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Open source software tool helps governments monitor COVID-19

March 19, 2020 by Gérard Krause and Bianca Poll

SORMAS software model. Credit: HZI

The SORMAS software shares vital data between responders. Illustration by Helmholtz Centre for Infection Research.

Adapting the SORMAS outbreak response software to the novel coronavirus pandemic.

The Surveillance Outbreak Response Management and Analysis System, or SORMAS, is an open source mobile and web application that enables health workers to notify health departments about new cases of epidemic-prone diseases, detect outbreaks, and manage outbreak responses. It's what the digital health sector refers to as a "global good," an adaptable, interoperable, open source software designed to meet the data and management needs of country health systems. And it's one of many such tools promoted by the PATH-led Digital Square initiative.

SORMAS was developed by the Helmholtz Centre for Infection Research (HZI) jointly with multiple international partners during the 2014 West Africa Ebola outbreak as an early warning and management system. As a multifunctional tool, it can be used for case surveillance, laboratory data management, contact tracing, and disease detection—all of which support the prevention and management of outbreaks. Since its development, SORMAS has been used in response to multiple simultaneous outbreaks of monkeypox, Lassa fever, and meningococcal disease.

A new module for COVID-19

With the emergence of COVID-19, HZI rapidly developed a module for detection and control of the virus. Both the Ghana Health Service and Nigeria Centre for Disease Control immediately activated this new module in more than 400 districts already using SORMAS, as well as in ports of entry such as airports and harbors, covering a population of more than 85 million. The Nigeria Public Health Service is using SORMAS for epidemiological follow-up and containment. In Nepal, national public health authorities are preparing to deploy SORMAS in response to the COVID-19 outbreak. The uptake in country adoption demonstrates the importance of having flexible, responsive options to health crises.

The SORMAS-CoV module contains all disease-specific diagnostic standards, case definitions, and containment procedures defined by the World Health Organization. All procedures are embedded in the new module and compatible with those already in the SORMAS software. This includes different user roles within public health services, such as local informants, epidemiologists, laboratory technicians, and point of entry officers. The module allows the targeted collection of relevant epidemiological data about the case person, including hospitalization, symptoms, and persons with whom they have come into contact. Furthermore, the task management feature, a strength of SORMAS, facilitates coordinated action of the surveillance personnel in the outbreak response.

The SORMAS interface

The SORMAS user interface.

SORMAS in action

The SORMAS tool provides information that health workers need to identify and slow the spread of disease. Armed with details about a patient’s symptoms, lab results, and hospitalization, surveillance personnel can contain the spread of an epidemic from reaching the wider population.

Identifying and tracking new cases

SORMAS supports the rapid identification and reporting of suspected cases. If a patient arrives at a hospital with possible signs of COVID-19, health workers or surveillance personnel are prompted by SORMAS with questions about symptoms specific to the virus, such as fever, coughing, and shortness of breath. A health worker can then create a new case in the system and note the hospital admission and quarantine procedures that have been used.

Laboratory results

Through SORMAS, laboratory personnel are alerted when a sample is sent for disease verification, and they are reminded to inform the hospital of the test results.

Contact tracing

SORMAS helps with follow-up and identifying possible transmission of the virus. Surveillance personnel can also register individuals in the system who have had contact with an infected patient. The system will schedule and document findings of the daily health monitoring of those contact-persons, which aids in the disruption of the transmission cycle.

SORMAS plays an incredibly important role in addressing infectious diseases—enabling better information sharing within a country and producing vital insights into how and where a disease is spreading. Learn more about SORMAS here: www.sormas.org.

This article is adapted from a post on the Digital Square blog. Digital Square is a partnership of the world's leading digital health experts from more than 40 organizations and countries, working together to strengthen digital health systems in emerging economies. This global digital health flagship is a PATH-led initiative funded and designed by the US Agency for International Development, the Bill & Melinda Gates Foundation, and a consortium of other investors.

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