Ethical accountability frameworks for automated syndromic surveillance alerts and decision support workflows

Abstract

Automated syndromic surveillance can accelerate detection, but weak accountability can amplify bias, cause alert fatigue, and undermine public trust. This paper proposes an ethical accountability framework that combines technical monitoring with governance controls across the alert lifecycle. Key elements include purpose and limitation statements for alerts, calibration reviews, bias and fairness checks, change logs tied to release approvals, and transparent communication of uncertainty to stakeholders. We provide a practical RACI model and review cadence that assigns ownership to program, epidemiology, privacy, and operations leads. The framework supports responsible automation while preserving rapid public health response.