Developing An Open Source Asynchronous Communication Framework for Public Health

Background: Communication within public health in Utah is predominately synchronous or one way, primarily via conference calls.  This has proven to be very inefficient and time-consuming. We surveyed 79 public health workers and found that over 70% of respondents favored an electronic asynchronous communication method, such as a secure website or email, even though this method was not available. To address this problem, we developed an open source asynchronous communication framework to facilitate new communication methods within public health.

Objective: The aims of this project were to implement an open source asynchronous communication framework within the Utah Department of Health and document the process of developing and distributing open source software within public health. Through this framework we wanted to improve communication between public health and its partners during routine and outbreak periods.

Methods: We used an open source platform (LAMP) to develop the framework. We used Agile project management and involved public health knowledge experts to provide design specifications and feedback. 

Results: We created a secure web-based communication suite (PHAccess) using an open source framework that is available to each of the public health districts.  This application provides several asynchronous tools such as web boards to track epidemiologic surveillance issues, secured web mail, secure document library, and clinician access for public health notifications and secured communication.  The system is setup in a modular fashion so adding additional modules can be done easily.  Authentication is done through the state-wide Utah Master Directory allowing for a single sign-on to many available state applications.

Conclusion: With over 273 registered users, asynchronous communication tools have proven to be a sustainable and viable option for public health.  Other public health departments can use the tools that we have developed and the lessons learned to implement a cost effective solution to secure asynchronous communication.