Health world leans on IT in Zika fight

Health organizations are incorporating IT plans into strategies to combat the Zika virus, to promote information sharing and track the spread of infections.

The response to Ebola is providing something of a use case for health officials. The Office of the National Coordinator has begun to digitize Zika guidance documents from the Centers for Disease Control and to develop common standards around vocabulary and data sets.

"Making sure everyone is using the same vocabulary standards makes the analytics very useful," ONC Public Health Coordinator James Daniel said at the organizations annual meeting on June 1. "We realized we really need to start developing an 'all hazards' approach, so that we've got something ready to go that we can implement with vendors in our next crisis situation."

The goal of the all-hazards approach is to plan for "any kind of hazard," and IT specialists "fit right into this framework," said ONC IT specialist Daniel Chaput.

Having the right IT on the spot can cut the time needed for accurate patient diagnoses and data collection and sharing, Chaput added. And a pre-existing emergency response framework can help make decisions flow faster and more accurately.

"We're looking at taking this framework and extending it some" to apply to Zika-specific scenarios, he said. "Luckily with both Ebola and Zika, it's been a relatively slow start-up. But there could be something that could come along that could ask health IT to move much quicker, and it would be nice if we didnt have to talk about 18-month release cycles in order to respond."

In addition to developing language standards and framework, Chaput said that stakeholders in the electronic health record community are closing in on a case reporting standard for Zika that would identify the disease in records across multiple systems.

Dr. Floyd Eisenberg of iParsimony showcased a Zika-specific screening algorithm developed for electronic health record systems and based on information provided by EHR vendors.

The algorithm resembles a flow chart, with branches, arrows and decision points based on answers to relevant questions – namely about pregnancy and travel to known locations of Zika exposure – in patient profiles. 

Additionally, the order sets for Zika treatment are in development and can be used by local sites and applications, but "to actually implement them in EHR is a big step," said Eisenberg.

"All of the coding doesnt necessarily map easily to what things are called locally because at the local site, they develop their own order catalogues," he explained. "So thats a little more challenging."

Other possible IT uses that were presented at the ONC meeting included further development to registries that could log individuals travel histories and track pregnant women who may have been exposed to the virus, but neither system is comprehensive or interoperable yet.

"I think case reporting is going to be something that becomes a very important part of this," Daniel said. "CDC does currently run a pregnancy registry system…but it's not currently connected to EHRs, and I think as that number grows, thats something we really need to consider – how to make that more interoperable."