Twenty-first century technological advances in mobile and cloud-based computing, remote sensing, machine learning, and data accessibility present a range of novel data streams on clinical and population health, human mobility patterns, habitat and infrastructure, and the environment— in near real-time. We use these data to advance evidence-based decision-making in public health emergencies through research, training, and translational interventions.

Our successful initiatives include cloud-based disease surveillance systems at the world’s largest mass gatherings, evaluation of the world’s largest NCD screening and management program, digital health innovation labs, and policy outputs — including the India Digital Health Network’s White Paper on its Healthcare Professionals Registry — that have helped shape national digital health architectures.

Projects

Healthcare-Professionals-Registry-White-Paper

India Digital Health Net

The India Digital Health Net (IDHN), hosted at the Harvard Mittal Institute, is a consortium of technology companies, scientists, lawyers, and policymakers from the U.S. and India, shaping India’s digital health ecosystem design and implementation.

Needs-Finding-Survey

National Digital Health Needs Finding Study

Billions of dollars have been invested over the past decade in developing digital tools to advance clinical and public health, with limited success. Misalignment of incentives among public health administrators, hospital leadership, payers, clinicians, patients, and others, as well as poor needs-finding and limited attention to sound design principles, has prevented digital tools from reaching their full potential — despite staggering advances in natural language processing, machine learning, and cloud computing.

The National Needs Finding Study maps these areas of convergence through an exhaustive 200+ hours of stakeholder interviews employing generative design research methodology.

Community Science Alliance

Non-Communicable Disease Software Solution Optimization

The India Digital Health Network (IDHN), in collaboration with researchers from St. John’s Research Institute, completed an optimization of the Government of India’s NCD software solution. The study was quasi-experimental and used human-centered design methods to identify problems in the NCD platform and its implementation, ideate improvements, iteratively test design prototypes, and validate the usability of the optimized platform.

The study took place in 26 Government of Karnataka health facilities and involved over 240 person-hours of participant observations, several contextual interviews and focus group discussions, and over 140 usability tests in field settings. The tools and approaches used are available for further studies in digital health implementation in India.

Reimagining-Health-Data-Exchange

The Vinyasa Tool for mHealth Solutions

The Vinyasa Tool was developed to comprehensively and efficiently elicit input from end users and improve digital health platforms like India’s NCD Portal. It draws on mHealth research to assess adoption and suggest design changes, leading to better user uptake and potentially improved health outcomes.

CrisisReady banner

CrisisReady

CrisisReady, based at the Harvard Data Science Initiative and Direct Relief, is co-directed by Drs. Balsari, Buckee, and Schroeder. The CrisisReady team has responded to over 50 global disasters since its inception in 2022. It operates a live decision-support tool, ReadyMapper, which is deployed within hours of a major disaster being anticipated or declared.

The CrisisReady team also provides daily situational awareness (SitRep) reports (“ReadyReports”) to emergency and humanitarian response agencies and communities impacted by disasters worldwide. CrisisReady’s Data-Methods-Translational Framework enables our team to scale data-driven decision-making globally through a network of regional partners. Read more about the framework here.

community health workers
Photo: Soumi Das

Community Science Alliance (CSA)

The Community Science Alliance (CSA) is a network of community-based healthcare organizations, technology companies, and physician-scientists from India and the U.S.

CSA aims to improve evidence-based clinical care delivery by providing hyper-contextualized decision-support tools to clinicians, based on available resources, population demographics, local epidemiology, availability, and affordability.

This hyper-contextualized knowledge is delivered through personalized apps, podcasts, and fellowships, sustaining a community of practitioners who inform and maintain the guidelines.*

Coronavirus

COVID-19 Mobility Data Network (CMDN)

Led by Dr. Caroline Buckee, Professor of Epidemiology and Associate Director of Harvard’s Center for Communicable Disease Dynamics, the COVID-19 Mobility Data Network (CMDN) was a network of infectious disease epidemiologists at universities worldwide, working with technology companies to use aggregated mobility data to support the COVID-19 response.

Kumbh Mela
Photo: Prashant Kharote

EMCOUNTER: Syndromic Surveillance System at the World’s Largest Mass Gathering

Dr. Balsari’s team (then at Weill Cornell), in collaboration with the Harvard Mittal Institute, developed an online, mobile syndromic surveillance system for the world’s largest mass gathering—the 2013 Kumbh Mela. The platform de facto became the world’s largest cloud-based syndromic surveillance system for a mass gathering. It was redeployed in 2015, completely replacing paper records with digital devices.

Publications

A standardised differential privacy framework for epidemiological modeling with mobile phone data

Balancing Privacy and Accuracy in Epidemiological Modeling with Mobile Phone Data

October 27, 2023 | PLOS Digital Health

Merveille Koissi Savi, Akash Yadav, Wanrong Zhang, Navin Vembar, Andrew Schroeder, Satchit Balsari, Caroline O. Buckee, Salil Vadhan, Nishant Kishore

This publication introduces a standardized differential privacy framework to protect personal data while analyzing disease spread using mobile phone data. By adding statistical noise, this method preserves privacy while maintaining the accuracy of key epidemiological measurements.

The study tested privacy protection across ten COVID-19 tracking metrics and found that data remained reliable even with significant privacy safeguards. The team also provided a modular software pipeline to help researchers replicate and adapt the framework. This work supports the OpenDP project, ensuring that sensitive data can be securely shared for public health research.

Wildfire Threat to Inpatient Health Care Facilities in California, 2022

April 5, 2023 | American Journal of Public Health, Volume 113, Issue 5

Neil Singh Bedi, Caleb Dresser, Akash Yadav, Andrew Schroeder, and Satchit Balsari

This study evaluates the wildfire risk to inpatient healthcare facilities in California by analyzing their proximity to high-risk Fire Threat Zones (FTZs). Findings reveal that half of the state’s inpatient beds are within 0.87 miles of a high-risk FTZ, and 95% are within 3.7 miles.

The study underscores the need for stronger facility-level preparedness, including smoke mitigation, evacuation planning, and resource allocation, to safeguard patient care during wildfires.

CrisisReady’s novel framework for transdisciplinary translation

Case-studies in wildfire and hurricane response

January 10, 2023 | The Journal of Climate Change and Health, Volume 9 (2023) 100193

Andrew Schroeder, Caleb Dresser, Akash Yadav, Jennifer Chan, Shenyue Jia, Caroline Buckee, Satchit Balsari

In two case studies, the CrisisReady team describes how they have negotiated access to privately-held data sources, such as anonymized geolocation data from cellphones, while striking a balance between data security and public health utility.

The Vinyasa Tool for mHealth Solutions: Supporting Human-Centered Design in Nascent Digital Health Ecosystems

2023 | JMIR Formative Research, Volume 7, Issue 1

Verghese Thomas, Bharat Kalidindi, Abijeet Waghmare, Abhishek Bhatia, Tony Raj, Satchit Balsari

The Vinyasa Tool is a qualitative research instrument designed to support human-centered design in mHealth solutions for low- and middle-income countries (LMICs).

By addressing usability challenges that often hinder adoption, the tool helps developers, healthcare administrators, and researchers assess user needs, workflows, system interoperability, and information governance before full-scale deployment.

Organized into 11 sections with 71 questions, it facilitates focus groups and interviews with healthcare workers to ensure mHealth solutions are relevant, usable, and sustainable.

Location Data in the Context of Public Health, Research, and Law Enforcement:

An Exploration of Governance Frameworks

August 23, 2022 | The National Academies Press, Natl Acad Sci Eng Med

Professor of Epidemiology at Harvard T.H. Chan School of Public Health Caroline Buckee co-organized a virtual workshop with the National Academies of Sciences, Engineering, and Medicine‘s Committee on Science, Technology, and Law on how location data can be used in public health, research, and law enforcement.

This report provides an overview of the proceedings that took place during the workshop.

All-cause excess mortality across 90 municipalities in Gujarat, India, during the COVID-19 pandemic (March 2020-April 2021)

August 16, 2022 | PLOS Global Public Health

Rolando J. Acosta, Biraj Patnaik, Caroline O. Buckee, Mathew V. Kiang,Rafael A. Irizarry, Satchit Balsari, Ayesha Mahmud

Official COVID-19 death counts in Gujarat significantly underestimate the true toll. This study, using civil death records from 90 municipalities, reveals a substantial rise in all-cause mortality during the pandemic.

The findings highlight the widespread impact of COVID-19 and the need for more accurate mortality tracking.

The Use of Human Mobility Data in Public Health Emergencies

April 9, 2022 | CrisisReady.io

Caroline Buckee, Andrew Schroeder, Jennifer Chan, Satchit Balsari

This white paper summarizes key learnings from a four-part seminar, “Safe, Fair, Equitable and Responsible Use of Human Mobility Data,” which identified the technical, regulatory, and translational gaps that preclude the effective integration of novel data into disaster response.

Applying Human-Centered Design Principles to Digital Syndromic Surveillance at a Mass Gathering in India: Viewpoint

January 10, 2022 | Journal of Medical Internet Research, Volume 24, Issue 1

Aamir Shaikh, Abhishek Bhatia, Gaurav Yadav, Srushti Hora, Christopher Won, Madhura Shankar, Andrew Heerboth, Prashanth Vemulapalli, Pranav Navalkar, Ketaki Oswal, Christopher Heaton, Sanjay Saunik, Tarun Khanna, Satchit Balsari

This study emphasizes the role of human-centered design in successfully adopting digital syndromic surveillance tools at mass gatherings.

A case study from a large event in India (30 million attendees) shows how contextual relevance, stakeholder participation, customizability, and rapid iteration drove high user satisfaction and adoption, even in a chaotic, resource-limited setting.

The findings provide lessons for scalable, sustainable digital health solutions, especially amid India’s digital health reforms.

Data in Crisis: Rethinking Disaster Preparedness in the United States

September 1, 2021 | New England Journal of Medicine, Medicine and Society

Caroline Buckee, Satchit Balsari, Mathew V. Kiang

Despite the availability of large-scale data on medical needs, population vulnerabilities, physical and medical infrastructure, human mobility, and environmental conditions, the translation of these data and methods into improved disaster response faces substantial challenges.

The authors of this paper discuss these challenges, and argue that a sustained commitment and investment in the necessary data systems, methodological tools, and translational pipelines is required to prepare for the natural disasters facing us.

A retrospective analysis of hypertension screening at a mass gathering in India: implications for non-communicable disease control strategies

July 20, 2017 | Journal of Human Hypertension, Volume 31

S Balsari, P Vemulapalli, M Gofine, K Oswal, R Merchant, S Saunik, G Greenough, T Khanna

This study evaluates the impact of hypertension screening at the 2015 Kumbh Mela in India as part of a broader non-communicable disease (NCD) control strategy. Of the 5,760 participants, 33.6% screened positive, with most unaware of their condition.

The findings highlight low awareness, treatment, and control rates of hypertension, emphasizing the potential and challenges of opportunistic screening at mass gatherings for improving public health outreach and NCD management in India.

Using mobile technology to optimize disease surveillance and healthcare delivery at mass gatherings: a case study from India's Kumbh Mela

September 1, 2017 | Journal of Public Health (Oxford), Volume 39, Issue 3

Dhruv S. Kazi, P. Gregg Greenough, Rishi Madhok, Aaron Heerboth, Ahmed Shaikh, Jennifer Leaning, Satchit Balsari

This study examines the use of mobile technology for disease surveillance and healthcare delivery at mass gatherings. Researchers piloted a tablet-based system at India’s Kumbh Mela, demonstrating its ability to track patient encounters, monitor illnesses, and optimize resource allocation in real time.

Findings highlight the potential of user-centered mobile health solutions to improve public health response in large-scale, resource-limited settings.

Public health aspects of the world’s largest mass gathering: The 2013 Kumbh Mela in Allahabad, India

December 2016 | Journal of Public Health Policy, Volume 37, Issue 4

Satchit Balsari, P. Gregg Greenough, Dhruv Kazi, Aaron Heerboth, Shraddha Dwivedi, Jennifer Leaning

The 2013 Kumbh Mela in Allahabad, India, the world’s largest mass gathering, hosted over 70 million devotees over 55 days, presenting unique public health challenges.

With uncontrolled crowd surges and a temporary infrastructure, key concerns included crowd safety, water sanitation, disease surveillance, and healthcare delivery.

This study examines the event’s public health measures, identifies critical challenges, and offers recommendations for improving preparedness at future large-scale gatherings.

Water, Sanitation, and Hygiene at the World's Largest Mass Gathering

February 2015 | Current Infectious Disease Reports, Volume 17, Issue 2

Michael Vortmann, Satchit Balsari, Susan R Holman, P Gregg Greenough

The 2013 Kumbh Mela, the world’s largest mass gathering, drew 120 million participants. To support the event, a temporary city was built with roads, electricity, water, sanitation, and healthcare facilities.

This study examines the water, sanitation, and hygiene (WASH) measures implemented to prevent disease outbreaks, particularly diarrheal diseases, and assesses preparedness and response strategies. The findings provide lessons for improving public health management at future large-scale gatherings.

Healthcare Professionals Registry

August 1, 2021

Abijeet V Waghmare, Akhil Malhotra, Angshuman Sarkar, Bharat Kalidindi, Dhinagaran D, Ryan Fernandez, Satchit Balsari, Sehj Kashyap, Tony Raj, Verghese Thomas

On June 22, 2021, the National Digital Health Mission (NDHM) and National Health Authority (NHA) of India released a consultation paper on its proposed Professionals Registry, a vital public good building block of the national digital health ecosystem.

The India Digital Health Network (IDHN) recommended that enrollment be required in phased manner; the registries be tiered; verifications be time-bound, distributed and prioritized; scope of the registries be significantly broadened.

Healthcare Facilities Registry

August 3, 2021

Abijeet V Waghmare, Akhil Malhotra, Angshuman Sarkar, Bharat Kalidindi, Dhinagaran D, Ryan Fernandez, Satchit Balsari, Sehj Kashyap, Tony Raj, Verghese Thomas

On June 22, 2021, the National Digital Health Mission (NDHM) and National Health Authority (NHA) of India released a consultation paper on its proposed Facilities Registry, a critical building block of the national digital health ecosystem under development. In response to request for public comment, the India Digital Health Network (IDHN) at Harvard’s Lakshmi Mittal South Asia Institute submitted a response drafted through a collaboration of domain experts from India and the US.

Responses to the Government of India’s Joint Parliamentary Committee’s Consultation on the Personal Data Protection Bill

February 1, 2020

Abhijeet Wagmare, Adrian Gropper, Angshuman Sarkar, AV Sethuraman, Clay Heaton, Geetika Sethi, Guriqbal Sngh Jaiya, Harpreet Singh, Jimmy Anthony, Nivedita Saksena, Rahul Matthan, Satchit Balsari, Shrey Desai, Sneha Vaidhyam, Supten Sarbadhikari, Tarun Khanna, Tony Raj

The IDHN team submitted comments to a Joint Committee of the India Parliament on the 2019 Personal Data Protection Bill, which aims to protect the personal data of individuals throughout India. In our comments we highlighted the implications of this law for health data and academic research being undertaken in the country.

Response To The Invitation For Public Comment National Digital Health Blueprint

August 4, 2019

Abhijit Gupta, Abijeet Waghmare, Adrian Gropper, Angshuman Sarkar, A V Sethuraman, Devesh Varma, Dhruv Pandey, Harpreet Singh, Jimmy Antony, John Halamka, Namrata Arora, Nivedita Saksena, Rahul Matthan, Satchit Balsari, Sneha Vaidhyam, Sunita Nadhamuni, Supten Sarbadhikari, Tarun Khanna, Tony Raj, Vivek Divan

In 2019, the India Digital Health Network (IDHN) recommended Regulatory Sandboxes in response to India’s proposed National Digital Health Blueprint (NDHB), enabling controlled testing of novel technologies before large-scale implementation.

In August 2020, the National Health Authority launched the NDHM Sandbox, allowing third-party software integration and validation with NDHM APIs.

Responses To The White Paper Of The Committee Of Experts On Data Protection Framework For India: A Lens On Health Data

February 1, 2018

Abhijit Gupta, Abijeet Waghmare, Adrian Gropper, Angshuman Sarkar, A V Sethuraman, Devesh Varma, Dhruv Pandey, Harpreet Singh, Jimmy Antony, John Halamka, Namrata Arora, Nivedita Saksena, Rahul Matthan, Satchit Balsari, Sneha Vaidhyam, Sunita Nadhamuni, Supten Sarbadhikari, Tarun Khanna, Tony Raj, Vivek Divan

On November 27, 2017, in response to the white paper published by the Committee of Experts on Data Protection Framework for India, the India Digital Health Network (IDHN) recommended that India’s data protection law include health data security, prioritize privacy by design over consent-based systems, define data portability for structured health data, favor anonymization over de-identification, and enforce fiduciary responsibility for data controllers. 

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