In mid-July, the U.S. Department of Health and Human Resources claimed that the Trump administration's directive to hospitals to bypass the Centers for Disease Control and Prevention when reporting patient data was made in collaboration with CDC leaders.

This past Friday, however, CDC Director Dr. Robert Redfield told members of Congress that the CDC "wasn't directly involved in the final decision."

During a hearing of the House Select Subcommittee on the Coronavirus Crisis, Redfield told Rep. Maxine Waters, D-California, that he had "not directly" discussed the decision to change the reporting practices with either Vice President Mike Pence or HHS Secretary Alex Azar.

"I was told once the Secretary's office made the decision," he said, though he maintained that "we did work in cooperation" and that he thought "it was an important decision."

Redfield also said, "CDC, then and now, continues to have access to all data."

WHY IT MATTERS

Since the switch to the HHS TeleTracking system, reports have continued to emerge about the delay in data availability. The HHS Protect Public Data Hub, meant to make at least some of the numbers broadly available, has not been updated since Thursday, July 30, belying agency claims that the switch was rooted in the need for efficiency. 

The hospital utilization numbers, which show hospital capacity by state, have not been updated since Thursday, July 23.

When the hub was first unveiled, at least one hospital association pointed out that HHS was listing hospitals as "not reporting" data when they were actually closed; HHS, in an email to Healthcare IT News, acknowledged the existence of errors.

Hospitals have reported "chaos" when trying to switch to the new system – a situation that's particularly fraught, given the general understanding that allocations of remdesevir will hinge on reporting numbers.

Redfield said during the hearing that the change was necessary in order to track real-time hospital data.

"We collectively understood the reason … is there were substantial advancements in therapeutics with remdesivir, which made it really important to be able to understand who was newly hospitalized in real time that day," said Redfield.

Waters pressed Redfield on whether patients' access to remdesivir should hinge on hospitals' ability to comply with the new reporting requirement. Redfield did not directly answer the question. Instead, he said that the change came from making sure patients weren't denied access to remdesivir.

Redfield said that despite decades of underfunding, "we [at the federal government] do have a comprehensive response … within the capabilities that we do have."

THE LARGER TREND

Controversy has swirled in the wake of the HHS announcement, with many members of Congress, state attorneys general and industry groups asking the administration to reverse the guidance. 

"COVID-19 data collection and reporting must be done in a transparent manner and must not be politicized, as these data are essential to informing an effective response to the pandemic and to establishing public trust in the response," read a letter from more than 100 public health, research, medical, science and legal organizations. 

"Data transparency is particularly critical in the midst of an unprecedented national health crisis that is disproportionately impacting certain segments of the U.S. population, including Black/African American, Latinx and Native American communities," the letter continued.

ON THE RECORD

"We are seven months into this global pandemic, and it is with great humility that I share with you that this is the most complex public health response this nation has undertaken in more than a century," said Redfield during the hearing.

"We are operating in a highly dynamic environment. We are adapting evidence-based strategies and pushing for innovative solutions to confront this unprecedented public health crisis," he said.

Kat Jercich is senior editor of Healthcare IT News.
Twitter: @kjercich
Healthcare IT News is a HIMSS Media publication.