Chikungunya virus disease (CHIK) is a mosquito-borne viral infection currently widespread in the Caribbean with the potential for emergence and endemicity in the U.S. via infected travelers and local mosquito vectors. CHIK disease can be severe and disabling with symptoms similar to dengue. CHIK is not a U.S. nationally notifiable disease and tracking travel-associated and locally acquired cases is currently dependent on voluntary reporting via ArboNET. While ArboNET cases are laboratory confirmed and highly specific, ArboNET is a passive surveillance system where representativeness and timeliness may be lacking. In contrast, submitting an electronic bill following HC services is the most mature and widely used form of eHealth. Providers are highly motivated to submit claims for reimbursement and the eHRC process is ubiquitous in the U.S. HC system. HIPAA-compliant eHRCs from provider offices can be captured in e-commerce and consolidated into electronic data warehouses and used for many purposes including public health surveillance. eHRCs are standardized and each claim contains pertinent person, place, and time information as well as ICD-9 diagnostic codes. IMS Health (IMS) is a global HC information company and maintains one of world’s largest eHealth data warehouses that processes ~1 billion provider office eHRCs annually. IMS consolidates eHRCs from >60% of all U.S. office-based providers from all parts of the U.S. The size and predictability of the eHRC flow into the IMS data warehouse supports projections of national estimates and time trends of conditions of interest.
Objective
This paper describes how high-volume electronic healthcare (HC) reimbursement claims (eHRCs) from providers’ offices can be used to supplement Chikungunya surveillance in the U.S.