PathCheck is launching an advisory service and a professional service to help states build, launch, and deploy their EN Express solutions. Today, Google and Apple announced EN Express, which builds on the Google Apple Exposure Notification API (GAEN) first released in May.  EN Express is designed to improve the adoption of exposure notification (EN) in US states that are not ready to deploy a full-featured exposure notification app. 

Express drives the adoption of EN as well as the adoption of PathCheck built apps. However, it works differently on iPhones and Android phones: 

  • On iPhones: EN Express will be built into the operating system and configurable by users in iPhone Settings. No app is required to receive EN. However, the Settings screen can nudge the user to download the full-featured PathCheck built app. These nudges will help drive the adoption of full-featured apps. 
  • On Android phones: States can choose between a barebones Express app or a full-featured PathCheck built app. States can submit an app configuration file to Google. But states are responsible for verification workflows and many other tasks. PathCheck can help states launch an EN Express Android app. States can easily upgrade that app to a full-featured app when they are ready for deeper community engagement and higher efficacy. 

PathCheck Foundation, a spin-off from MIT, is committed to deploying smartphone-based solutions for the pandemic, starting with exposure notification and case management. We are delighted to see this next big step in the EN deployment. EN Express will drive awareness and adoption of EN across the US. It will give states that want a very basic solution, a way to get live with exposure notification, and a path to upgrade to more functionality from a full-featured app when they are ready.

Launching EN Express can be contrasted with launching a full-featured app. A full-featured EN app includes a wide range of capabilities not available in EN Express. To date, states and countries have only launched full-featured apps, so the available data on efficacy comes from these more robust solutions. Because EN Express is different on iPhones and Android phones the choice requires some consideration.

To help drive the adoption of exposure notification solutions, PathCheck is launching an advisory service to help states evaluate whether they want to use a full-featured app or start with EN Express. Through this service, we can also help states with their EN Express deployments.



Interested in EN Express? Contact us

On iPhone, we strongly recommend that states enable EN Express even if they already have or are planning to deploy a full-features app. For Android, states will need to evaluate if they want to deploy a full-feature app or a simple EN Express app. For both options, states are responsible for many steps including signing up for APHL server, websites with public information, verification code generation, setup technical support, integrate with existing CRM solutions, and launch public awareness campaigns. These stages add significant complexity and delay. PathCheck is here to provide those services and also help states upgrade at a later point to a full-featured app.

 

Pros of EN Express on iPhones 

  • Works with or without a full-featured app 
  • Can promote adoption of a full-featured app
  • Increases EN adoption by people who don’t download a full-featured app

 

Pros of EN Express App on Android 

  • Simple and easy to create and deploy
  • Generated from the same EN Express configuration file as iPhone
  • Provides the bare minimum functionality

 

Cons of EN Express App

  • Insights on cases or exposures per county or zip code not available
  • Missing important features to restart economy: Large employers (or Universities) prefer steering employees to on-site manual contract tracing, but they cannot include customized pages inside the state app that could help provide rapid response 
  • Increases work for public health: ‘If you are exposed, call this number’ will increase the health department’s workload. Express lacks modules for case management operations such as self-screening, symptoms diary, and test result integration.
  • Regional customization to address urban-rural variations is not possible. This is required for risk scoring (thresholds to trigger EN) based on caseloads or testing availability 
  • Cannot deliver context-specific messaging from public health authority to PHA to user 
  • Difficult to create engagement or drive behavior, e.g. to keep Bluetooth on
  • No insights or questionnaire to investigate super-spreader events, finding index case using forward and backward contact tracing, spread analysis

 

Misconceptions

It is important to clarify a few misconceptions.

  • EN Express offers no adoption advantages over a full-featured app. Google will provide nudges for users to download the state apps independent of whether the state has an ENX app or a full-featured app. Apple will provide nudges to turn on using the OS level EN alerts and to download the full app.
  • On iOS, Apple does not provide an app. But, both solutions can co-exist ENX inside the OS and a full-featured app.
  • On Android, Google provides a barebones free app. Thus states must choose between a barebones app and a full-featured app. If the state has an iOS app, but only a barebones app for Android, the user experience between the two platforms will be inconsistent.
  • States are responsible for many steps such as verification workflow, technical support, CRM integration, and awareness campaigns.

 

Pros of a Full-Featured PathCheck App

  • Easy and simple to create and deploy with an established open source project
  • Consistent experience across iOS and Android
  • Compatible with EN Express on iPhones
  • Provides more features to increase engagement, sharing, and efficacy
  • Provides continuous innovation and development adding new results based capabilities
  • Customizable to address unique needs of a jurisdiction, school or employer
  • Leverages the same promotion services from Google and Apple to drive downloads
  • Works seamlessly with the same APHL servers EN Express uses


PathCheck has developed a free, open-source, full-featured app for exposure notification that is already being implemented by teams in more than seven states and countries worldwide. In addition, other teams have launched full-featured EN apps in Ireland, Germany, Japan, Alabama, Virginia, as well as other states and countries. The quality and capabilities in these apps is rapidly advancing, which is making them more effective. We have a sustained commitment, charitable funding, and an active open source community to continue innovating and developing capabilities that improve the impact and value of full-featured EN apps. We see these apps expanding to help states with a comprehensive mobile response to COVID-19. 

 

What is PathCheck’s mission?

Our mission is to contain the pandemic and revitalize economies while preserving individual privacy and liberty. We see EN Express as an important new capability now available to states that is very consistent with our mission. As a non-profit, we’re not here to make money or deliver shareholder returns. We’re wholly focused on the mission. We’re excited to be able to support states whether they want to deploy EN Express or a full-featured app, or simply need help making a decision about the best strategy for their jurisdiction.

Our team was the first to launch an exposure notification app in the US in mid-March.  We were the first team to propose a decentralized privacy-preserving scheme where healthy users never have to upload their information and the server cannot centralize data about the residents. We were also the first to write the paper about the unintended consequences of such apps, ‘Apps Gone Rogue’. These design principles are referenced by the US CDC. Our team was also the first to propose national coordination of the apps during US Congressional Testimony. We have always said that we are here to collaborate and not compete. We have become one of the largest non-profit open-source projects for Covid19.

PathCheck’s goal is to explore and deploy high-tech, high-impact solutions. Along the way, we will absorb complex technology, build it and make it available to everyone for free. Our mantra is to innovate, share knowledge, build flagship solutions and deploy and disseminate. We do that through papers, thought leadership, software, deployments, our partner network,  and advisory services. 

For digital contact tracing and exposure notification, PathCheck has gone through that cycle: innovate, deploy, disseminate. There is a lot still a lot that needs to be done: improve user engagement, reduce friction to testing, simplify diagnosis verification, connect apps to public health, and improve trust to restart the economy.

 

About PathCheck Foundation

PathCheck Foundation, a generously funded 501(c)(3) non-profit spin-off from MIT, is deploying smartphone-based pandemic response solutions using an open-source, open standard interoperable model. In the first stage, PathCheck is delivering Google/Apple Exposure Notification based full-featured apps in 5 US states/territories and multiple nations. PathCheck is committed to sustained innovation in the middle of rapidly changing protocols, APIs, and epidemiological research in the pandemic response. Follow updates at https://pathcheck.org/en/blog/