Memo for February 8th Joint Subcommittee Hearing on “The Federal Response to COVID-19”
TOPIC: Pandemic data failures at CDC and problems with the agency’s proposed fix
The U.S. Centers for Disease Control and Prevention (CDC) failed to collect and share meaningful, useful public health data during the pandemic. The agency’s proposed reorganization, including the creation of an Office of Public Health Data, Surveillance and Technology, will not fix the problem if it remains a command-and-control, federally dominated model that has no local buy-in or governance. Instead, CDC and the Centers for Medicare and Medicaid Services (CMS) should work with states to develop their own health data collection systems, with local stakeholders fully buying into the mission and utility, that share appropriate information with CDC.
The inability of the CDC to accurately collect and share data in real time was one of the agency’s biggest failures during the COVID-19 pandemic.
CDC had little capacity to collect data on bed availability, access to respirators, early treatment, and efficacy of types of treatment. What data it did collect was sometimes weeks old and was not useful and/or accessible by health care practitioners and public health officials.
The underlying reason for this failure is simple: Health care is practiced at the local level. Therefore, health data must be collected at the local level. This requires local buy-in and governance from practitioners, public health officials, payers and patient groups. CDC does not have these relationships or governance.
In response to these and other failures, CDC has proposed a reorganization including the creation of the Office of Public Health Data, Surveillance and Technology. This reorganization will fail if it remains a federally dominated system because a national agency can never develop the sort of close working relationships with health care leaders across the country that local institutions can.
There are some states that do a good job collecting health data. They’ve succeeded because they are locally built to serve local health care needs and have buy-in from local health care practitioners and officials. Instead of trying to collect all data itself, CDC and CMS should work with states to establish their own Health Information Exchanges based on the models that work, who then share appropriate data with CDC.
5 QUESTIONS FOR CDC DIRECTOR WALENSKY
Members should use Director Walensky’s testimony on February 8th to pose five key questions about CDC’s data collection plans.
- What is your view of what states can or should do related to health data collection?
- Are there any states that you think are doing health data collection well? If yes, why?
- Describe the proposed relationship between state-based Health Information Exchanges and the new CDC Office of Public Health Data, Surveillance and Technology.
- Why should CDC be trusted with a national database for public health? What sort of data governance would be needed to foster trust with states?
- What is CDC’s plan to get local hospitals, providers and payers to share data with CDC? Why would they view CDC as trustworthy for collecting data? What would CDC need to build trust?