“It’s $ 500 versus literally $ 5,000,” said Bob Kocher, a partner at venture capital firm Venrock, which has been helping California manage its coronavirus testing effort.
In the early 2010s, the federal government spent billions to encourage doctors to replace fax machines with electronic records. That program, known as the HITECH Act, did not include similar funds for public health departments to help them automatically digitize faxes and other non-standard results. Nor did it require hospitals and doctors’ offices to build technology that automatically sends relevant test results to local health officials.
Public health departments, whose budgets have been cut in the past decade, were unable to fund digital updates on their own.
“The best way I can describe it is by imagining you are on the information superhighway, but traveling with a bus pass,” said Oscar Alleyne, senior advisor to the National Association of County and City Health Officials. “Money was invested to bring medical practices to electronic health records. There was no investment to develop a similar technology that links public health with that system. “
CDC has modernized public health reporting, but on a smaller scale. In the mid-2010s, the agency used $ 13 million in Affordable Care Act funds to help state and municipal health departments go digital. Although that program made some progress, it did not move the country to a fully digital public health reporting system. There have been some smaller one-time grant programs in recent years, but there is no long-term source of funding for digitization.
“What we learned really quickly is that this is a difficult problem,” said Dr. Frieden, the former CDC director. “You have hundreds of labs and thousands of tests. Nothing is interoperable because they have not been ordered to do that. “
Dr. Frieden noted that in other countries, such as Britain and Canada, patient data travels with a unique number that identifies who it belongs to. The United States attempted to establish a similar system in the mid-1990s, but it died after Congress passed legislation that prohibited the federal government from creating the new identification numbers.
