Are public-health data systems up to the coronavirus challenge?
- By Derek B. Johnson
- Mar 11, 2020
A more modern public-health data system would have improved detection and tracking of the coronavirus as it spread across the country, health officials said.
Officials from the Centers for Disease Control and Prevention told members of a House appropriations subcommittee on March 10 that updating the agency's core data reporting, analysis and surveillance capabilities to better track emerging health threats is one of their highest budget priorities.
Current efforts include modernizing current software systems and tools, increasing interoperability with stakeholder systems, coordinating IT investments and expanding public and private partnerships to monitor the spread of viruses and other health issues. Another initiative flags needed enhancements to the National Notifiable Diseases Surveillance System to improve data collection, sharing and analysis across the public-health sector, as well as acceleration of electronic laboratory reporting.
The Labor, Health and Human Services, Education, and Related Agencies Subcommittee Chair Rep. Rosa DeLauro (D-Conn.) said the testimony on the coronavirus outbreak "further confirms the need for modernizing our public-health data system" and asked how CDC's response might have been different if those improvements had already taken place.
"One is that we would have detected it much, much sooner and been able to contain it further and more effectively," said Dr. Ileana Arias, associate deputy director for public health science and surveillance at CDC.
Currently, Arias said there is a "delay in finding out what is happening and who it is happening to," citing "unfortunate barriers that the current systems have with getting that information from health-care providers, from states, that we can use to engage in that response earlier."
Volume is an issue too, with Arias estimating that CDC's public-health data systems are only capable of handling about 75% of the data coming in from the states, localities and private labs that conduct much of the testing. That percentage will only go down in the coming years if requested updates aren't funded and implemented, she said.
The lack of up-to-date information makes it difficult to facilitate a real-time response and predict trends.
“I want predictive analysis to be the name of the game, not just for CDC but for the entire public-health structure of this country," CDC Director Robert Redfield told the panel.
Redfield also cited the need to upgrade the center's laboratories spread out across the country and bolster the public-health workforce inside and outside of the federal government, noting that CDC "has leveraged every one of these capabilities so far in response to the COVID-19 outbreak."
The modernization initiative is expected to take place over multiple years and budget cycles, leaving little likelihood that they will be complete or functional in time to target COVID-19.
Arias said CDC is finalizing such a plan now.
The CDC's latest budget request calls for $30 million to fund the public-health data modernization in 2021. That money would support efforts to help state and local health departments move their data capacities toward "the desired future state," improving CDC's own internal capacities to support advanced tools and capabilities, carry out strategic hospital and workforce development activities that enhance data science and informatics capabilities and engage with other public-health organizations.
IT problems of a different nature interrupted the Department of Health and Human Services’ coronavirus response funding planning, according to a March 10 report by Politico.
On Feb. 23, the Centers for Medicare and Medicaid Services conducted an email test, sending thousands of messages through the HHS email servers and crashing the system -- without having alerted agency leaders or the CIO. The outage in the secretary’s office lasted much of the day, and some emails were delayed up to 11 hours.
In response, HHS has removed the agency’s control over its own email operations and will audit its entire IT infrastructure.
This article was first posted to FCW, a sibling site to GCN.
Derek B. Johnson is a former senior staff writer at FCW.