Cloud Software Fights Zika in Florida, Zip Code by Zip Code

One of the many challenges presented by the Zika virus is that its symptoms differ for different kinds of victims. A healthy adult male may contract the virus and see few or no symptoms, while as we have heard so often,  the virus can bring about serious birth defects in the unborn child of a pregnant woman.
What to do about a disease that carries such distinct dangers for different people? In Florida, cloud-based healthcare services company athenahealth is using big data to seek out those in danger and give them the information they need.
In one Miami neighborhood, Wynwood, cases of Zika have been growing, apparently transmitted by infected mosquitos. Just hours after the Center for Disease Control issued a travel warning for Wynwood on Tuesday, athenahealth ran a query in its Electronic Health Record, a database of information gathered from its widely-used athenaClinicals software. The company tailored the search to find the group most at-risk for the Zika virus: men and women of reproductive age (19-45) in the two Miami zip codes – 33127 and 33137 – for which the CDC had issued its warning.
The search winnowed the 30,000+ residents of Wynwood down to just 1,850 people with an especially serious risk of Zika infection.
“We can see geographically where the patients live and then we can narrow it down by their age and gender to even more directly focus our outreach,” says Stewart Richardson, a Senior athenahealth data expert.
Next, the company identified two major care providers associated with these patients: Borinquen Health, the largest health center in Wynwood, and Florida Woman Care, the largest OB/GYN group in the state.  These two providers alone turn out to serve 1,600 of the 1,850 at-risk people.
Together with Borinquen and Florida Woman Practice, atheanahealth then began reaching out to at-risk individuals directly. It wrote e-mails, made phone calls, and sent text messages that explained precautionary measures that may reduce the risk of a Zika infection: things like consistent condom use during pregnancy and regular application of insect repellant.
“The real benefit of outreach is prevention,” says Dr. Karen Harris, an OB/GYN at Florida Woman Care, “When we alert these patients that they’re in an at-risk area for Zika, we hope that they will immediately start prevention strategies. Primary prevention is the only way we’re really going to abate the Zika crisis.”
Athenahealth’s data analysis provides a  very specific list of people that makes prevention outreach far easier. “This may be one of the first times we’ve looked very carefully at geography. Place-based healthcare is really new and on the forefront of where we’re headed,” Dr. Harris notes, “This is terrific that we’ve been able to get down to the zip codes.”
Previously, healthcare providers had to issue general warnings to many thousands of people when a certain health crisis necessitated specific care or prevention measures. Now, clinics and groups like Florida Woman Care can target the few hundred patients most in need.
Athenahealth has for some time compiled data and used it to warn healthcare providers of potential problems – patients with a substance abuse risk being prescribed opiates, for example – but this is the first time the Watertown, Massachusetts-based company has decided to reach out to patients directly. That outreach, athenahealth insists, is because of the seriousness of the Zika outbreak in South Florida
“Reaching out to patients directly is something new we decided to do this time because of the unique nature of the CDC alert,” observes Dr. Brian Anderson, a senior manager of clinical effectiveness at athenahealth, “There is a real patient safety crisis.”
Athenahealth will continue to track Zika-related data in the coming weeks and months. Already, the company has noticed a spike in orders for Zika screening tests around the country. The next step, researchers and clinicians say, will be recording and analyzing the results of those tests in company databases as clinics and labs fax them back and forth.
Cloud-based data is already helping reach out to potential Zika patients and encouraging prevention. Now, athenahealth executives hope, the same data will help contain the epidemic by tracking diagnosed patients and the disease’s spread.