Patient Data Exchange Barriers Impact COVID-19 Reporting

Patient Data Exchange Barriers Impact COVID-19 Reporting

Over 40 percent of hospitals reported that public health agencies are unable to effectively receive patient data, which impacts the way COVID-19 is reported and treated, according to a study published in the Journal of Informatics in Health and Biomedicine.


Interoperability and patient data exchange is crucial to minimizing the spread of the coronavirus.


Researchers need to know how many individuals tested positive for coronavirus, demographic data from those individuals, the number of individuals who are seen at health facilities, how many were hospitalized, and the length of the hospital stay.


On the behalf of Vice President Mike Pence, the Centers for Medicare & Medicaid Services (CMS), requested hospitals report coronavirus testing data directly to the US Department of Health and Human Services (HHS).


Since private and commercial laboratories already report their findings, Pence asked all hospitals that are performing “in-house” or onsite testing to report testing data to HHS each day.


However, because data reporting is not always thorough, the collected information is not entirely accurate.


“These gaps have come into sharp relief during the COVID-19 outbreak,” wrote the study authors. “Despite billions of dollars in federal investment in digitizing the US health care system, aggregating information such as test results and potential cases was done in a patchwork way, with data sharing often occurring via fax or phone.”


“Had electronic data sharing been in place, hospitals could have quickly transmitted COVD-19 testing results and syndromic surveillance data to public health agencies to supplement their testing and provide greater clarity on disease prevalence and incidence.”


Researchers from Harvard Business School, University of San Francisco Department of Medicine, and Indiana University’s Richard M. Fairbanks School of Public Health dissected 2018 American Hospital Association data. They utilized this data to find the most common barriers that hospitals face when it comes to patient data reporting.


Next, they compared it to current COVID-19 projections on total COVID-19 infections, infections causing hospitalization, and hospital bed capacity at the hospital referral region (HRR) level.


Through those two data sets, researchers found that 41.2 percent of hospitals said public health agencies were unable to electronically receive data. Next, 31.9 percent of hospitals reported interface issues, such as costs and complexity. Other barriers included the inability to extract EHR data, separate data standards, and the inability to send data.


Researchers also noted more than 50 percent of larger hospitals with needed bed capacity were unable to receive data electronically.


“Since public health agencies are generally located at the state or county level, there is likely significant variation across agencies in capacity to electronically receive and aggregate data from hospitals in their locale,” the study authors noted. “Additionally, given the large jurisdictions many public health agencies serve, hospitals within the same jurisdiction are likely to vary in their capacity to report this data electronically.”


“As a result, the agency is charged with adopting and maintaining multiple routes of data submission, to cater to varying hospital abilities. Little is known regarding how well the process of hospital reporting to public health agencies functions or what the barriers to reporting are.”


Separate data from a 2016 found that 79 percent of public health agencies have electronic disease reporting systems and larger hospitals have greater rates of adoption. While these hospitals have the infrastructure to exchange data, it does not always mean it can be executed. The COVID-19 pandemic has brought this point to bear


“COVID-19 has shown that lack of data can hinder pandemic management efforts,” concluded the authors. “Test results and syndromic data should flow seamlessly from hospitals to public health agencies. Policymakers should prioritize investment in public health IT infrastructure along with broader health system information technology for both long-term COVID-19 monitoring as well as future pandemic preparedness.”




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