The effort to combat the COVID-19 pandemic in the United States has been hampered by poor communication across the nation’s public health agencies, healthcare systems, and the public itself. In June, the Trump Administration informed hospitals that they were now to report COVID-19 data to a newly created database overseen by the Department of Health and Human Services (HHS). However, on August 20, the Wall Street Journal erroneously published an article stating that the HHS had reversed course, a claim HHS subsequently denied. These mixed messages can have severe consequences on the integrity of the nation’s health data infrastructure as hospitals struggle to stay in compliance while combatting the pandemic.
Industry frustration prompts response
At the start of the pandemic, providers were asked to submit testing, capacity, and patient data to the CDC’s National Health and Safety Network (NHSN), the nation’s widely-used infection tracking system. However, in a June 10 memo to hospital administrators, the Trump administration announced that all capacity and utilization data relating to COVID-19 were to be submitted directly to the HHS through the privately contracted data company, TeleTracking® Technologies, Inc.
Hospitals scrambled to reconfigure their reporting systems and integrate them into their EHRs in order to comply with the new regulation. These changes included requirements to collect data on over twenty additional data elements and answer over one hundred new questions every day. Existing data systems had to be rewritten to include these elements in their queries, analytics, and data formats.
Many industry groups were dismayed at the decision. The American Medical Informatics Association (AMIA) released an open letter outlining their concerns, stating that the shift would “create data gaps, hindering efforts to recognize, understand, and evaluate important trends related to COVID-19”. These concerns may indeed be warranted. For example, in mid-August, TeleTracking® refused to provide details about its data collection and sharing process to Congress, which for many was a confirmation of existing fears about data transparency in the new system.
A call for clarity
The AMIA letter concluded, “Trust is based on widely shared core values of transparency, veracity, and accountability. If information is not complete, accurate, or open to review, the public health system is compromised and our ability to respond appropriately and rapidly is similarly damaged.”
The sudden switch from the NHSN to a new, un-tested system threatens both data integrity and privacy, and leads to delayed, incomplete or inaccurate data. Hospitals and EHR vendors have little time to digest sudden changes in policy. Going forward, policymakers must keep an open line of communication with the healthcare industry to ensure that providers have enough time to retool their information systems. In this rapidly evolving pandemic, we cannot afford any future lapses in data.