key: cord-0866963-o0gdcv4s
authors: Sheng-Kai Ma, Kevin; Tsai, Shin-Yi
title: Integrating Travel History via Big Data Analytics Under Universal Healthcare Framework for Disease Control and Prevention in the COVID-19 Pandemic
date: 2020-09-23
journal: J Clin Epidemiol
DOI: 10.1016/j.jclinepi.2020.08.016
sha: b75edca4825ed956dbf37ca2e23be714dd59451d
doc_id: 866963
cord_uid: o0gdcv4s

nan

To the dear editor: In this letter we reported Taiwan's experience of disease control and prevention in the COVID-19 Pandemic by Big Data-driven Universal Healthcare. Big data analytics has facilitated healthcare quality promotion by analyzing electronic medical records, socio-demographics, and environmental factors, to optimize treatment decisions [1, 2, 3] ; moreover, its roles in predicting and tracking emerging infectious diseases, including the coronavirus pandemic, have also been proposed [3, 4] . In countries offering universal healthcare systems (UHS), claimed healthcare informatics of payers could serve as an abundant source of massive database due to universal coverage. This indicates that the intersection of public health policies and technology could bring about additional benefits of healthcare reform through integrated real-time data analytics [5] .

Take Taiwan for example, cloud computing-based healthcare databases within the UHS have been part of its critical national infrastructure. Such platform has allowed healthcare providers to query travel history on a real-time basis, as well as manage the allocation of personal protective equipment. Collected data of beneficiaries (> 99.5% of all residents) regarding medical records, lab data, images, and prescriptions from all healthcare providers during the past 24 years are retrievable [6] . As data analytics and cloud technology allow for both personalized medicine and public health policy-making, Taiwan authorities have been allowed to adopt low stringent level strategies as opposed to lockdown policies among other high income countries [7] . Remarkably, the utilization of UHS databases may realize cost-effective and efficient solutions to epidemic prevention in the early outbreak.

After the severe acute respiratory syndrome outbreak in 2003, Taiwan CDC (TCDC) commenced transferring real-time infectious disease registry data to this monitoring system, and since 2016 real-time analytics were enabled via cloud computing, concatenation of intramural data on all severe influenza cases was practiced. Therefore, alerts were indicated prior to the official recognition of COVID-19 outbreak [3, 4] , which travel history databases were subsequently concatenated to trace the source. Inauguration of such travel history tracking system would involve data transfers as well as managerial issues including ownership and governance, which interdepartmental communication would be more efficient within a single-payer UHS. For instance, the tracking system in Taiwan was co-operated by the Immigration Agency and TCDC, which the traveling history of beneficiaries and their corresponding history of contact were retrievable with insurance or passport numbers. As the UHS provider, government also gave access of the above information to healthcare providers external to the universal insurance plan, including dental, aesthetic, or physiotherapy clinics, as well as nursing home and blood donation sites, to reduce iatrogenic viral exposure and postponed care.

During the era of healthcare reform, we advocate for integrative systems that promote not only accessible healthcare services, but cost-effective tracking of potent factors for the emergence of diseases, so as to achieve pandemic management.

J o u r n a l P r e -p r o o f

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Response to COVID-19 in Taiwan: Big Data Analytics, New Technology, and Proactive Testing

Covid-19 and the Need for Health Care Reform

Protecting Healthcare Workers During the Coronavirus Disease 2019 (COVID-19) Outbreak: Lessons From Taiwan's Severe Acute Respiratory Syndrome Response

The authors declare that they have no known competing financial interests or personal relationships which have, or could be perceived to have, influenced the work reported in this article.Kevin Sheng-Kai Ma J o u r n a l P r e -p r o o f