As part of HHS ‘response to President Bidens Executive Order to ensure a data-driven response to COVID-19 and major future public health threats, ONC’s Health Information Technology Advisory Committee (HITAC) recently held an expert hearing to understand the performance of public health data systems during the response to the COVID-19 pandemic and other gaps in current infrastructure.
HITAC members heard from a variety of experts to provide further information on the work of the Public Health Data Systems Task Force. Commentary, Deputy Director of the Centers for Disease Control and Prevention (CDC) Dan Jernigan noted that in addition to collecting information for short-term needs related to pandemic relief efforts, the CDC took a long-term, sustainable approach Improving public health data systems.
Upcoming recommendations of the Public Health Data Systems Task Force will identify and prioritize policy and technical gaps that need to be addressed to ensure a more effective response to future public health threats. These recommendations are expected to be published later this summer.
Take a holistic approach to public health data systems
Dr. Tom Frieden, President and CEO of Resolve to Save Lives (and former CDC director) opened the “Big Picture” discussion on where something went wrong in the pandemic response. He addressed pre-existing weaknesses across the public health ecosystem and gaps in the sharing of critical data between federal, state and local health authorities. He explained that the essence of effective response is learning to adapt and adapt as we move forward. Since “we are less used to the urgency that communicable disease control demands of us in public health,” said Dr. Peace that everyone at all levels must work together to move the country forward so that it needs to be better positioned for the future.
Public Health Systems Performance During COVID-19: Big Picture Perspectives
To fill the technical gaps in the flow of information, we need to build systems that are well integrated and able to seamlessly address the needs of an emergency public health threat. “Our data systems are not end-to-end connected or integrated in public health and healthcare,” said Dr. Mark McClellan from the Duke Robert J. Margolis Center for Health Policy at HITAC and brought an overall perspective into the discussion.
The panelists also spoke about the impact of political measures to address needs both nationally and across county borders in the future. For example, health data systems are very different from public health data systems and vary by state and county. “Problems we face with data systems are political science problems, not computer science problems,” said Dr. Michael Fraser, CEO of the Association of State and Territorial Health Officials. Dr. Linda Rae Murray, assistant professor at the University of Illinois School of Public Health, agreed, stressing that both political and organizational barriers play a role in creating health inequalities. She said, “Public health is really everything … all of these economies, political systems, belief-based systems, where we have a lot of data, we have to incorporate into public health.”
Technical and infrastructural questions: current status and future requirements
Paving the way into a future where our health data systems share information and adapt in real time to new threats requires partnerships across all sectors. President Biden’s Executive Order confirms the importance of collecting, analyzing, and sharing COVID-19 data with state, local, tribal and territorial authorities. According to Dr. Karen DeSalvo, former National Health IT Coordinator and current Google Health Chief Health Officer, requires that we fix any deficiencies in this process that we have a 21stNS Century the infrastructure of the public health system.
Dr. DeSalvo said strategic partnerships are important and have proven very effective during this pandemic, as has been working with academic and public health corporate partners around the world to develop tools that will improve disease surveillance around the world. She stressed that in an ideal future state, focus should be on open standards, not proprietary ones.
Creating the public health ecosystem of the future
Application programming interfaces (APIs), artificial intelligence and cloud computing systems will help set the course for our future path. The 21stNS Century Cures Act and the information exchange provisions in the ONC’s Cures Act Final Rule have enabled the first steps in making data available across the healthcare system. Health IT developers, policy makers, providers and patients will be able to securely access their information with the wider adoption of standardized APIs.
Panellists all spoke about the need to have quick access to data and the importance of doing so, especially in a crisis response environment. Dr. Joneigh Khaldun raised concerns about the widespread use of spreadsheets to gather information at the height of the pandemic. In Michigan, for example, the computing capabilities were “out of date” and had to be rebuilt while managing the response. New innovations and improved demographic data collection, especially for marginalized and underserved communities, integrated into public health data systems, will be key to responding to the pandemic and future health inequalities.
On behalf of HITAC and the Public Health Task Force, we would like to express our thanks to all speakers and experts who supported this important meeting and to all those who continue the conversation.
If you missed the public health data systems hearing, all the details can be found on ONC’s HITAC page.
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