Boston Children’s Hospital is Creating a Strep Throat App

The new program could reduce unnecessary doctor’s visits.

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How many times have you had a sore throat, had to take the day off work to go to the doctor, only to find out it’s just a cold? This scenario is all too familiar. But we are in the midst of an overprescribed antibiotic epidemic, and Boston Children’s Hospital is working on an app that could save you a trip to the doctor, and save you from taking unnecessary meds.

A new risk measure tool called “home score” is a program for people with symptoms of strep throat to take at home before they head to the doctor.

Dr. Andrew Fine and Dr. Kenneth Mandl of Boston Children’s Hospital combined patients’ symptoms and demographic information with data on local strep throat activity to estimate strep risk. The “home score” represents the first health care tool to bring patient-contributed data and public health “big data” together to assess an individual’s risk for a communicable disease. Their work was published in a new paper in the Annals of Internal Medicine

The score is calculated using a patient’s symptoms (like the presence or absence of fever and/or cough) and age. It also incorporates a statistic developed by Mandl and Fine, which captures the recent strep incidence in the patient’s geographic area. If a patient’s home score is low, then his or her risk of having an active strep infection is also low and a doctor’s visit may not be warranted.

“Because sore throat is so common, reducing these visits could alleviate strain on the health system, while saving significant opportunity costs for patients,” Fine says. The home score could allow someone with a sore throat to learn whether they should consider getting a strep test without leaving home. “Using the home score could empower patients to make informed decisions about their medical care by contributing information about their symptoms,” he says. “Integrating local epidemiological context with the symptom information permits calculation of a personal, local risk of strep throat.”

The home score was developed using aggregated patient visit data provided by MinuteClinic, CVS Caremark’s retail health clinic business. Researchers looked at 71,776 patients aged 15 years or older with sore throat who visited a clinic from September 2006 to December 2008. “The basic math here is that if group A strep is present in patients around you then you are more likely to have strep,” Mandl explains. “The local epidemiology is so informative that when combined with just a few additional facts from an individual we can arrive at a reasonable initial diagnosis, without a health care visit.”

If the new technology is developed and widely adopted, Boston Children’s Hospital estimates that 230,000 doctor visits could be avoided each year.

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