The recent decision to shift daily data reported by hospital administrators about their capacity and hospital beds occupied by COVID-19 patients from the Centers for Disease Control and Prevention (CDC) to the Department of Health and Human Services’ (HHS) TeleTracking system has sparked concerns among state officials who are on the pandemic’s frontline, and infectious disease and health care experts.
The change that shifts data reporting from CDC’s National Healthcare Safety Network (NHSN) – the most widely used hospital infection tracking system in the United States – affects data transparency and potentially its use. State and local health departments and health care systems have historically had immediate access to NHSN COVID-19 data for hospitals in their jurisdictions, which included bed occupancy, health care worker staffing, and personal protective equipment (PPE) supply status and availability. States have used this critical information to shape local responses and for planning.
The HHS TeleTracking data is designed to inform federal decisions, including allocation of supplies, treatment, and other resources. However, unlike the NHSN data, the TeleTracking data will not be publicly available.
The Administration raised general concerns about the existing system’s capacity to keep up with the needs of the pandemic when the data shift was announced. Some prior reporting was criticized for aggregating tests for active coronavirus with tests for recovered patients at the state level. Hospitals have also raised concerns about incomplete data and burdensome reporting. Despite these criticisms, experts question the decision to replace the system rather than improve it, citing the lack of a national strategy that continues to hinder efforts to use centralized information to identify areas of greatest need.
State and local health officials concur with the experts and have raised concerns that the change may worsen the response to the pandemic because a critical role of state health departments is aggregating data to identify challenges and recommending policy approaches and solutions. Creating a new system in the midst of a pandemic without involving affected state and local health officials is counter-productive, critics argue. They note that correcting the under-funding for data infrastructure at the federal, state, tribal, and territorial levels would go farther to support improvements.
According to state officials, including Massachusetts’ Gov. Charlie Baker, the lack of access to hospital testing, capacity and utilization, and patient flow data will hinder efforts to understand regional trends. Officials from Idaho’s Department of Health and Welfare raised concerns about the impact of the data-reporting change on the department’s information on the number of people in hospitals, in their intensive care units, and on ventilators.
Maine’s Center for Disease Control and Prevention officials noted their state will continue to collect and publicly report its COVID-19 metrics and will still be able to access data from other states, but raised concerns about new reporting burdens for Maine hospitals and shared concerns about the lack of state input into federal decisions.
The implications of the shift from an established routine, and its impact on relationships between states, the CDC, and hospitals, are not yet clear. According to one state official, “We were working with hospital partners and then all of a sudden a monkey wrench was thrown at them.”
As states battle to control the pandemic, access to quality data on hospital testing, capacity and utilization, and patient flows will continue to be critical to monitor local situations and identify greatest needs.