Senators Urge Health Agencies to Utilize More Technologically Advanced Systems to Increase Accuracy and Efficiency in Tracking Coronavirus Infections and Potential Infectious Disease Outbreaks to Better Protect Communities
Washington, D.C. – Colorado U.S. Senator Michael Bennet joined a bipartisan group of senators in calling on the Department of Health and Human Services (HHS) and the Centers for Disease Control and Prevention (CDC) to improve, automate, and modernize Coronavirus Disease 2019 (COVID-19) data collection and management as communities across the country grapple with how to reopen as safely as possible. In a letter sent to HHS Secretary Alex Azar and CDC Director Dr. Robert Redfield, Bennet and the lawmakers specifically called on the agencies to harness technologically advanced systems and build on existing data sources in order to provide public health officials and community leaders with more accurate, real-time information as they make critical decisions about reopening.
Unfortunately, recent reports have shown that case reporting and contact tracing across the country are being hampered by a fragmented health system and antiquated technology, including manual entry of patients’ data and results and sharing of such results through paper and pencil or fax.
In their letter, Bennet and the senators wrote: “During an emergency such as the current pandemic, scaling up and using existing systems to the greatest extent possible can improve data collection and contact tracing efforts. We therefore ask that you and your colleagues utilize and build on existing data sources, such as electronic health record (EHR) and laboratory information management systems (LIMS), claims databases, and other automated systems to provide government leaders, public health officials, community leaders, and others with actionable, easy-to-interpret data from a wide-ranging set of sources. Data generated by contact tracing, syndromic surveillance, and large-scale testing can help inform decisions on how to safely reopen communities and bring economies back online. Modernizing and automating data collection should augment detection, testing, and contact tracing plans, while also helping to prevent and improve the management of new outbreaks.”
The bipartisan group of senators highlighted the fact that some of these tools are already being successfully utilized in communities across the country. They noted: “Fortunately, software-based systems providing data management for state public health entities and major testing laboratories already exist, and they are more efficient and accurate while reducing the burden of excess paperwork. For example, North Carolina and Florida have taken steps to modernize and improve patients’ Covid-19 test results and other infectious disease symptoms. In Florida, nurses can register patients for Covid testing in the field using tablet computers that are connected to a HIPAA compliant cloud. By managing the patient and order requisition information electronically, lab processing time is reduced and transcription errors are eliminated.”
Throughout this crisis, Bennet has called for Congress to better invest in the country’s public health infrastructure. Bennet joined a bipartisan letter to the CDC and HHS in April urging the agencies to build on existing reportable disease frameworks in order to better track coronavirus infections and improve contact tracing. By doing so, the health agencies could determine and log who has developed antibodies to the coronavirus and who may be immune. In April, Bennet announced legislation to establish a national Health Force, which would recruit, train, and employ hundreds of thousands of Americans to expand the public health workforce for COVID-19 response efforts and strengthen the country’s capacity to meet longer-term public health needs. In July, Bennet introduced the Timely and Effective Systematic Testing (TEST) Act to strengthen the nation’s health preparedness efforts for COVID-19 recovery and future pandemics by requiring a plan for diagnostic testing and public health system integration to better detect infectious diseases, prevent outbreaks, and avoid future economic shutdowns related to pandemics.
In addition to Bennet, the letter was signed by U.S. Senators Tom Carper (D-Del.), Bill Cassidy (R-La.), Richard Blumenthal (D-Conn.), Bob Casey (D-Pa.), Susan Collins (R-Maine), Chris Coons (D-Del.), Tina Smith (D-Minn.), Thom Tillis (R-N.C.), and Mark Warner (D-Va.).
The text of the letter is available HERE and below.
Dear Secretary Azar and Director Redfield:
While the Administration and states take important steps to reopen communities across the country as safely as possible, in part by increasing COVID-19 testing capacity, we ask that you also prioritize the real-time collection and distribution of infectious disease data across federal, state, and local governments. As demand for COVID-19 testing increases, healthcare workers and administrators are increasingly burdened with manual, antiquated, and often inaccurate data entry and management for patient health conditions, patient registration, sample collection, and testing operations. Thus, we urge that you work more closely with states, health care providers, and private sector stakeholders to modernize, automate, and streamline COVID-19 and other infectious disease and symptom data collection and management as quickly as possible.
An analysis in Health Affairs suggests lab reporting networks will have to scale up electronic reporting at least three-fold to capture the millions of COVID-19 tests per week as recommended by epidemiologists. To meet this demand, data collection and management platforms must be simple and efficient to use while minimizing errors. However, as many facilities continue to resort to hand-written labeling and recordkeeping, manual data entry can lead to serious concerns such as transcription errors, compliance risks, and delayed turnaround. For example, a 2019 study on point-of-care results found clinically significant errors in 3.7 percent of manual data entries, of which 14.2 percent included potentially dangerous transcription errors. Manually entered result flags deviated from the laboratory information management system (LIMS) in 73.9 percent of tested pairs, underlining the importance of automated tools.
Fortunately, software-based systems providing data management for state public health entities and major testing laboratories already exist, and they are more efficient and accurate while reducing the burden of excess paperwork. For example, North Carolina and Florida have taken steps to modernize and improve patients’ COVID-19 test results and other infectious disease symptoms. In Florida, nurses can register patients for COVID-19 testing in the field using tablet computers that are connected to a HIPAA compliant cloud. By managing the patient and order requisition information electronically, lab processing time is reduced and transcription errors are eliminated.
Automating the tedious task of data entry and management improves health care facility workflow and frees up providers to focus on patients. In addition, new software and technology systems are helping to improve data collection and patient engagement. Therefore, we urge CDC to move forward with the deployment of coordinated, interoperable real-time, nationwide public health surveillance systems. Ideally, these systems would be searchable at a zip code level as well as by symptoms and co-morbidities.
During an emergency such as the current pandemic, scaling up and using existing systems to the greatest extent possible can improve data collection and contact tracing efforts. We therefore ask that you and your colleagues utilize and build on existing data sources, such as EHR and LIMS systems, claims databases, and other automated systems to provide government leaders, public health officials, community leaders, and others with actionable, easy-to-interpret data from a wide-ranging set of sources. Data generated by contact tracing, syndromic surveillance, and large-scale testing can help inform decisions on how to safely reopen communities and bring economies back online. Modernizing and automating data collection should augment detection, testing, and contact tracing plans, while also helping to prevent and improve the management of new outbreaks. We look forward to discussing strategies to improve COVID-19 data collection and disease management with you.
Lastly, it is important to work to improve the quality of data collected to include race, age, gender and location. Higher data quality would allow for improved tracking of disease progression and better data collection on more vulnerable populations, such as those living in dense populations, older populations, and gender or other distinct population groups.
Sincerely,