As public health experts continue to emphasize the unpredictability of the H1N1 flu virus, federal agencies and healthcare companies alike are developing a host of surveillance systems to better understand the deadly strain and its effect on the American public—as well as open new business lines.
From the Centers for Disease Control and Prevention—the HHS agency that has guided the nation through this year's global flu pandemic—to large, publicly traded companies such as General Electric Co. and Microsoft Corp., to smaller healthcare information technology providers, there has been a surge in efforts either to enhance existing flu-tracking systems for public health experts or create new ones for consumers.
In October, GE Healthcare announced that the CDC had selected the company to provide extensive surveillance data for both H1N1 and seasonal flu activity throughout the U.S. According to the announcement, GE Healthcare reports information gathered from its nationwide electronic database of nearly 14 million patient records to help the Atlanta-based agency track the spread of the virus in near real time.
For this, participating physicians automatically contribute de-identified data to the company's Medical Quality Improvement Consortium—a repository of anonymous clinical data and best practices—through GE's Centricity EMR when they document information collected during patient visits.
Kathleen Gallagher, an epidemiologist at the CDC, says GE is one of five sources the agency has employed to enhance the data surveillance systems it currently has in place. The others are Cerner Corp., which has an electronic product for laboratory tests; for-profit hospital chain HCA, which provides both inpatient and outpatient data; SDI Health, a healthcare analytics company; and the Distribute project, a network of more than 40 state and local health jurisdictions that conduct surveillance on flu-like illness in emergency departments.
Gallagher says the greatest challenge is trying to “fine-tune” the answers to certain questions because the data are still so new to the people who are using it.
“The GE data wasn't originally intended to get information on influenza epidemiology,” Gallagher says. “It was intended as an EMR. We've been working through all of those issues early on so we can feel that we have the data from the EMR that will best answer the question we want it to answer.”
Another federal agency to employ a tracking system related to the flu is the Food and Drug Administration, which chose Wolters Kluwer Pharma Solutions to track the treatment of H1N1 and other flu viruses. Wolters Kluwer provides information and analytics to the pharmaceutical, biotech and medical-device industries. While the company would not provide detailed information on its work for the FDA, it explained its work in general terms.
“We've got a number of proprietary data assets that provide us with insights into retail pharmacy claims, and we take claims assets and combine them in a way that allows us to look at different types of therapies,” says Peter Demogenes, senior director of product management for Wolters Kluwer in Phoenix.
In the case of the flu, the company has conducted a number of studies to combine information, such as how frequently patients take medication and if they continue using that medication. Based on that information, Demogenes says, the company's customers gain insight into whether patients are using the medication properly. He acknowledged the concern of some who think prescription claim information should not be shared with anybody, but says he finds it can be useful, such as in assisting the U.S. government during the pandemic.
“As a consumer and a father of two kids and a husband,” Demogenes says, “I get to see the benefits of what this information can do.”
For other consumers like Demogenes—as well as hospitals and health plans—there are other flu-tracking systems to help assess symptoms and determine if patients have the flu. In early October, Microsoft launched its online H1N1 Flu Response Center that offers consumers a self-assessment from Emory University in Atlanta.
Another is Feeling Flu, a Web portal from Atlanta-based A.D.A.M., a public company that creates technology solutions for employers, benefits brokers, healthcare organizations and Internet companies. Offered in both English and Spanish, the Feeling Flu site allows consumers to answer questions about their symptoms and then provides a “personal action plan” based on evidence-based guidelines. Rick Leach, senior vice president of health solutions at A.D.A.M, says the company has created what he calls a “mini flu center” that is a derivative product from its main Web site that hospitals can use on their own Web sites.
A.D.A.M. also works with the Beryl Cos., a Bedford, Texas-based provider of outsourced call-center services. Beryl's H1N1 Risk Assessment offers consumers the opportunity to call and speak with trained medical advisers who can provide information about the virus and help them through a three-minute self-assessment that A.D.A.M. developed.
As helpful as these surveillance systems are in tracking flulike symptoms and treatment, none has the capability to predict how, if at all, the virus will change as the U.S. heads into what has traditionally been the busiest months of a typical flu season.
“I think it's too hard to predict,” Gallagher says. “I could say that having all of these alternative data sources will allow us very quickly to see if there is any change in direction.”
