Sunday, February 12, 2023

In 2006, Congress ordered HHS to integrate health-data systems; it still hasn't been done, and that causes problems

Photo by Irwan, Unsplash
"The pandemic highlighted ineffective data infrastructure across the U.S. health system," reports Sam Whitehead of Kaiser Health News. "Coronavirus case reports sent by fax machine. Clunky tech for monitoring vaccine distribution. . . . Supply chain breakdowns that left health-care providers without needed protective equipment. . . . And Congress knew about the potential for these problems long before Covid. Lawmakers mandated the Department of Health and Human Services to better integrate U.S. data management systems to allow stakeholders to better share information years ago, in 2006."

Whitehead starts with a real-life example: "In early 2020, as they tried to fight covid-19 across two rural counties in North Carolina, the staff of Granville Vance Public Health was stymied, relying on outdated technology to track a fast-moving pandemic." They had to use "five data systems. One was decades old and complicated. Another was made of Excel spreadsheets. None worked well together or with systems at other levels of government."

Whitehead gives several reasons the data system wasn't improved: the complexity of the task and inadequate funding; a federal-first approach to health that deprives state and local agencies of resources; unclear ownership of the project in HHS; insufficient enforcement mechanisms to hold federal officials accountable; and little agreement on what data is even needed in an emergency."

Soumi Saha, senior vice president of government affairs at Premier, a health-technology company, told Whitehead, “What keeps me up at night is that we forget about the past two and a half years, and we just move on — that we don’t take the opportunity and time to truly reflect and make needed changes.”

Whitehead reports: "Different hospitals often use different electronic health-record systems, so are frequently unable to share patient data with one another, much less with the federal government. . . . Much of the 2019 bill mandating the data-sharing network’s creation is set to expire in September, and reauthorizing the law could be a challenge in a split Congress where House Republicans have announced their intention to examine the U.S. response to the pandemic."

Dr. Georges Benjamin, executive director of the American Public Health Association, told Whitehead, “Congress has an opportunity now to build the public health system. What are they doing? Undermining public health legal authorities, demonizing public health officials. It’s almost like we didn’t learn anything.”

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