It’s been a bad year for the flu. The Centers for Disease Control and Prevention (CDC) just announced that flu-related hospitalization rates are exceeding milestones set during the 2014-2015 season. If trends continue, analysts are predicting 36 million flu cases this season, including 700,000 hospitalizations and at least 56,000 flu-related deaths.

These numbers emphasize what patients are increasingly aware of – influenza virus is no small issue when it comes to public health. With a bad flu year, we’ve also seen more discussions about how digital and mobile technologies might help. From telemedicine to smart thermometers, digital and mobile health have a role to play in influenza treatment and prevention.

A problem waiting for solutions

CES 2018 was a good reminder that the current pace of digital health innovation is truly remarkable. From tiny wearable sensors to digital cancer therapies, technology is producing some amazing solutions for healthcare.

But as Chilmark Research’s Brian Eastwood recently wrote, sometimes it feels like these technology solutions are still waiting for the right problem. I mean, smart shoes are cool and everything, but they aren’t solving our most pressing healthcare challenges.

While CES 2018 gave the healthcare industry solutions in search of real problems,” Eastwood writes, “headlines proclaiming that this year’s bad flu season is poised to get worse present a real problem that could benefit from a variety of tech-enabled solutions.” Technology companies need to focus solution development on specific problems that add value to healthcare. Flu prevention and treatment, it turns out, offers just such a problem that could benefit immensely from digital health.

Flu-related digital health applications already exist, but this promising confluence is still seen as emerging. As John Brownsein, chief innovation officer at Boston’s Children’s Hospital, told MobiHealthNews, “There’s many parts of the patient’s journey where digital tools can play a big role in terms of the flu epidemic.”

Digital tools for patients

When confronted with flu-like symptoms, more patients are turning to digital tools like telemedicine. Leading companies like American Well and Teladoc have seen a spike in flu-related calls this season. According to Dr. Sylvia Romm, medical director at American Well, “Just over the past month we have seen an increase of 300 percent for flu-related calls on American Well’s platform.”

Teladoc vice president of health services Dr. Jason Tibbels attributes this increase to a bad flu season. But he also notes a growing acceptance of telemedicine as a legitimate way to receive care. “Largely, people are engaging more, and seem to be more comfortable engaging a virtual health encounter to address influenza,” Tibbels says.

“Just over the past month we have seen an increase of 300 percent for flu-related calls on American Well’s platform.”

Digital health tools beyond telemedicine also play a role in flu treatment and response. The most notable example is the Kinsa Smart Thermometer, which uses temperature readings to offer personalized guidance on how to soothe symptoms and when to call the doc. The company collects aggregated, de-identified data every time a user takes their temperature or self-reports symptoms to the app.

Kinsa’s thermometer has emerged as one of the most promising tools for tracking influenza. After developing the product over two and a half flu seasons, the company’s data now rivals the CDC at tracking flu trends.

As Kinsa CEO Inder Singh puts it, the difference is that Kinsa is getting their data in real time. “So we’re getting ours in realtime much earlier than any other data set, except perhaps social media, and certainly it’s more accurate than social media because it’s real illness data,” Sign explains. “It’s not a proxy from searches or conversations, it’s direct data.”

Data collection

Kinsa and other digital health technologies offer a wealth of timely data on epidemics that could help guide flu response strategies.

Efforts to use internet search data as proxies have been around for a while, but with mixed results. The most notable example is Google Flu Trends, which launched in 2008 but shutdown in 2015 when it proved inconsistent. Epidemico is a similar, ongoing project that collects data from social media and other sources to model public health trends.

The challenge with these broad, non-specific approaches is that you never know why someone was searching for a particular flu-related term. These data sets are also missing key demographic information about the person typing in the query.

“Why aren’t we just engaging people more directly to be part of flu surveillance more broadly? Why not put the public back in public health, make them an active participant?”

These limitations have led to alternative approaches to using digital health for flu tracking. Flu Near You is a disease surveillance project that attempts to engage people more directly in flu tracking. As John Brownstein, chief innovation officer at Boston Children’s Hospital, told MobiHealthNews, “Why aren’t we just engaging people more directly to be part of flu surveillance more broadly? Why not put the public back in public health, make them an active participant?”

Flu Near You does just that. Through a web or mobile app, users are pinged each week to take a quick survey disclosing their symptoms. This data is translated into an active disease map and other resources that Brownstein’s team shares with the CDC.

Directly engaging users in this way has multiple benefits. While the resulting dataset is necessarily much smaller than aggregated Google searchers, it is much more accurate. Further, engaging thousands of users promotes public flu education and vaccine awareness.

“Contribute to your community’s health and help track the flu,” read’s Flu Near You’s tagline. While this mass public education approach isn’t easy, it has a role to play. As the initiative’s website puts it, “We believe that letting individuals report symptoms in real-time can complement traditional tracking while providing useful information directly to the public.”

Online and mobile participatory surveillance approaches aren’t new (Flu Near You started in 2011), but their use is still limited. It may be years before the full potential of these and other digital health tools are brought to bear on the influenza virus. As John Brownstein summarizes, “To be perfectly honest, I still think these tools are in the hands of smaller numbers of people, whether it’s digital thermometers or crowdsourcing tools or symptom checkers. I still think it’s early.”

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