Wehealth All-hazard Platform at the NACCHO Preparedness Summit 2023

The National Association of County and City Health Officials (NACCHO), the voice of the country’s nearly 3,000 local health departments, held the 2023 Preparedness Summit from April 24-27, 2023 in Atlanta, GA. More than 2,700 public health experts, healthcare leaders, and emergency management specialists attended in-person and virtually. This event is the first and longest running national conference on public health preparedness.

Conference theme for 2023: The historic response effort to combat COVID-19 has consumed our attention since January of 2020. At the same time, other all-hazards threats continued, and the need to address them has remained ever present. This response also put into sharp focus the need to place health equity at the forefront of preparedness to truly build and strengthen the resilience of our communities. As we recover from the prolonged pandemic response and begin to define the endemic phase of COVID-19, natural disasters, emerging infectious diseases, terrorist threats, climate issues, and maintenance of all-hazards plans can now be reexamined. The theme for the 2023 Preparedness Summit, Recover. Renew: Reprioritizing All-Hazards Preparedness, will provide an opportunity to revisit these pressing issues and share resources, shape policies, and build skills to mitigate a variety of threats. By renewing our commitment to all-hazards preparedness, we can equip our communities to meet current and future threats, while building response plans and frameworks that are inclusive, responsive, flexible, and adaptable.

Video

Here's a video of the presentation of the Wehealth All-hazard Preparedness Platform at the conference.

Transcript

This is a read-along version with the slides and transcript.

Sameer: Hi, I'm Sameer Halai. I'm the CEO at Wehealth, and I'm here to talk about the lessons that we learned building our all hazards platform based on the work that we did in Arizona and Bermuda. But before we get started, I would love for you to install this app so you can really follow along and get a better sense of what I'm talking about here. So if you're on Android or an iPhone you can just go to the play store or app store and search for Wehealth Notify. And you'll find this app. It's an app that's free available to the public. Anyone in the US or worldwide can install it. And if you have any concerns about installing, yet another app, please know that this is actually one of the safest apps you can install. It cannot access your location. It cannot get any of the personal information off your phone. It doesn't require a login. It just sits there anonymously doing what it does. So when you go through the onboarding flow, you will reach a screen where we'll ask you to set your community. You can go ahead and type in the zip code of where you live or anything you're familiar with, and it'll then translate that to the nearest county that the zip code is in. And then set that as your community in the app.

Sameer: So the first thing that we learned while working on this in the last three years is the importance of having a feedback loop. The hardest thing about the pandemic was not really understanding the impact of our individual actions. If I wear a mask, what does it do? If I get vaccinated, does it actually make a difference? If I stay home, do not go to the grocery store or do not see my grandma what this is actually gonna do. So we found it was really important to show local information to our end users. So we are not just looking here at national data, global data or state data, but county level data. So I can see within my county, and you can see that on your phone right now if you install the app, you can see the latest CDC levels for hospitalization, inpatient utilization and, and cases per 100k. So this really gives me a better sense of where I am and what's going on around me. I want to know what's happening around me. So that was the key kind of thing that we found was really, we saw a very high engagement with that kind of information. What we see in the middle is actually a screenshot from a different app. That's our portal app that's designed for just public health. And that's the feedback loop on the public health side. What is the ROI and engagement with what we are doing here? Right? We really need to know that. So that's what this lets us see. We made sure that KPIs were part of our thinking from day one, and so it made it very easy to understand, alright, we are doing X and we are seeing Y, which means it's working. And that's an example on the right. Just timely communication as part of the feedback loop. What you're seeing here is an example of one of the surveys that goes out. It's a post-exposure survey that's sent to people who have been notified that they may have a high exposure to Covid. And we saw that 10%, like one in 10 people who received a notification actually took the time to fill out a survey, right? That's high. 10%. And this number is actually from last month. We're talking about Q1 of 2023, where we are seeing this high engagement. 70% of the people reported being aged 50 years or older, and 37% reported having risk of severe illness or a weakened immune system. So without this, we wouldn't even know that we are still helping people receive timely information that's valuable to them. And so that's why the feedback loop is super important. 

Sameer: The other thing we learned quickly was the importance of a community focus. Every community understands their needs. They have their own strategies, their own resources, and their own priorities. And we need to empower them to do what they do best, which is figure out what's right for them. And so that's why inside the app, when you install it you really have an opportunity to completely customize your experience based on the community you're in. It can be a county or a tribal nation or a university a workplace, a senior living center, hospitals, they all have different needs. And that's what we saw, like one of the senior living locations is just 50 people, but they have their own mitigation planning. They have their own resources they want to point to. Universities, they have their campus health and they want to redirect their students and staff to what's available on campus. So that level of customization is key and that's where empowering it to go up from the bottom  is how we can really achieve the outcomes that we're looking for. 

Sameer: The other thing we realized was the importance of having realtime updates. Now, I'm just gonna be honest here. There were times in the last years where we all know that the cdc guidelines were outdated. Everyone knew they were outdated. We were waiting for the new guidelines. But that one month or two months created a vacuum in which disinformation flourished. Because when we have a delay in updating, we are actually inviting misinformation to fill that vacuum and that's what we've been seeing. So that's why we made it super easy to make updates to the platform. Updates do not require an app update. There is no release of something new. The information is updated in seconds. So you can go in again on the left what you are seeing is a screenshot of the portal that's available for public health. They can go in and change any information and it's boom, live in real time. And not just live as in just a content update, you can actually see on the right when someone is receiving an exposure alert, it can actually personalize information. So I'm seeing take a test on April 25th, not take a test six days after exposure, but then I have to do the math to think about, okay, when was this again? I don't remember. And so on. So we are giving rich information and updating that in real time. 

Sameer: The other thing we realized and were very humbled by just how complex Covid ended up being between vaccination immunization requirements: are we gonna need one, two or boosters, The variants reinfections, it was just quite complex and so we made sure we took a step back and just thought about it in terms of an all hazards platform. So you can see we came up with this idea of factors. What factors lets us do is you as a community manager decide what kind of hazards are relevant to your community, and you include them as factors in the platform. So here we have some covid related factors, but we can also have influenza. We can even have radiation exposure if the community has risk of power plant meltdown or a nuclear war, right? We can have these factors and plan for mitigation around those risks. So what happens by adding the factors is that the population gets stratified. Based on the risk to those different factors. And then the factors get set. Based on a few different ways. When you install the app, the app can detect some factors for you. For example, again using COVID exposure, the app can detect exposure to covid, so it can set that factor for you. It can also have input from an external system. We have lab integrations where if there's a PCR test at a lab, Then you have the option to take this verified report from the lab into the platform and set a factor that way. And the third thing is, of course, just self-report. As a user, you can just self-report your factors. You can just say, Hey, I just tested positive, because I tested at home, what do I need to do? So regardless of how the factors get set, then we have the opportunity to have different mitigation plans in place and to communicate that out to everyone quickly. So here again, you're seeing an example of a piece of information that's tailored to someone who just received an exposure notification, and we want to direct them to resources that are relevant to them in that situation.

 Sameer: The other thing we realized was translations was one of the reasons that content updates slowed down, and we wanted to do what we could to make that easier. So what happens on our platform now is anytime you make any change to any content, It gets instantly translated to 40 languages. And we use a combination of AI tools and human review and then also auditing to make sure that for all those languages we are on point. It's a big undertaking, but we wanted to make sure that everyone has this problem to solve. And if we can actually just  bring the best practices to everyone, then we can focus more on the strategy and let the platform make sure that everyone gets the right information quickly and at the same time.

Sameer: We are doing some  ongoing research on a few things that we've learned as well. Here's an example of something that we are doing with  MIT Lincoln Labs. So what we're seeing here is a bunch of robots that are on these moveable platforms. And all of them have a phone on them with our app installed on it. And so what the folks at MIT did, they were evaluating different exposure notification technologies, and we were one of the partners that they worked with. And so here we will see a simulation of people moving about in a physical space. The person in purple marked with a purple indicator there is infected and then moving around in this room. And then the other phones nearby are sensing that person's  presence anonymously. And then you can see number 12 just went red, which means they had enough exposure, which at that time probably was 15 minutes at close distance. And now that person has moved. Number 16 has moved a different part of the room. So we see number one is now seeing exposure. Number 14 is seeing exposure. At some point, a threshold will be met and boom. Now number one also has met the threshold. So this is a good way to understand how does a Bluetooth based detection technology map to real physical behavior and how the virus would actually spread in that physical space. So what we learned was that yes, this requires phone and phone. And we can do better. We can do more, and we can do more than just covid. And so that's why we're working on introducing beacons, which would be stationary hardware installed in physical spaces, cost nothing like $5 or something. If you've ever been to like a mall and walked by a store let's say, you have an iPhone and you walk by the Apple store. Your phone can notify you that you were near an Apple store. Apple Store doesn't know that you were there, but you know that you were near the Apple store. So that maintains privacy, and we can leverage that same idea to make sure we can detect exposures in public spaces.

Sameer: The other thing we're working on is related to what I just talked about in terms of translations. What happened in October, 2022 with ChatGPT will be remembered as a sea change in, in the world. And in a few months our internet is gonna explode with a lot of nonsense. There's gonna be just so much high quality looking information that is primarily gonna just be trying to sell you something. Or trying to just scam you or misinform you. That's the world we are looking at. So what we are trying to do is how can we leverage generative AI to actually do what we want to do better, which is reach more people and, and make sure we don't  allow a vacuum to exist, go where people are. So I'll play this video of a person, this is actually not a real person. It's an AI avatar, and everything this person is saying was generated by AI. 



Sameer: What we have learned is that the best way to utilize wisdom, Is to funnel it back into the product and the platform so that everyone can benefit from everyone's battle scars. We all have battle scars over the last three years and the product reflects them and it's stronger and better because of that. And that's what we are here for. We wanna talk about how. What we are building  has evolved into a pretty robust all hazards platform that anyone can use. It's already ready to go. Any county in the US can already use it. It takes seconds to onboard, someone takes minutes to set up the content and you're good to go. So I'm very curious to hear about your thoughts on this. Any questions you may have, I'm happy to answer. And then I have a lot of questions I wanna ask you.

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The summit was a great way to connect with everyone and better understand how we can all be better prepared for all hazards to help make our communities more resilient. Our 1 year old twins also made a brief appearance at the conference :)