With thousands of lives and trillions of dollars at stake and economies reeling from the global pandemic, the U.S. government agency most responsible for decisions to guide the response has been using faxes and phones to collect vital data from front-line workers, then entering the information manually—leading to delays and mistakes.
This is inexcusable and intolerable, veteran health policy experts Doug Badger and Joel White write in Why is the CDC fighting today’s coronavirus with yesterday’s technology?
Recognizing the huge data collection problem at the Centers for Disease Control (CDC), the Department of Health and Human Services in July launched an on-line reporting system—which must have been a lot like assembling an airplane mid-flight—to collect more and better data quickly and efficiently.
HHS took action because of the CDC’s long-standing failure to modernize its data systems. But even this much-needed upgrade created a brouhaha of its own by entities resisting the change.
“Things must change, and quickly, to improve our understanding of the pandemic and prepare us for future crises,” Badger and White write.
“[I]t is essential to collect timely information on hospitalizations and mortality, the age and comorbidities of patients, and total net active cases. It is scandalous that this data is not uniformly defined and reported.”
Data collection and exchange are vital to mounting a timely and effective response to the global pandemic, but the CDC is and has been shockingly deficient in responding to repeated demands to modernize its antiquated methods.
Data is reported by phone or fax through more than 100 uncoordinated reporting systems. And even then, the data reported is not what is most needed.
The CDC system requires medical professionals, exhausted by the demands of providing actual care, “to re-enter data by hand when they report to public health agencies,” even though virtually all hospitals and the great majority of physician offices have electronic systems they already are using to file insurance claims.
We should all be outraged. The CDC was established 76 years ago. “Yet its COVID-19 data pales in comparison to what’s available on websites that didn’t even exist a few months ago,” Badger and White write. “One of these, The Atlantic’s COVID Tracking Project, was launched in March—the same month Congress gave the CDC $1 billion to collect the same data.
“Multiple Congresses and administrations have tried to drag the CDC into the 21st century, to no avail. Since 2006, the CDC has ignored four separate laws requiring it to build a modern, efficient system for collecting information to combat disease.” The agency ignored warnings from the Government Accountability Office about the dangers of its inaction.
“Compounding the problem is the fact that CDC reporting is usually a one-way street: Health care workers report to public health officials but get little information back. The result: Clinical knowledge, patient data and best practices for treating COVID-19 aren’t being shared in real time for hospitals and policymakers to use. That is costing lives, as well as trillions of dollars.”
Badger and White write the information the CDC collects should be shared in real time with front-line professions to inform public health decision-making and clinical care.
And the data transmitted to the federal government should, of course, protect privacy and be de-identified. The government must use the latest information technologies to collect and protect the data—and, more importantly, save the thousands of lives that could be spared by better clinical decisions based upon faster access to more accurate information from the front lines.
Data are reported by phone or fax through more than 100 uncoordinated reporting systems. And even then, the data reported is not what is most needed.