Tech

Fighting Zika With Network Medicine

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On Monday, the medical establishment and the general public were put on alert by an emergency notification from the Centers for Disease Control and Prevention: Florida’s Miami-Dade County had 14 confirmed cases of the Zika virus, the infectious disease which causes birth defects, and was at risk of continued active transmission.  In the following days, the CDC has advised pregnant women and their partners to avoid Wynwood, a small community north of downtown Miami–the first time it has ever issued a travel alert in the United States for an infectious disease. It has also issued specific Zika guidelines for the Wynwood region for patients who have traveled to the area on or after June 15th.

Moments like these test our healthcare system and reveal its weaknesses.  We’ve spoken often on this blog about healthcare’s connectivity problem: islands of information and data siloes that don’t talk to one another, sometimes to lethal effect. Public health crises demand that health information flow freely and that healthcare providers have the latest clinical guidelines at their fingertips.

Unfortunately, this isn’t the first time that athenahealth has had to overcome information barriers to respond to concerns about infectious disease.  Last year, at the height of the ebola crisis in Texas, athenahealth rapidly deployed an updated CDC guideline in our EHR to provide content and alerts to assess for Ebola symptoms, travel history, and risk of exposure.

This is what we call Network Medicine: activating the latest, most evidence-based clinical guidelines to deliver them rapidly to our clients for activation—no software update required.

In the days since the CDC’s Zika guidance, athenahealth has assembled a Network Medicine task force once again to help Florida providers affected by the Zika outbreak.  We’re using the power of our network to knit together islands of information—in this case, individual practices in Florida with unidentified patients at-risk of infection—and help our providers activate the CDC’s updated guideline to screen, educate, and protect their patients.  Our strategy is two-fold: identify patients living in the affected region and treated by providers on the athenahealth network; then, equip providers with the tools to perform outreach to those patients and bring them in for treatment.

On Tuesday, we ran a query across athenaNet to identify patients with addresses in the affected area.  The results were astonishing: More than 1800 men and women living in or near the Wynwood area, spanning 94 providers at 24 different practices on the network, fit the CDC’s criteria and may require testing.

We’ve partnered with clinical leadership at the two most affected client sites–a prominent OB/GYN group, and Borinquen Health Care Center of Miami Dade, the largest Federally Qualified Health Center in the Wynwood region–to develop customized, direct-to-patient campaigns to deploy via email and phone.  Today and tomorrow, these clients will be contacting targeted patients with our help.  When they bring those patients in for screening, they’ll find the CDC’s clinical guideline directly embedded in their EHR.  It’s a compelling example of the power of our network, and of what the right information—at the right time, in the right place—can do.

In the coming days, we will continue to partner with other affected client sites in Florida to replicate this process.  We’ll also be using the power of our network to study the volume and age distribution of Zika testing across the US.  You can find that and other coverage at athenaInsight.

With a heat map of potentially vulnerable patients in the Wynwood area, the race is on to connect providers to the information they need to turn insight into action.

Brian Anderson, MD is senior manager, clinical effectiveness athenahealth.

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Adrian Gropper, MDjamesepurcell@KarenSibertMDJohn Irvine Recent comment authors
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Adrian Gropper, MD
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Adrian Gropper, MD

This post is interesting on many levels but HIPAA is not one of them. Network Medicine as a title is a Rorsachach test for all sorts of commercial and strategic interests that drive medical information technology. For example, – How centralized do we want our health IT to be – one Epic or athenahealth for the entire country? – Is it good to have different versions of an EHR in different hospital systems like Epic or is it better to have a cloud EHR like athenahealth where everyone is using the same version? – Who at athenahealth decides to deploy… Read more »

jamesepurcell
Member

This is the poster girl for making any changes to HIPAA and other so-called privacy laws that threaten this sort of positive outreach. I’m sure there are some at athenahealth (i.e., attorneys of which I am one) that counselled, “no, no, it’s too risky.” To have done this shows vision and some courage.

Now the issue is how do we change laws and regulations to take a more sensible approach to sharing healthcare information WITHIN the delivery system???

Good work.

@KarenSibertMD
Member

This gives me hope for the EHR, which has been a source of considerable despair in my several years of using Epic. There is absolutely no question of any HIPAA violation in contacting patients who are already enrolled in a healthcare system and registered with their health records in the EHR. It would be irresponsible NOT to do so; we’ve just never had the technology to connect the dots. HIPAA rules chiefly concern disclosure of information to an outside party without the patient’s consent. And, as the recent Orlando shootings illustrated, even those rules can be waived legitimately in emergency… Read more »