US hospitals rush to adopt new HHS coronavirus data system, some states see ‘data blackout’

Hospitals and states are struggling to adopt a new national Covid-19 data reporting system hastily implemented by the Trump administration last week that has left some, mostly rural, states in the dark about the severity of their own outbreaks of coronavirus.

The Department of Health and Human Services abruptly ordered all hospitals last week to stop reporting their coronavirus data to the former National Health Safety Network of the Centers for Disease Control and Prevention. Instead, hospitals were ordered to report the data to HHS through a new portal that launched on Monday. HHS gave hospitals two days to comply and linked their cooperation to the distribution of remdesivir, a vital drug used to treat Covid-19.

HHS officials said they made the move to ensure the federal government had more complete, real-time data used to make important decisions, such as the remdesivir distribution. But it has left some states without key information about their own Covid-19 outbreaks: coronavirus hospitalizations, available hospital beds, and ICU beds available.

Some states do not collect the data themselves and rely on CDC to collect and share that information, which public officials use to decide how to allocate key resources. The abrupt change left many hospitals, especially smaller, more rural ones, as well as local policy makers in the lurch as health systems transition to the new system, officials in Montana, Idaho and Missouri told CNBC. .

In Missouri, hospitals have done their best to build computer systems to quickly report the data to CDC, Missouri Hospital Association spokesman Dave Dillon told CNBC. About 99% of hospitals across the state successfully reported their Covid-19 data to CDC before the change, he said. In the past four days, only 82% of Missouri hospitals submitted data to the new system, according to HHS data.

“It is taking time to swing,” Dillon said. HHS requested new and “poorly defined” data that it did not previously collect for CDC, he said. Additionally, the state used the data from the CDC to build its own Covid-19 control panel for the public and now cannot access the same information on the new HHS platform, he said.

As a result, the hospitalization data presented on the Missouri dashboard has not been updated since July 12. The Missouri Department of Health and Senior Services website now says: “Please note that due to an abrupt change in the data measures and reporting platform issued by the White House … Missouri Hospital Association ( MHA) and the State of Missouri will be unable to access critical hospitalization data during the transition. “

“This is the worst possible time for a data blackout,” said Dillon. “It is very possible that during downtime, Missouri exceeded the all-time high for hospitalizations.”

Hospitals in the state are working “nonstop” to comply with the new guide, Dillon said, and the state is working to gain access to complete HHS data so that it can update its dashboard. She said the state hopes to be able to update basic information such as “beds, vents and admissions” available as early as this week.

“Until MHA can see everyone’s data, we won’t be able to report. More critically, we won’t be able to understand where the resources are needed,” he said. “It is difficult to handle this crisis when the posts continue to move forward.”

While HHS is collecting hospital data from all states, that information remains incomplete. But the agency says it is collecting more information than the CDC was able to obtain.

Across the country, nine states currently have less than 50% of their hospitals reporting data through the new HHS system, according to the agency’s website. Approximately 25% of hospitals in North Dakota and 28% in Louisiana reported their Covid-19 hospitalization data through the new system as of Wednesday, HHS data shows.

To be sure, many states and hospitals were able to transition to the HHS portal without a problem. And some states were already collecting their hospital data and didn’t lose much, if any, information when the CDC system was shut down.

John Haupert, CEO of the Grady Health System in Atlanta, Georgia, for example, said the new reporting system has not been a great burden on them.

“A little more information is requested, but in our opinion it is essential information for [HHS] to be able to make decisions, “he said in a conference call organized by the American Hospital Association.” As for the effort to send the data and collect it, that has not been significant. “

The Covid Monitoring Project, which monitors Covid-19 hospitalizations and other coronavirus statistics across the country, said most of its data has been kept uninterrupted.

“However, some smaller states like Idaho, South Carolina and Missouri were using the CDC system that HHS replaced to provide data to the public,” the Covid Monitoring Project said in a statement to CNBC. “Now, those states are struggling to create new pipelines that can provide that data.”

Idaho can finally access HHS data, but its own Covid-19 control panel was out of date for several days during the transition. The information, however, is still incomplete. “Not all hospitals report, so it presents some challenges,” said Kelly Petroff, spokeswoman for the Idaho Department of Health and Welfare.

Until those data are restored, some researchers, states and others lack critical information to track and respond to the outbreak, according to the Covid Tracking Project, which is a voluntary organization launched by journalists at The Atlantic.

“This is important because current hospitalization data has become the most reliable indicator of the severity of outbreaks in different states,” the group said. “Unfortunately, we are now unsure whether some of the erratic changes in hospitalizations we are seeing are due to reporting problems or real changes on the ground.”

HHS Chief Information Officer José Arrieta told reporters in a conference call Monday that the new system collects data from approximately 4,500 hospitals most days, compared to 3,000 hospitals under the old CDC reporting system. .

“From our perspective, when we look at the total number of hospitals reporting since the transition occurred, the number actually increased quite significantly,” he said. “We realize this is a change and every time there is a change, it obviously creates a little bit of tension, maybe a little bit of pain in the transition.”

An HHS spokeswoman told CNBC that the agency “made several calls” with hospitals and industry representatives to “share details of the program changes and answer questions.” HHS also established a service desk to help hospitals send their data, he said. The new TeleTracking system provides more frequent and detailed data, which will help the United States’ response, he said.

“This methodology also highlights recent increases in cases in states / territories and allows us to allocate more amounts of commercially available remdesivir to areas of the country with the greatest need,” he added.

The transition is difficult for smaller, rural hospitals that don’t have as many resources, Charles Kahn, CEO of the Federation of American Hospitals, told CNBC.

“On the other hand, the data is necessary for the distribution of remdesivir and other materials … so you can see their reasoning for collecting much of the data they are now asking for,” he said in an interview.

Brian Whitlock, CEO and President of the Idaho Hospital Association, said the burden of policy change weighs heavily on some hospitals in his state. Hospitals had approximately 36 hours to transition to the new system, and the federal government threatened to cut resource allocations such as remdesivir if they didn’t, he said.

Part of the problem, he said, is that the state contractor was not initially authorized to access HHS data. So Idaho hospitals now have to report the data to both the federal and state governments instead of a centralized database as they adjust to the new system, he said.

“When you talk about a critical access rural hospital you may have someone wearing another half dozen hats in the hospital, who is tasked with reporting Covid-19 as an extra hat,” Whitlock said. “We are discovering that that person, who already wears half a dozen hats, now has to go back and make duplicate reports to the state system until we can figure out how to cross data between those two systems.”

Before the policy change, he said Idaho was successfully collecting data from “almost every hospital” in the state. HHS says it is now collecting data from about 65% of hospitals. Whitlock, however, said he is confident that more hospitals will adapt to the new system in the coming weeks. But that added stress comes when Idaho is dealing with a big spike in cases and cash-strapped hospitals struggle to care for patients and fewer staff. Many hospitals had to lay off workers after several states imposed mandatory closings that banned elective surgeries earlier this year.

“It’s kind of a cheat 22 taking limited resources you have in your hospitals and adding additional responsibilities and reporting requirements to those thin resources,” Whitlock said. “It would have been more time to make these changes and some resources to pay for these changes.”

– CNBC’s Bertha Coombs contributed to this report.