Measuring public health communication effectiveness with real time data from electronic health records

Cloud-based health information technologies are an accurate, efficient, and rich data source for monitoring local, national and seasonal health trends.  More specifically, modern electronic health records (EHR) provide public health officials and researchers a timely view of local and national healthcare trends, including the effectiveness of public communications campaigns. We used daily EHR data to assess the impact of a December 3, 2014 CDC advisory, advising healthcare providers to prescribe antivirals for the treatment and prevention of influenza.

An automated extract of daily data from an EHR was developed to produce provider specific counts of office visits, influenza related diagnoses (using ICD-9 codes), antiviral prescriptions and vaccinations (CPT codes). This data is based on office visits that, in 2014, represented approximately 12,000 primary care providers across the United States, with approximately 700,000 visits per week.

For each day in the 2012-2013, 2013-2014 and 2014-2015 influenza seasons, we calculated rates of influenza-like illness (ILI) and antiviral prescriptions. Antiviral prescription rates did not increase after the December 3, 2014 CDC advisory, beyond seasonal increases in prescription rates that are positively correlated with ILI rates.  We did find a linear-log relationship between antiviral prescription rates and ILI rates.  We also found that antiviral prescription rates increased between the 2012-2013 and 2013-2014, and remained higher for the 2014-2015 season, compared to the 2012-2013 season.