What the Fax?
May 12, 2020
Politicians have turned their focus to restarting the economy, but doing so depends on public health workers stopping the spread of the coronavirus. And they are missing one critical tool: data.
Listen to the full episode below, read the transcript or scroll down for more information.
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The Problem: Outdated and Underfunded
The health care industry has spent billions in public and private dollars over the last decade to modernize its data infrastructure, but public health has been left behind. While most hospitals now have electronic health records, public health departments are still relying heavily on phones and faxes to fight the spread of the coronavirus.
A lack of rapid and reliable access to data has public health officials struggling to do the testing, tracing and surveillance work required to safely reopen our country.
The recent CARES Act did include $500 million to fix these flawed systems, but experts worry it is too little, too late.
The Evidence: Data Dysfunction
These data deficiencies were documented long before this pandemic. One study done a decade ago showed lab results sent to public health departments were missing demographic information at alarming rates. On average, patient phone number was included on just 40% of results and race on about 53%.
Current data are harder to come by in the midst of a pandemic, but some more recent reported statistics include:
²Data from select regions shared by the Council of State and Territorial Epidemiologists.
The Impact: The Disease and the Decisions
This problem is not new, but its impact is felt much more acutely during a public health crisis, when as epidemiologists like to say, “The data must move faster than the disease.”
Slow and unreliable data is hampering our coronavirus response in three key ways:
Possible Solutions: Policy, Tech and Funding
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Select Research and Reports on Public Health Data and COVID-19:
Data Interoperability and Exchange to Support COVID-19 Containment (Farzad Mostashari and Mark McClellan; Duke Margolis Center; May 2020)
Federal Health Advisory IT Committee (HITAC) Meeting on COVID-19 (April 15, 2020)
The Urgent Need for a 21st Century Data Superhighway (Council of State and Territorial Epidemiologists)
AMIA Electronic Case Reporting Presentation (April 28, 2020)
HIPAA and COVID-19 (HHS, 2020)
Janet Hamilton, MPH, Executive Director, Council of State and Territorial Epidemiologists
Richard Danila, PhD, Deputy Epidemiologist, Minnesota Department of Health
Katie O’Donnell, Public Information Officer, Larimer County Department of Health and Environment
Arien Malec, Senior Vice President, Change Healthcare; ONC Health IT Advisory Committee member
Julia Adler-Milstein, PhD, Professor of Medicine and Director of the Center for Clinical Informatics and Improvement Research, UCSF
The Tradeoffs theme song was composed by Ty Citerman, with additional music this episode from Sample Focus, Broke for Free, Unheard Music Concepts and Blue Dot Sessions.
This episode was reported and produced by Leslie Walker. It was mixed by Andrew Parrella.
Additional thanks to:
Ben Moscovitch, Zach Bernstein, John Kansky, Shaun Grannis, Mary Hill, Hector Gonzalez, Ganesh Persad, Allison Culpepper, Mariann Yeager, Debbie Condrey, John Loonsk, Melora Simon, Hong Truong, the Tradeoffs Advisory Board…
…and our stellar staff!