1 7 Portals Powering Patient Engagement

Because of the partial government shutdown, the Centers for Disease Control and Prevention (CDC) has had to furlough most of its workforce and can no longer provide national data on disease surveillance. To help fill this temporary gap, health IT vendor Athenahealth has begun offering data on the prevalence of the flu, using de-identified patient information collected from its cloud-based EHR.

Meanwhile, Athenahealth's subsidiary Epocrates has launched a free "bugs + drugs" mobile app to help physicians ascertain the prevalence of antibiotic-resistant bacteria, including e. coli and staph infections, in their communities. Like the flu surveillance effort, "bugs + drugs" takes advantage of de-identified patient data from the EHRs of more than 43,000 providers who use Athenahealth software.

Athenahealth began publishing its data on flu outbreaks because it was concerned about the hole in the public health infrastructure, said Josh Gray, VP of AthenaResearch, a division of the Watertown, Mass.-based firm, in an interview. "The government has now been shut down for a week, and the CDC has gone dark, and we think that's a real problem for public health," he said.

One reason it's a problem, he added, is that when patients who are at risk hear about flu outbreaks, they're more inclined to get shots. "Without that sentinel effect, we're concerned vaccination rates might be lower."

[ Read more on how the shutdown is affecting different branches of the government. Government Shutdown: Defense Industry Feels Impact. ]

Athenahealth has data from providers in 48 states, said Iyue Sung, a senior data scientist at AthenaResearch. That data represents more physician practices on the east and west coasts and the south than in the central and mountain states. But last year, Athenahealth researchers did internal research on flu trends and found that the results closely mirrored the CDC's national data, he said.

While AthenaResearch is focused on tracking the flu right now, it is also looking at the feasibility of doing surveillance on patterns of GI disease and pneumonia, Gray said. It has also done research to measure the prevalence of pollen allergies.

The company's initial research on allergic rhinitis encounters with primary care providers broke them down by regional prevalence. With the flu surveillance, it's just providing national data.

The bugs + drugs campaign, in contrast, aims to geo-locate the patients infected with MSRA and other antibiotic-resistant bacteria by associating them with each patient's zip code of residence, said Anne Meneghetti, MD, executive director of medical information for Epocrates.

The Epocrates app can be helpful to providers who might be unaware that such infections are occurring in their communities. These providers might not be planning to send samples to a lab for testing or they might be waiting for the results to come back. In either case, Meneghetti said, they can use the app to find out how prevalent the resistant germs are in the area and what kind of antibiotics to use for treating the bacteria that are susceptible to certain drugs.

Currently, the superbug app is available only for the iPhone and iPad. About 70% of Epocrates users are on Apple's iOS platform, Meneghetti said, but the company has not ruled out releasing Android and Windows versions.

Athenahealth's actions raise the possibility that other cloud EHR vendors could help do disease surveillance in a way that's never been possible before. Social media could be harnessed for the same purpose. For example, researchers have mined Twitter to track disease outbreaks.

Athena's efforts in this area, however, are intended primarily to aid university researchers. "In the long run, we're developing relationships with academics in which they can easily access well-curated, cloud-based data sources," said Gray. "We hope to be able to help physicians and other providers evaluate the best approaches to clinical practice."