Technology vendors are partnering with federal, state and local health officials and healthcare providers in Zika-affected communities to use mapping technology and health IT to track the Zika virus and identify patients potentially at risk of infection.
With Florida health officials reporting confirmed cases of local transmission of the Zika virus in a Miami neighborhood and the Centers for Disease Control and Prevention (CDC) issuing a travel advisory warning for the Miami-Dade County area, health officials and healthcare providers in the affected community are actively trying to target at-risk patients for testing and outreach in order to combat the spread of the mosquito-borne virus.
Borinquen Health Care Center of Miami Dade, which is located in Miami, appears to have one of the largest impacted patient populations, with approximately 1,382 patients that have been identified as being potentially at-risk for infection, according to data from Watertown, Mass.-based athenahealth, a health IT vendor. Athenahealth is using real-time data from its nationwide network of more than 80,000 providers and its database of patient health records to track patients potentially at-risk of infection in the affected community.
On Monday, the CDC issued its first ever travel advisory warning for a part of the continental U.S., warming pregnant women to avoid travel to the square-mile area of the Wynwood neighborhood in north Miami after Florida health officials reported 14 locally transmitted cases of the Zika virus.
In the advisory, CDC officials said test results showed that spraying, removing standing water and other efforts had failed to kill off many of the Aedes aegypti mosquitoes, which can carry Zika. “This information suggests that there is a risk of continued active transmission of Zika virus in that area. As a result, CDC and Florida are issuing travel, testing and other recommendations for people who traveled to or lived in the Florida-designated areas on or after June 15, 2016, the earliest known date that one of the people could have been infected with Zika,” the CDC advisory stated.
Specifically, the CDC recommended that pregnant women not travel to the identified area and that pregnant women who traveled to this area on or after June 15 should be tested for Zika.
Following the CDC’s travel guidance and testing recommendations issued Monday, athenahealth has identified 1,850 patients being treated by 94 providers at 24 different athenahealth clients within the affected Miami area who are potentially at risk, according to Brian Anderson, M.D. senior manager of clinical effectiveness at athenahealth.
Athenahealth is using is network insights to focus on Miami providers in order to help them identify patients at risk of infection and to streamline outreach and potential testing, per the CDC’s recommendation.
Anderson says, “When the CDC publishes updates, we can then identify specific patients that might be at risk for contracting the Zika virus based on those guidelines. We’re taking the real-time update to a guideline that the CDC may be publishing, like the CDC did on Monday at 4 pm when they published their first ever first travel advisory for the continental U.S. and focused in on the Wynwood neighborhood. The athenaResearch team then identifies women of reproductive age and adult men who are sexually active and collocating that segment population to the zip codes relevant to Wynwood. We then take the information and reach out to those providers that have those patients letting them know that there is a new CDC guideline that just came out, and here is a list of patients who we think are relevant to that guideline.”
He continues, “It’s important and helpful for providers to say on top of guidelines and new updates to ensure that their patients are receiving the best, most up-to-date care, education and prevention and, in this case, screening for Zika for patients who live in the Wynwood neighborhood.”
Anderson adds, “This is what we like to call ‘network medicine:’ activating the latest, most evidence-based clinical guidelines to deliver them rapidly to our clients for activation.”
Of those 1,850 patients targeted for testing and outreach within the Wynwood area, about 75 percent were identified as patients of Borinquen Health Care Center according to athenahealth data. Working with athenahealth, Borinquen Health Care Center has been able to activate the CDC’s updated guidelines immediately, according to Diego Shmuels, M.D., director of quality and clinical practice management at Borinquen Health Care Center. “This has enabled us to educate and protect our patients, and the community we serve,” Dr. Shmuels said in a statement.
According to Anderson, in addition to identifying Borinquen Health Care Center patients potentially at-risk of infection, athenahealth also is working with the medical practice on an outreach campaign to contact those patients. "We are developing an outreach campaign across phone, email and text in which we reach out directly to patients at risk to make sure they come in and get screened,” Anderson said. That outreach campaign will be deployed later this week.
At the same time, the World Health Organization, the State of Florida, the CDC and the Department of Health & Human Services are using Geographic Information System (GIS) mapping technology as part of Zika virus containment and prevention efforts. GIS software company Esri provides technology that generates smart maps derived from a wide variety of data resources and then publishes them across information networks. These organizations have used the same smart mapping technology to mitigate West Nile Virus and Ebola, according to an Esri media representative.
The Pacific Disaster Center (PDC) has been using Esri’s mapping software, open data and Web GIS platform to track the outbreak of Zika on a global scale, according to the company. PDC provides situational awareness information for all manner of disasters, and the center uses the mapping platform’s capabilities to add different data layers—hospital density, rain and vector programs—to maps. Smart map technology provides insight into mosquito populations to help organizations identify regional vulnerabilities and potential virus outbreaks. PDC then serves its map products around the world to organizations that depend on it for intelligence about specific regions.
“Esri GIS technology specifically allows us to characterize the Zika virus outbreak and contextualize it for decision makers,” Dr. Joseph Green, PDC's health risk specialist, said in a prepared statement. “Our maps describe the distribution of suspected cases at national levels throughout Latin America and the Caribbean.”
PDC gathers Zika virus information from weekly epidemiology updates and bulletins obtained from health organizations worldwide. In return, the center publishes regular updates, including online maps that track the increase and decrease of reported and suspected cases over time.
The anthenaResearch team also has been tracking Zika testing using data from its national network of providers. “From our network, we can see what sort of lab tests and other orders that providers are doing for their patients. Now that there have been tests developed for the Zika virus, we can go in and track which providers are ordering tests for which of their patients, and then connect that back to patients, so we can see demographic information. Right now, we’re tracking the ages and genders of the patients getting tests, as well as their insurance, whether it’s commercial insurance or Medicare or Medicaid or whether they are uninsured,” Stewart Richardson, senior athenaResearch associate, says.
According to recent data from athenahealth clients, 89 percent of the tests have gone to women, with most administered to women ages 19 to 44. The second-largest group to take the tests have been men in the same age bracket. And, 76 percent of the tests have been administered to patients with commercial insurance, with 15 percent being patients on Medicaid.
“So far, the tests seem to be going to people most likely to need them, as opposed to people acting out of panic,” Richardson said in an athenahealth insight blog post.