CDC: Data modernization would have improved coronavirus detection, tracking
- By Derek B. Johnson
- Mar 10, 2020
Photo credit: Katherine Welles/Shutterstock.com
Centers for Disease Control and Prevention officials urged lawmakers today to fund an existing data modernization initiative that they say would have led to faster detection and tracking of coronavirus as it spread across the country.
The CDC's Public Health Data Modernization Initiative is designed to invest in new and upgraded technologies that detect, track and analyze trends around disease outbreaks.
Officials told members of the House Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies that updating the agency's core data reporting, analysis and surveillance capabilities to better track emerging health threats is one of their highest budget priorities.
Efforts include modernizing current software systems and tools, increasing interoperability with stakeholder systems, coordinating IT investments and expanding public and private partnerships to monitor the spread of viruses and other health issues. Another initiative flags needed enhancements to the National Notifiable Diseases Surveillance System to improve data collection, sharing and analysis across the public-health sector as well as acceleration of electronic laboratory reporting.
Right now, the agency's systems are not set up to easily intake and process data from states, localities and private labs that conduct much of the testing that happens for emerging diseases like the novel coronavirus.
Alex Azar, the secretary of Health and Human Services, made a similar point at a March 9 White House press briefing, noting that there's no way yet for health officials to track the total number of coronavirus tests administered to Americans because many are taking place at hospitals and private labs that aren't required to report their test results to the CDC.
"CDC is actively working right now to build that IT connectivity with them so that we can gather that information," Azar said.
That reality has often provided public-health organizations like CDC with information that is out of date and not geared toward facilitating a real-time response.
"I'm hoping that the legacy for the time I get to lead the CDC is one thing, I help rebuild the core capabilities of the public health system of this country," said CDC Director Robert Redfield. "That is data. Not data when I get presented something that I know happened two years ago, but I want predictive analysis to be the name of the game, not just for CDC but for the entire public-health structure of this country."
Redfield also cited the need to upgrade the center's laboratories spread out across the country and bolster the public-health workforce inside and outside of the federal government, noting that CDC "has leveraged every one of these capabilities so far in response to the COVID-19 outbreak."
Subcommittee Chair Rep. Rosa DeLauro (D-Conn.) said that the testimony on the coronavirus outbreak "further confirms the need for modernizing our public-health data system" and asked how CDC's response might have been different if those improvements had already taken place.
"One is that we would have detected it much, much sooner and been able to contain it further and more effectively," said Dr. Ileana Arias, associate deputy director for public health science and surveillance at CDC. "The other is even before detecting … and analyzing that information along with health data, we could have started to see that there might have been a problem even before getting scared about the number of cases being detected."
Under the status quo, Arias said the agency has a "delay in finding out what is happening and who it is happening to," citing "unfortunate barriers that the current systems have with getting that information from health-care providers, from states, that we can use to engage in that response earlier."
Volume is an issue too, with Arias estimating that CDC's public health data systems are only capable of handling about 75% of the data coming in from states and other sources, and that percentage will only go down in the coming years if requested updates aren't funded and implemented.
The modernization initiative is expected to take place over multiple years and budget cycles, leaving little likelihood that they will be complete or functional in time to target COVID-19. Rep. Tom Cole (R-Okla.) said appropriators would likely support increased investment for IT modernization, but he said they need a multiyear plan from the agency detailing their funding needs.
"It really helps … particularly on technology because we tend to invest once, and the speed of change is much faster than we usually anticipate, so you end up with equipment that's out of date pretty quickly if we don't have some way of thinking proactively about what you need going forward," he said.
Arias said CDC is finalizing such a plan now.
The agency's latest budget request calls for $30 million to fund the public-health data modernization in 2021. That money would support efforts to help state and local health departments move their data capacities toward "the desired future state," improving CDC's own internal capacities to support advanced tools and capabilities, carry out strategic hospital and workforce development activities that enhance data science and informatics capabilities and engage with other public-health organizations.
The Trump administration has asked for significant cuts to CDC funding and programs in its recent proposed budget, though it did call for a $50 million increase for global health-security measures that detect diseases. Those proposed cuts were largely panned by Congress, and members from both parties indicated they would not be relying on administration figures in upcoming appropriations talks.
"Look, we're not going to cut CDC by $700 million," said Cole. "What this committee will wrestle with is what's the appropriate increase, honestly, going forward, and what are the things we need to prepare you as best as we possibly can to deal with things like you're dealing with right now."
Derek B. Johnson is a former senior staff writer at FCW.