Rapid use of EHR data critical to Zika public health response
The public health response to the outbreak of the mosquito-borne Zika virus is relying heavily on information technology to help prevent its spread, particularly among pregnant women who are at risk of passing the illness on to fetuses and causing congenital birth defects.
Since early 2016, the Centers for Disease Control and Prevention and the Office of the National Coordinator for Health IT have been collaborating with electronic health record vendors to develop resources to support rapid deployment of critical information through EHRs and other clinical software in the battle against Zika. CDC and ONC are coordinating several activities including developing algorithms, standardizing vocabulary sets, incorporating Zika order sets into HIT products, as well as reaching out to EHR vendors.
“We are really dealing with computer science vs. the biological sciences,” said Daniel Chaput, an ONC public health analyst, during an education session at the HIMSS17 conference in Orlando. “Never before in history has there been a situation where a bite from a mosquito can result in a devastating malformation.”
As of February 7, more than 1,450 pregnant women in the United States have been identified with laboratory evidence of Zika virus infection, with more than 3,150 such cases in the U.S. territories, according to the CDC.
Floyd Eisenberg, MD, president of iParsimony contends that lessons learned from the public health response to infectious diseases like Ebola do not easily translate to combating the current Zika crisis.
“From an IT perspective, it was simpler with Ebola, even though the disease is much more acute,” observed Eisenberg. “But, with Zika virus, there’s a lot more to deal with in terms of identifying risk—where someone was, when they were there, what tests need to be done, in what sequence, what to do for them, as well as what they should do to avoid pregnancy or—if they are already pregnant—to manage pregnancy.”
However, according to Eisenberg, capturing pregnancy status in women of child-bearing age is “not as easy as it sounds in the EHR.” In addition, he said complicating matters is the fact that Zika can also be transmitted sexually and that pregnant women and their sexual partners can be exposed to the virus during travel to areas of active local transmission.
“It’s really important to collect data on all these women who are exposed and what happens to their children,” Eisenberg added.
Sanjeev Tandon, MD, lead for CDC’s EHR Meaningful Use & Public Health Project and the CDC Zika Response Health IT Team, said that “as we start to go into the mosquito-breeding season in the next few months, CDC will be keeping a watch” over the emerging situation from its Emergency Operations Center, which is actively monitoring and coordinating the federal government’s response to the U.S. outbreak.
“We receive the clinical guidance from CDC that comes out of the Emergency Operations Center, and we transform that guidance for EHR to develop decision support to implement those rules consistently,” added Chaput.
“We are still in full active mode,” concluded CDC’s Tandon.