RI growing app to supply providers, monitor signs and places of COVID-19 sufferers
PROVIDENCE, RI (WPRI) – Rhode Island has signed a contract with Salesforce.com to develop a mobile app that connects COVID-19 patients to services and helps public health officials track their contacts, locations and symptoms, according to a target 12 review of the deal.
The agreement with the San Francisco-based software company – entered into through a reseller company called Carahsoft Technology Corp. – Provides insight into how the state is trying to automate its current system of delivering services, scheduling tests, and finding people who may be contracting the disease from the infected, a response tactic known as “contact tracing” is.
“We’re taking a paper-based system and replacing it with a more efficient one,” wrote Health Ministry spokesman Joseph Wendelken in an email. “We have to do that because the response has become so great.”
Rhode Island began contact tracing for COVID-19 when the first positive case was announced on March 1st. As of Saturday, positive cases had grown to 2,349 and the number has been trending upward faster as testing became more widely available.
When someone tests positive for the disease, Ministry of Health officials collect information about those people’s travel history and who they’ve interacted with. After collecting the personal information, health authorities try to contact these contacts to determine if testing or quarantine is required.
The Salesforce agreement marks a major shift from the state’s personal strategy to an application-based program managed by a third-party vendor.
The app-based program is designed to make the process more efficient, but the idea of automating contact tracing using cell phones – a strategy already being used in other countries – has won over advocates of civil liberty, including Jennifer Sista Granick and Jay Stanley of the American Union for Civil Liberties.
“Policymakers need to have a realistic understanding of what the data generated by cell phones can and cannot do,” write Granick and Stanley in a white paper entitled “The Limits of Tracking in an Epidemic.”
“As always, there is a risk that a simplified understanding of how technology works can result in investments that are of little use or even counterproductive and invade privacy for no real benefit,” they added.
Salesforce has signed a six-month contract to set up and provide free support for the program and app. The estimated value of the work according to the contract is $ 280,486. And while Salesforce, the Department of Health, and the state IT team continue to sort out the details, the overall goal is relatively simple.
“The state of Rhode Island has hired Salesforce to support its COVID-19 response management activities and enable a nationwide system for ubiquitous testing, contact tracing and effective quarantine,” Salesforce representatives wrote in the contract. “The aim is to reduce infections by preventing exposed people from spreading COVID-19.”
Based on the contract, the app will provide public health officials with digital tools to monitor patient symptoms and track down contacts. The effort is made possible through interviews, gathering of contact information, and gathering of “related organizational and location information” as per the deal.
On the support side, the app will help people schedule tests and give people in quarantine and isolation access to services such as food delivery and telemedicine, Governor Gina Raimondo explained in one of her daily news stories last week.
The platform could also help public health officials predict the future spread of the disease and offer other analytical tools that could help better inform the state’s response efforts and future containment strategy. Based on current state-based modeling – which has not been publicly shared – the pandemic is unlikely to peak in Rhode Island until the end of the month at the earliest, according to Raimondo.
That means leaders are still very focused on responding to the disease, but the Salesforce deal shows Raimondo is starting to focus more on developing a containment strategy for the future. With no vaccination or approved treatment currently in place, leaders across the country are struggling to find a way to both protect the health of citizens and get them out of their homes and back to work.
“If I want to reopen this economy, it has to be more automated and scalable, so we’ve worked hard to build a system,” Raimondo said on Wednesday of contact tracing.
Rhode Island’s economy is on the brink, with COVID-19-related unemployment claims exceeding 135,000 since early March.
Harvard University economist Nicholas Mankiw, who chaired the Council of Economic Advisers under President George W. Bush, suggested that if the pandemic is somehow contained, employment could be restored. However, he cautioned that month-long closings would likely mean companies would close for good, which would result in fewer jobs for people looking to return to work.
“That decline could have a quick recovery,” Mankiw said last week during a discussion with Brown University President Christina Paxson. “That depends on how quickly the pandemic continues.”
Emerging strategies for opening up the economy without a vaccine or properly screened treatment include ubiquitous testing and retesting – along with some level of surveillance to help with contact tracing, quarantine, and isolation.
Harvard researchers suggest that an effective testing strategy would require retesting the entire population about every three to four days to control the disease, while another group said targeted contact tracing using technologies like Bluetooth might prove more efficient .
“There are strong arguments for using digital contact tracing in combination with other technological interventions to fight COVID-19, and there are reasons to believe that it does not require major privacy sacrifices for this technology to work,” the researchers wrote .
Other countries – including China, South Korea, Spain, and Thailand – have all implemented a mandatory and voluntary type of location tracking that has apparently worked with varying degrees of success.
Whether something similar could happen in Rhode Island in the future is not entirely clear, but leaders assure that any information that is ultimately collected will be protected by federal health care privacy laws that would also apply to Salesforce.
“The Salesforce platform is the channel,” said Wendelken. “There are confidentiality rules and requirements associated with this technology, just as there are when third parties process sensitive information or health information for the state.”
Bluetooth technology is currently not mentioned in the contract with Salesforce. And “GPS upload and automation” is outside the scope of duties that the company has taken on for the state. However, the contract makes it clear that such work can be carried out on request.
Chirag Patel, director of enterprise applications and IT for the state’s information technology division, leads development work for Rhode Island. He told The Providence Journal last week that GPS tracking is not currently part of the mission. Raimondo previously told reporters it was too early to tell. When asked for clarification, Raimondo spokesman Josh Block said both statements were true.
“Current planning does not include the use of GPS tracking technology,” Block wrote in an email. “But it is too early to say if we could look into this as this situation evolves.”
Eli Sherman (esherman@wpri.com) is an investigative reporter for WPRI 12. Connect with him on Twitter and Facebook.
