COVID data failures create pressure for health care overhaul
Poor information-sharing between hospitals and public health agencies has hurt the response to the pandemic
After t errorists sl ammed a pl a ne i nt o t he Pentagon on 9/11, ambulances rushed scores of the injured to community hospitals, but only t hree of t he patients were taken to specialized trauma wards. The reason: The hospitals and ambulances had no real-time information-sharing system.
Nineteen years later, there is still no national data network that enables the health system to respond effectively to disasters and disease outbreaks. Many doctors and nurses must fill out paper forms on COVID19 cases and available beds and fax them to public health agencies, causing critical delays in care and hampering the effort to track and block the spread of the coronavirus.
“We need to be thinking long and hard about making improvements in the datareporting system so the response to the next epidemic is a little less painful,” said Dr. Dan Hanfling, a vice president at In-Q-Tel, a nonprofit that helps the federal government solve technology problems in health care and other areas. “And there will be another one.”
There are signs the COVID-19 pandemic has created momentum to modernize the nation's creaky, f r agmented public health data system, in which nearly 3,000 local, state and federal health departments set their own reporting rules and vary greatly in their ability to send and receive data electronically.
Sutter Health and UC Davis Health, along with nearly 30 other provider organizations around the country, recently launched a collaborative effort to speed and improve the sharing of clinical data on individual COVID cases with public health departments.
But even that platform, which contains information about patients' diagnoses and response to tre atments, doesn't yet include data on the availability of hospital beds, intensive care units or supplies needed for a seamless pandemic response.
The f e deral government spent nearly $40 billion over the past decade to equip hospitals and physicians' offices with electronic health record systems for improving treatment of individual patients. But no comparable effort has emerged to build an effective system for quickly moving information on infectious disease from providers to public health agencies.
In March, Congress approved $500 million over 10 years to modernize the public health data infrastructure. But the amount falls far short of what's needed to update data systems and train staff at local and state health departments, said Brian Dixon, director of public health informatics at the Regenstrief Institute in Indianapolis.
The congressional allocation is half the annual amount proposed under last year's bipartisan Saving Lives Through Better Data Act, which did not pass, and much less than the $4.5 billion Public Health Infrastructure Fund proposed last year by public health leaders.
“The data are moving slower than the disease,” said Janet Hamilton, executive director of the Council of State and Territorial Epidemiologists. “We need a way to get that information electronically and seamlessly to public health agencies so we can do investigations, quarantine people and i dentify hot spots and risk groups in real time, not two weeks later.”