Development and Implementation of Electronic Disease Early Warning Systems for Optimal Disease Surveillance and Response during Humanitarian Crisis and Ebola Outbreak in Yemen, Somalia, Liberia and Pakistan.

Objective: To share lessons learned with experience in concept development of electronic disease early warning system (eDEWS) as a standardized informatic tool for optimal disease surveillance for early warning and response Network (EWARN) during humanitarian crisis.

Methods: We did literature search, review and analysis to document system attributes of existing electronic tools being used for disease surveillance, early warning and health management information system (HMIS). We generated baseline information and conducted multiple planning sessions with stakeholders for EWARN system requirement elicitation and validation to inform concept development of standardized electronic tool.

Results: We identified 98 electronic health projects, classified 22 projects under 'Disease and epidemic outbreak surveillance' theme, whereas only four electronic tools met our selection criteria and were reported to be implemented in humanitarian settings complimentary to EWARN. Baseline information was obtained to guide work on requirement gathering and analysis process, and development of concept for a standardized electronic tool for EWARN.

Discussion: The eDEWS was enhanced with an objective to develop standardize electronic tools and data collection procedures to monitor diseases and health events for alert detection in global humanitarian settings. The enhanced system could be harnessed as a powerful tool by outbreak response teams in getting vital epidemiological information for appropriate and timely response during emergencies.

Conclusion: eDEWS experiences in Yemen, Somalia, Liberia and Pakistan offers an opportunity to learn and apply lessons to improve future health informatics initiatives or adapt eDEWS as a feasible standardized approach to enhance EWARN implementation during humanitarian crisis, and potential integration into routine surveillance systems.