As Florida gears up to combat the spread of the Zika virus, electronic health records vendor athenahealth has offered its technological capabilities to providers to help them identify patients who might be at risk of infection.
So far, athenahealth has identified more than 1,800 patients at risk, treated by 94 providers. In addition, the vendor is currently working with Borinquen Health Care Center of Miami-Dade County, which is home to one of the largest impacted populations with nearly 1,400 at-risk patients, according to athenahealth’s analysis, which it conducted using its cloud-based EHR.
Ground zero in the battle against Zika is Miami-Dade. On Monday, the Centers for Disease Control and Prevention issued travel guidance and testing recommendations to Miami’s Wynwood neighborhood, where cases of the illness, caused by mosquito transmission, have been confirmed.
Among the CDC’s recommendations were that pregnant women should not travel to the area and that pregnant women who live in or frequently travel to this area should be tested in the first and second trimester of pregnancy.
“At 4 p.m. on Monday, the CDC for the first time published an update to their guideline that included a travel advisory,” says Brian Anderson, MD, senior manager of clinical effectiveness at athenahealth. “That travel advisory got our attention.”
Within a couple of hours of the CDC’s alert, Anderson and Stewart Richardson, a senior athenaResearch associate at athenahealth, ran an EHR network query looking for women of reproductive age (19 to 45 years old) who could be sexually active or are pregnant, as well as men of the same age group that could be sexually active with those women.
“We ran a filter to our network data looking for the ZIP codes relevant to the Wynwood region,” adds Anderson. “The power of the network allowed us in a few short hours to identify 1,850 patients who met that criteria, had not been tested and needed to be screened.”
Of the 1,850 at-risk patients identified, 1,352 patients were determined to belong to one medical practice—Borinquen Health Care Center— in the Wynwood neighborhood. According to Anderson, based on the data, athenahealth reached out to Borinquen’s medical director in an effort to help them engage patients for outreach and testing.
Most people with the disease are asymptomatic, and even those with symptoms probably would not normally go to the doctor and get diagnosed, given that the symptoms can be mistaken for the flu, Anderson notes. “This is something that can’t wait for the patient to come into the office,” he says. “We’re trying to get the patients to be at the point of care.”
As part of its proactive engagement campaign, athenahealth has partnered with Borinquen and is sending out emails to patients and automated phone calls to inform them that they need to come in for a Zika screening.
“Working with athenahealth, we have been able to activate the CDC’s updated guidelines immediately to educate and protect our patients, and the community we serve,” said Diego Shmuels, MD, director of quality and clinical practice management at Borinquen Health Care Center.
In addition to Borinquen, Anderson relates that athenahealth is also working with a large obstetrics and gynecology group in the same area to contact more than 250 at-risk patients.
Anderson credits athenahealth’s cloud-based EHR for the speed with which the vendor has been able to conduct “network medicine” by taking the CDC guideline and running a query in real time, based on the alert, to help providers target patients who are at risk.
“Given that we are a cloud-based, single-instance platform, we can push out updates to the guideline immediately, as well as patient-facing education materials and newly recommended questions/screening tests,” he concludes. “It’s not just identifying the patients and doing the campaign outreach. It’s then taking the content—the actual things that the CDC is asking providers to screen for—and having those components built out into the EHR.”
“Electronic health records could be a promising tool to assist with this work,” says Margaret Honein, chief of the CDC’s Birth Defects Branch and co-lead on the Pregnancy and Birth Defects Task Force in the agency’s Zika response. “One variable that is critically important, because of the risk that Zika poses to pregnant women, is making sure that pregnancy status is consistently captured in EHRs so we can quickly identify those people who are pregnant.”
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