tetano
Editor, Senior Moderator
JMIR Public Health Surveill
. 2021 Nov 30.
doi: 10.2196/32680. Online ahead of print.
An Evaluation of the Text Illness Monitoring (TIM) Platform for COVID-19: A Cross-Sectional Online Survey of Public Health Users
Heather A Joseph[SUP] 1 [/SUP], Susan Z Ingber[SUP] 1 [/SUP], Chelsea Austin[SUP] 2 [/SUP], Caroline Westnedge[SUP] 3 [/SUP], F V Strona[SUP] 1 [/SUP], Leslie Lee[SUP] 1 [/SUP], Ami B Shah[SUP] 3 [/SUP], Lauren Roper[SUP] 1 [/SUP], Patel Anita[SUP] 1 [/SUP]
Affiliations
Abstract
Background: The U.S. public health response to the 2019 Novel Coronavirus (COVID-19) pandemic has required contact tracing and symptom monitoring at an unprecedented scale. The Centers for Disease Control and Prevention and several partners created a text illness monitoring (TIM) platform in 2015 to assist U.S. public health jurisdictions with symptom monitoring for potential novel influenza virus outbreaks. Since May 2020, 142 federal, state, and local public health agencies have deployed TIM for COVID-19 symptom monitoring.
Objective: We evaluated the utility, benefits, and challenges of TIM to help guide decision making for improvements and expansion to support future public health emergency response efforts.
Methods: We conducted a brief online survey of previous and current TIM administrators (admin users) from November 28, 2020 through December 21, 2020. Closed- and open-ended questions inquired about the onboarding process, decision to use TIM, groups monitored with TIM, comparison of TIM to other symptom monitoring systems, technical challenges and satisfaction with TIM, and user support. A total of 1,479 admin users were invited to participate.
Results: Ninety-seven admin users from 43 agencies responded to the survey. Most admin users represented the Indian Health Service (36.1%), state health departments (26.8%), and local or county health departments (18.6%), and almost all were current users of TIM (90.4%). Among the agencies represented,11 (25.6%) used TIM for monitoring staff exclusively, 13 (30.2%) monitored community members exclusively, and 19 (44.2%) monitored both staff and community members. Agencies most frequently used TIM to monitor symptom development in contacts of cases among community members (65.1%, 28/43), followed by symptom development among staff (62.8%, 27/43) and among staff contacts of cases (55.8%, 24/43). Agencies also reported using TIM to monitor patients with COVID-19 for the worsening of symptoms among staff (48.8%, 21/43) and community members (41.9%, 18/43). When asked to compare TIM to previous monitoring systems, 78.4% (40/51) of respondents rated TIM more favorably than their previous monitoring system, 19.6% (10/51) said there was no difference, and 2.0% (1/51) rated the previous monitoring system more favorably than TIM. Most respondents found TIM favorable in terms of time burden, staff burden, timeliness of the data, and the ability to monitor large population sizes. TIM compared negatively to other systems in terms of effort to enroll participants (persons TIM monitors) and accuracy of the data. Most (89.4%, 76/85) reported they would highly or somewhat recommend TIM to others for symptom monitoring.
Conclusions: This evaluation of TIM showed that agencies used TIM for a variety of purposes and rated TIM favorably compared to previously used monitoring systems. We also identified opportunities to improve TIM; for example, enhancing the flexibility of alert deliveries would better meet admin users' varying needs. We also suggest continuous program evaluation practices to assess and respond to implementation gaps.
. 2021 Nov 30.
doi: 10.2196/32680. Online ahead of print.
An Evaluation of the Text Illness Monitoring (TIM) Platform for COVID-19: A Cross-Sectional Online Survey of Public Health Users
Heather A Joseph[SUP] 1 [/SUP], Susan Z Ingber[SUP] 1 [/SUP], Chelsea Austin[SUP] 2 [/SUP], Caroline Westnedge[SUP] 3 [/SUP], F V Strona[SUP] 1 [/SUP], Leslie Lee[SUP] 1 [/SUP], Ami B Shah[SUP] 3 [/SUP], Lauren Roper[SUP] 1 [/SUP], Patel Anita[SUP] 1 [/SUP]
Affiliations
- PMID: 34882572
- DOI: 10.2196/32680
Abstract
Background: The U.S. public health response to the 2019 Novel Coronavirus (COVID-19) pandemic has required contact tracing and symptom monitoring at an unprecedented scale. The Centers for Disease Control and Prevention and several partners created a text illness monitoring (TIM) platform in 2015 to assist U.S. public health jurisdictions with symptom monitoring for potential novel influenza virus outbreaks. Since May 2020, 142 federal, state, and local public health agencies have deployed TIM for COVID-19 symptom monitoring.
Objective: We evaluated the utility, benefits, and challenges of TIM to help guide decision making for improvements and expansion to support future public health emergency response efforts.
Methods: We conducted a brief online survey of previous and current TIM administrators (admin users) from November 28, 2020 through December 21, 2020. Closed- and open-ended questions inquired about the onboarding process, decision to use TIM, groups monitored with TIM, comparison of TIM to other symptom monitoring systems, technical challenges and satisfaction with TIM, and user support. A total of 1,479 admin users were invited to participate.
Results: Ninety-seven admin users from 43 agencies responded to the survey. Most admin users represented the Indian Health Service (36.1%), state health departments (26.8%), and local or county health departments (18.6%), and almost all were current users of TIM (90.4%). Among the agencies represented,11 (25.6%) used TIM for monitoring staff exclusively, 13 (30.2%) monitored community members exclusively, and 19 (44.2%) monitored both staff and community members. Agencies most frequently used TIM to monitor symptom development in contacts of cases among community members (65.1%, 28/43), followed by symptom development among staff (62.8%, 27/43) and among staff contacts of cases (55.8%, 24/43). Agencies also reported using TIM to monitor patients with COVID-19 for the worsening of symptoms among staff (48.8%, 21/43) and community members (41.9%, 18/43). When asked to compare TIM to previous monitoring systems, 78.4% (40/51) of respondents rated TIM more favorably than their previous monitoring system, 19.6% (10/51) said there was no difference, and 2.0% (1/51) rated the previous monitoring system more favorably than TIM. Most respondents found TIM favorable in terms of time burden, staff burden, timeliness of the data, and the ability to monitor large population sizes. TIM compared negatively to other systems in terms of effort to enroll participants (persons TIM monitors) and accuracy of the data. Most (89.4%, 76/85) reported they would highly or somewhat recommend TIM to others for symptom monitoring.
Conclusions: This evaluation of TIM showed that agencies used TIM for a variety of purposes and rated TIM favorably compared to previously used monitoring systems. We also identified opportunities to improve TIM; for example, enhancing the flexibility of alert deliveries would better meet admin users' varying needs. We also suggest continuous program evaluation practices to assess and respond to implementation gaps.