Hospitals are having a hard time reporting data to public health agencies, according to a new JAMIA study, which finds patchwork data sharing, "often occurring via fax or phone."
Hospitals may encounter administrative or logistical hurdles when reporting data to public health agencies – which, in turn, can hinder essential information tracking in times of infectious disease outbreaks.
In a study published in the Journal of the American Medical Informatics Association, Harvard Business School researchers used data from the 2018 American Hospital Association Annual Survey and IT supplement to examine the barriers hospitals faced when trying to meet meaningful use requirements.
One significant challenge, researchers found, was the ability of agencies to receive the data hospitals were mandated to send.
"More than four in 10 U.S. hospitals report that public health agencies are unable to receive electronic data," researchers wrote.
"This finding may reflect the fact that substantial federal funding has been devoted to hospital information technology adoption, including the ability to send data electronically, without a concomitant investment in the ability of public health agencies to receive and act upon this data."
WHY IT MATTERS
The Centers for Medicare and Medicaid Services requires hospitals to send data to city or state health departments. These requirements, researchers noted, were implemented in part to allow agencies to respond efficiently to epidemics and pandemics.
Still, they write, reporting gaps exist, and the novel coronavirus outbreak has made those inefficiencies clear.
"Despite billions of dollars in federal investment in digitizing the U.S. healthcare 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," researchers wrote.
"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," they continued.
Most of the 3,512 hospitals surveyed, the research team found, reported at least one barrier to sharing electronic data with health agencies, with public health agencies' capability being the most common hurdle. Interface-related issues, such as costs or complexity, were the next most common issues.
Other problems cited included challenges extracting the data from electronic health records, different vocabulary standards, hospital capacity and lack of information about which public health agency should receive the information.
"One state had no hospitals reporting public health agency inability to receive electronic data while several states had the majority of hospitals reporting that barrier," researchers explained.
"Differential funding levels priorities for public health agencies at the state and local level may explain some of this geographic variation," they continued.
Researchers also noted that some public health agencies may have only been able to receive data from certain EHR systems, which could explain the variation in answers even within the same state.
THE LARGER TREND
Researchers have noted the importance of data interoperability in containing the effects of COVID-19 around the country.
Earlier this month, a Duke-Margolis Center for Health Policy research team recommended better commercial lab reporting, improved access to clinical data and more reliance on the National Syndromic Surveillance program to manage the continued spread of COVID-19.
And although CMS has offered some flexibility for implementing interoperability requirements, experts say the crisis has only highlighted the need for efficient information sharing – including with patients.
"The COVID-19 pandemic gripping the nation underscores the importance of these regulations in enabling greater data exchange and providing patients with their information," said Ben Moscovitch, Pew's project director for health information technology, in April.
ON THE RECORD
"Many areas reporting barriers to public health receipt of electronic data are also projected to be overwhelmed by COVID-19 patients, indicating that it is not just low density or rural areas who lack critical IT infrastructure for electronic disease surveillance," said researchers in the JAMIA study.
"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," they continued.