HHS changes may drive hospitalization reporting challenges

This past week, the Department of Health and Human Services (HHS) opened up a new area of data reporting for hospitals around the country. In addition to their numbers of COVID-19 patients and supply needs, hospitals are now asked to report their numbers of influenza patients, including flu patients in the ICU and those diagnosed with both flu and COVID-19.

The new reporting fields were announced in an HHS directive on October 6. They became “available for optional reporting” this past Monday, October 19; but HHS intends to make the flu data fields mandatory in the coming weeks. The move makes sense, broadly speaking—as public health experts worry about double flu and COVID-19 outbreaks putting incredible pressure on hospital systems, collecting data on both diseases at once can help the federal public health agencies quickly identify and get aid to the hospitals which are struggling.

However, it seems likely that the new fields have caused both blips in HHS data and challenges for the state public health departments which rely upon HHS for their own hospitalization figures. As the COVID Tracking Project (and this newsletter) reported over the summer, any new reporting requirement is likely to strain hospitals which are understaffed or underprepared with their in-house data systems. Such challenges at the hospital level can cause delays and inaccuracies in the data reported at both state and federal levels.

This week, the COVID Tracking Project’s weekly update called attention to gaps in COVID-19 hospitalization data reported by states. Missouri’s public health department specifically linked their hospitalization underreporting to “data changes from the US Department of Health and Human Services.” Five other states—Kansas, Wisconsin, Georgia, Alabama, and Florida—also reported significant decreases or partial updates to their hospitalization figures. These states didn’t specify reasons for their hospitalization data issues, but based on what I saw over the summer, I believe it is a reasonable hypothesis to connect them with HHS’s changing requirements.

Jim Salter of the Associated Press built on the COVID Tracking Project’s observations by interviewing state public health department officials. He reported that, in Missouri, some hospitals lost access to HHS’s TeleTracking data portal:

Missouri Hospital Association Senior Vice President Mary Becker said HHS recently implemented changes; some measures were removed from the portal, others were added or renamed. Some reporting hospitals were able to report using the new measures, but others were not, and as a result, the system crashed, she said.

“This change is impacting hospitals across the country,” Becker said in an email. “Some states collect the data directly and may not yet be introducing the new measures to their processes. Missouri hospitals use TeleTracking and did not have control over the introduction of the changes to the template.”

As the nation sets COVID-19 records and cases spike in the Midwest, the last thing that public health officials should be worrying about right now is inaccurate hospitalization data. And yet, here we are.

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