have created tools like the ExAM command console that enable rapid updates to forms and data collections by end users without code or vendor intersession and the entire Salesforce platform has been developed in order to support what are often termed “citizen developers”, essentially the entire platform has been built to enable regular people to perform actions like adding fields easily.|
|Privacy||ExAM can be delivered with capabilities like Salesforce’s shield that enable significant encryption and anonymization capabilities. Our team regularly supports deletion requests and we are experienced in configuring and deploying our product and tools in high security environments like the Department of Veterans Affairs where there is a significant need to protect sensitive information.|
|Technical Support||ExAM comes with exceptional support and our team currently supports some of the world’s largest and complex implementations including a single implementation with more than 30,000 direct users and millions of external stakeholders participating via data collections and communities.|
|Vendor Experience||ExAM isn’t new to the public health space, we have dozens of hospitals that already use our product. We understand the space and the confluence of capabilities required to function in the space.|
|Localization||Self reporting features can be made available in the index patients and contacts language of choice in order to ensure ease of use within diverse communities.|
As we went through the exercise above one area that is interesting and where we have made an explicit decision to avoid some of the “preferred” capabilities is with regard to proximity tracking. For background the CDC breaks out the Contact Tracing lifecycle by task and criteria, but it also includes two icons. The first is for case management and the other for proximity tracking. I find this interesting because I think many Americans will be put off by proximity tracking in this context and that approaches that overly rely on this type of approach may fail because people will simply not feel comfortable opting in to a technology that tracks their every move and provides that information to the government.
The allure of course is that this type of approach at a high enough level of market saturation could enable us as a country to rapidly identify those who have been in contact with infected persons. However, if your locality counts on this strategy and finds that its population simply isn’t willing to opt into this level of personal tracking by the government and they don’t have the capabilities to do more traditional contact tracing they may be in a bigger problem than they might otherwise have been, especially if they have not invested in the people, technology and resources needed to perform this in other ways.
Here with the ExAM team we have really focused on automation without overly relying on the type of GPS and Bluetooth technologies that would fully automate the collection of contact information and focusing on automation that will enable the ability of tracers to handle more cases but without the perception of relying on “Big Brother” to trace contacts. This doesn’t mean we won’t use GPS or Bluetooth location capabilities, we will…the difference is that we will be using these explicitly at the users request and we will not be doing it by capturing the data of others passing in close proximity. It simply feels too invasive and I believe resistance to these types of solutions will render them ineffective and solutions that pursue this path will end up facing community resistance that will reduce the overall effectiveness of the effort.