How the past informs the present: Lessons learned from prior outbreaks

When the medical community encountered the Zika virus outbreak in 2015, IMO was ready to help with new terminology to document the disease. We learned some lessons in that situation – ones that are helping guide our response to the current novel coronavirus pandemic. IMO VP of Global Clinical Services, Steven Rube, MD, explains our past and current responses to these crises, and talks about how what we learned in 2015 is informing our efforts now.
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COVID-19-Zika

What did IMO do in response to the 2015 Zika virus outbreak and why was this important? 

In responding to the Zika virus, we made sure that providers who were treating Zika had the appropriate language and terms within their electronic health records (EHRs) to document that care. Having the language to describe a clinical situation appropriately and accurately is really important. It means that whatever terms are needed to describe a patient’s condition, like Zika virus, are already at the doctor’s fingertips when they’re actually seeing the patientFor Zika, IMO created these terms and made them available well before any of the standard code sets were able to do that. We also created functionality to do some grouping together of different kinds of Zika patients within that release. 

What are we doing to respond to the current COVID-19 outbreak? 

Like we did with Zika, we’re making sure the appropriate terms needed to document COVID-19 cases are available to the medical community. Especially with something like coronavirus, where the situation is changing rapidly and we get new information every day, having a robust vocabulary means that you can talk about patients accurately in their charts, which is really important for that patient’s care and for tracking and follow-up.  

We also created IMO Precision COVID-19 Sets, part of our of value set solution, so that health systems can easily identify and manage groups of patients who have been exposed to the coronavirus, are suspected of having the disease, and groups who already have itWe released it free of charge. This goes a long way toward accurate documentation and tracking for public health purposes, which is critical in a pandemic. We are also continually evaluating the need for additional terms and new IMO Precision Sets that we can make available quickly. 

How are these responses similar and different? 

They’re similar in that in both cases, IMO realized there was a critical need to get proper terms and language out to the medical community quickly, so that health systems weren’t missing any patients with these diagnoses due to a lack of correct terminology.  

Our response to the coronavirus outbreak is different primarily because COVID-19 is a different situation than Zika was. Not everyone turned their attention to Zika like they are doing with COVID-19. Zika didn’t reach pandemic level, so as a company we were still able to do business as usual and focus on other things, and frankly, so were our customersWith our coronavirus response we moved much more quickly and dedicated more resources to the response, primarily because it’s what the situation required. 

What did IMO learn during the Zika response that’s helped us coordinate our COVID-19 response? 

After Zika, we learned that we needed to be more organized with our approach and response to something like a new disease. Responding to the novel coronavirus pandemic has been an all-hands-on-deck situation, which makes different demands of our team. Critically, we learned that being more organized means being much more proactive. With Zika, we were more passive. We released terms and those who needed them downloaded them. The takeaway was that creating the content and adding the content to our products isn’t really that effective if people don’t know how to get it. With COVID, we have a directed approach where we’re actively communicating with our customers and partners, deploying our marketing team for help, and making sure people know how to get the terms and updatesFrom Zika, we learned that having this plan was super important. We learned that we needed to go beyond just creating the language, we needed to reach out and let the community know what we were doing, and we needed to follow up and make things easy.  

Are there any new challenges that the COVID-19 pandemic brings to IMO’s teams and our ability to help? What are they? 

Clearly, the quarantine and shelter-in-place orders not just for our company, but for most people in the country, makes this much different. It’s a huge challenge to pull off what we need to do and to do it without being able to interact with our teams and channel partners like we normally do. On the flip side, since everyone is working under the same restrictions we are, everyone’s working on solving that problem 

With the coronavirus pandemic, we realized early on that this was a very serious situation, and that we needed to get stuff out there. It probably helped that we had responded to the Zika situation before, so we not only had some practice, but we knew what to look for in the global medical community. Since this is a pandemic, we’re also changing how we release the content. Typically, international content lags behind domestic releases a little bit, because there are different regulatory hurdles we have to consider. For COVID-19though, we’re releasing everything to our clients in the US and abroad at the same time, which is new but important since there are no borders in this pandemic. We’re doing it all at once – looking at the whole ecosystem, not just the US. 

Another big difference in our response now is that when Zika hit, we hadn’t yet created our IMO Precision Sets interface, which meant we couldn’t provide users with a cohort tool to help manage population health. When the COVID-19 outbreak struck, we had designed and created several IMO Precision Sets for other uses, and we realized pretty quickly that it would be a very helpful tool during the pandemic. So, with that, we worked to create not only terminology solutions for coronavirus, but also IMO Precision COVID-19 Sets – basically any way we could take our existing offerings and use them to help, we did. We just happen to have more offerings that could be deployed now. But the IMO Precision Sets, to me, those are a major difference in this response.  

In his role as Senior Vice President of Global Clinical Services at IMO, Dr. Rube leads a team of clinicians and non-clinicians designed to take a proactive approach to customer service and sales. Prior to joining IMO, Dr. Rube practiced family medicine for 15 years. He also served as the Chief Medical Information Officer (CMIO) at a large urban hospital in Chicago, as well as the Chief Medical Officer of an electronic health records company.  Dr. Rube is board certified in Clinical Informatics and is a Fellow of The American Medical Informatics Association. 
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