Do lockdowns work? Are masks effective? Did schools make the right decisions?
During the COVID-19 crisis, these questions were urgent and pervasive. Yet, clear answers were often elusive, hindered by data gaps and inefficient information exchange. As we move toward a post-COVID future, we must ask ourselves: Is our healthcare data infrastructure prepared for the next health crisis? Our indicates that it is alarmingly unprepared.
Two major issues became apparent early in the pandemic. First, the lack of data interoperability and effective analysis impeded the delivery of real-time insights to those making critical decisions. Second, the slow exchange of patient data severely limited treatment efforts. In a situation where a rapid response was essential, accessing comprehensive electronic records from different providers was crucial.
This significant data gap was recognized at the highest levels of government. In 2021, President Biden enhanced public health reporting and data sharing. The National Academy of Medicine also highlighted this , calling attention to the healthcare sector's disjointed data management. These statements underscored the urgent need for a more streamlined and efficient approach to healthcare data.
In our study, we analyzed responses from a 2020 survey conducted jointly by the American Hospital Association and the Office of the National Coordinator for Health Information Technology. This survey, carried out between April and October 2021, specifically targeted hospitals' chief information officers to gather insights into their experiences during the COVID-19 pandemic.
Notably, nearly 3,000 hospitals participated in the survey. This represents over 50% of all nonfederal acute care hospitals in the U.S., providing a substantial and representative data sample for our analysis. We found that over half of U.S. hospitals reported data on hospital capacities and medical supplies utilization to various government levels, but only 18% found the reporting directives to be consistent across agencies. Many encountered confusing discrepancies, with 16% dealing with completely conflicting requirements.
Collecting this specific data was not a trivial task: 59% of hospitals had difficulty gathering data for federal reports, with state (57%) and local (26%) level requirements presenting similar challenges for hospitals. Issues such as inconsistent criteria, lack of standardized templates, and unclear instructions worsened the situation.
Worryingly, 32% of hospitals still used manual reporting methods, which were especially prevalent in rural areas. This not only delayed responses but also raised concerns about the accuracy of vital data, such as vaccine-related adverse events.
Moreover, less than 40% of hospitals could electronically access external COVID treatment data, indicating a serious gap in patient care continuity. About 12% of hospitals did not agree that they successfully submitted vaccine-related adverse events to relevant authorities, a factor that could further diminish public trust in the vaccine. Trust is essential for an effective health response, particularly during a pandemic. The difficulties some hospitals faced in reporting adverse events highlight the need for a more robust and transparent system.
Our findings suggest an urgent need for a complete overhaul: the development of a unified, efficient public health data system. A healthcare data infrastructure resilient to future pandemics requires a focus on data interoperability, streamlined reporting processes, and uniform standards. Enhancing electronic data exchange capabilities and providing additional support for rural and under-resourced hospitals are critical.
The implementation of a more robust and efficient healthcare data system would have far-reaching implications for public health. By ensuring data interoperability and streamlined processes, we can significantly improve the speed and accuracy of critical healthcare decisions, leading to more effective disease control measures and better patient outcomes. A unified data system would facilitate real-time tracking of disease spread, resource allocation, and patient treatment strategies. Additionally, it would enhance the public's trust in health interventions by providing transparent and reliable data. This trust is vital for the success of public health initiatives, particularly during a pandemic.
The lessons from the pandemic should guide us in reshaping our healthcare data infrastructure. This crisis presents an opportunity to make it not only more prepared for future emergencies but also stronger and fairer in its everyday functioning. We owe it to ourselves and to those who navigated these challenges to build a clearer, more effective infrastructure moving forward.
In essence, an improved data infrastructure is not just a technological upgrade; it's a fundamental step toward a healthcare system that is more responsive, resilient, and equitable, capable of managing future health crises with greater efficacy.
is the Eli Broad Endowed Professor of Accounting and Information Systems, professor of Finance (by courtesy), and law school faculty affiliate at Michigan State University Eli Broad College of Business in East Lansing.