Health IT groups say Trump administration's efforts to sidestep CDC hampers the COVID-19 response

Leading health IT groups are criticizing the Trump administration's move to abruptly change how hospitals report COVID-19 data, saying it jeopardizes public trust and hampers the industry's ability to respond to the pandemic.

July 10, the Trump administration directed (PDF) hospitals to sidestep the Centers for Disease Control and Prevention (CDC) and send critical information about COVID-19 hospitalizations and equipment to a different federal database set up by the Department of Health and Human Services (HHS).

The American Medical Informatics Association (AMIA) and the American College of Medical Informatics (ACMI) wrote an open letter claiming this shift in reporting will create data gaps, "hindering efforts to recognize, understand, and evaluate important trends related to COVID-19."

"As the number of Americans infected with the novel coronavirus edges closer to 100,000 per day, we must draw attention to a fundamental deficiency in our collective response to the outbreak of SARS-CoV-2: Policymakers at all levels of government—from local to state to federal—lack even the most basic up-to-date information to make informed decisions regarding our collective health," AMIA and ACMI wrote in the letter.

From the start of the pandemic, the CDC has collected data on COVID-19 hospitalizations, availability of intensive care beds and personal protective equipment (PPE). Hospitals must now report that information—including patient numbers, remdesivir inventory and bed and ventilator usage rates—to the new HHS Protect system.

Administration officials say replacing a data-collection system run by the CDC would streamline reporting and lead to more efficient distribution of therapeutics, testing supplies and protective gear.

HHS gave hospitals two days to comply and tied their cooperation to the distribution of remdesivir.

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There has been a public outcry among health experts, state health leaders and hospital officials warning that an abrupt change in how the Trump administration requires them to report coronavirus data will increase the burden on facilities already strained by the pandemic and could impede the distribution of critical medicines, The Washington Post reported.

The abrupt change also left many state officials and hospitals, especially smaller and rural ones, in the lurch, CNBC reported.

Hospital associations in Missouri and Kansas reported that HHS’ abrupt change in hospital data reporting leaves them unable to update their state COVID-19 dashboards which are used to guide statewide coronavirus planning.

Leading health IT groups are now adding their voices to the opposition, warning that the changes in data reporting will "worsen our ability to mitigate, suppress, and recover from our national public health emergency."

"Uncoordinated reporting of public health data severely hampers our ability to manage the COVID-19 pandemic nationally and locally," AMIA and ACMI wrote.

Those groups represent the professionals who methodically and deliberately design systems and use data, information and knowledge to advance health, including public health, they said.
AMIA and ACMI "strongly recommend" that the July 10 memo be rescinded, and hospitals continue reporting COVID-19 capacity and utilization data to the CDC through the National Health and Security Network (NHSN).

The CDC's portal is the nation’s most widely used healthcare-associated infection tracking system, serving more than 25,000 medical facilities, according to the groups.

While initial reporting efforts through NHSN were less than optimal and initially required manual data entry, efforts have been made since to automate the reporting of COVID-19 data, the groups wrote.

The groups voiced frustration that rather than fix problems with the existing system managed by the CDC, the Trump administration created a new system and now requires hospitals to collect and report daily more than 100 data elements about PPE, ICU beds, hospital admissions, emergency visits and potential therapeutic aids, such as remdesivir.

RELATED: Surescripts teams up with CDC, providers to accelerate COVID-19 case reporting

"The collection of these data is not the basic problem, but the decision to use a new, untested system rather the NHSN during a pandemic is highly problematic," the health IT groups wrote.

The use of this new system—outside the current public health infrastructure—creates burdens in collecting new and different data, invalidates existing tools for managing and reporting COVID-19 information, jeopardizes public trust and creates obstacles to transparency, fundamentally undercutting the objectives of public health, according to AMIA and ACMI.
The Trump administration is now requesting more than 20 additional data elements from hospitals without discussing the rationale, including how those data will be used, how those data will benefit participating hospitals or how other agencies with relevant responsibilities will have access to those data, AMIA and ACMI said.
The groups are calling on the Trump administration to invest in the CDC's NHSN, addressing its limitations, while leveraging existing and emerging data standards and health information systems.

"This will better position policymakers and public health officials to improve the health of all Americans for the long-term and to be better prepared for the next pandemic," the groups wrote.