Researchers at the Centers for Disease Control and Prevention will continue to have access to COVID-19 patient information, according to agency officials—despite the Trump administration ordering hospitals to bypass the public health agency and start sending data directly to HHS.
"We have not changed the data ecosystem," CDC Director Dr. Robert Redfield said on a call with reporters Wednesday. "We merely streamlined data collection mechanisms for hospitals on the front-lines."
The White House Coronavirus Task Force uses data collected from hospitals to inform decisions including where to allocate COVID-19 supplies and treatments, according to HHS.
News broke Tuesday that HHS, rather than the CDC, would begin collecting daily data reports from hospitals, including the number of hospitalized patients with suspected or confirmed COVID-19, available beds and ventilators, and COVID-19 patient deaths, among other information, raising concerns that public health researchers and agencies could lose access to the data.
Redfield on Wednesday said the CDC, as well as state and local health departments, will continue to have access to raw data through a centralized database called HHS Protect.
"No one is taking access or data away from CDC," he said. "This access is the same today as it was yesterday."
About 1,000 CDC experts currently have access to data in HHS Protect, he added.
Jose Arrieta, chief information officer at HHS, on the call said the department is "exploring" the best way to make data from HHS Protect available to the public, in addition to public health entities.
"It's not the way to do things," Dr. Georges Benjamin, executive director of the American Public Health Association, told Modern Healthcare. "Why didn't they strengthen the nation's infrastructure using the CDC backbone?"
Arrieta said a primary goal of the policy change was to reduce the reporting burden for hospitals, without requiring them to implement new technology. In its guidance, HHS noted separate governmental agencies had been requesting similar data, leading hospitals to have to submit multiple reports with the same data to different organizations.
"We're actually meeting hospitals technologically where they are from a reporting perspective," Arrieta said.
Hospitals as of Wednesday will submit daily data reports to HHS Protect, which was created in April to consolidate COVID-19 data from hospitals, states and other public and private sources. Hospitals can bypass this process if they've received written assurance from their state that the state plans to take over federal reporting responsibilities.
HHS Protect integrates information from 225 separate data sets, Arrieta said.
Previously, hospitals and states reported COVID-19 data to the CDC's National Healthcare Safety Network, a tracking system for healthcare-associated infection. From there, the data would be shared with HHS Protect.
"CDC has agreed to remove the (NHSN) from the collection process in order to streamline reporting," Redfield said.
The change "reduces the reporting burden, reduces the confusion and duplication of reporting, (and) streamlines reporting," he added.
But even if the new reporting process proves more efficient, hospitals will have to grapple with making the change amid a pandemic.
Dr. Grace Lee, a pediatric infectious disease specialist and associate chief medical officer for practice innovation at Stanford Children's Health, expressed skepticism that quickly rolling out a new process for data reporting would create efficiencies. She said hospitals are familiar with the NHSN, having used it for years before the COVID-19 outbreak.
"The National Healthcare Safety Network is a decades-old surveillance system that really has been critical to public health," Lee told Modern Healthcare. "You're asking people to change—in the middle of the COVID pandemic—how they're reporting that data. And, the request is to report into a new system that has never been used in this way before. I anticipate there will be challenges."
Before the policy change, Stanford Children's Health had reported its COVID-19 data to the California Department of Public Health, which subsequently reported to NHSN. Stanford Children's Health now is reporting to the California Department of Public Health and directly to HHS while they figure out the new process.
"Leveraging CDC's NHSN, to me, makes a lot more sense than asking all the hospitals to switch the way they're reporting," Lee said.
Carmela Coyle, president and CEO of the California Hospital Association, in a statement noted hospitals were given short notice to adjust to the new reporting process.
"While hospitals were given very little notice about the new reporting process and additional measures now being requested by the federal government, they are quickly making adjustments to their internal systems to meet the new U.S. Department of Health and Human Services requirements," she wrote. "Moving forward, hospitals encourage improved coordination between all governmental agencies at the local, state and federal levels in order to minimize administrative burdens and maximize transparency and accessibility of this important data."
With NHSN, hospitals had the option to review data they submitted to the system and benchmark themselves against other organizations, Lee said. It's unclear whether HHS Protect will provide that capability.
In a special bulletin, the American Hospital Association urged its members to "report the data to HHS as requested. HHS stressed in the announcement the importance of reporting the requested data on a daily basis to inform the administration's ongoing response to the pandemic, including the allocation of supplies, treatments and other resources."
Arrieta on Wednesday said HHS Protect, the new database, is "powered by eight different commercial technologies."
The HHS Protect webpage directs to a log-in page from Palantir Technologies, a Palo Alto, Calif.-based big data analytics company.
Hospitals and states submit COVID-19 data reports through a system managed by TeleTracking Technologies, a Pittsburgh-based health data company best known for its patient flow software. With the TeleTracking system, HHS officials will be able to update the type of data hospitals and states are prompted to submit more quickly and as information about COVID-19 emerges.
HHS more rapidly updating the data elements hospitals are expected to submit is the biggest change hospitals will experience from this shift in reporting requirements, according to Arrieta.
"We will be asking hospitals to report that data," he said.
