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Public Health Needs Modernized Data Infrastructure, Cloud

Various modernization initiatives to improve public health have pivoted as a result of the pandemic.

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Federal health IT officials are strategizing around modernized data infrastructure and capabilities, the cloud and telehealth to boost public health missions, agency representatives said during an AFCEA public health webinar this week.

Amid public health demands during the COVID-19 pandemic, modernization and data have been some forefront concerns of health IT officials as they try to keep up with demand for mission needs.

Vid Desai, CTO at Food and Drug Administration, for instance, said his agency has needed to revamp data infrastructure and is working to get there.

“The pandemic has obviously highlighted the need for a solid data infrastructure,” Desai said. “We published the Technology Modernization Action Plan September of last year, and we had planned to publish a data plan to go along with that … we’ve now published that, we’ve hired a CDO and we’re forming a data team to start to address the data infrastructure issue.”

With better data infrastructure, Desai added, FDA can understand and act more effectively around certain critical areas, such as getting to better management of the agency’s supply chain. The infrastructure behind the data FDA has will enable the agency to better clean its data and make it more usable for mission areas overall, Desai said.

FDA Chief Medical Officer for In Vitro Diagnostics and Center for Devices and Radiological Health Medical Affairs Director Dr. Sara Brenner also plays a role in strengthening data in the public health realm of the federal government. She said she’s the diagnostic data lead the Health and Human Services Data Standards and Execution Workgroup, where she’s improving data quality, flow and extracting information from diagnostics as they’re increasingly being used for COVID-19.

Improvements in public health data systems, Brenner said, has been critical for improving understanding of diagnostics and getting a better understanding of COVID-19.

“From a diagnostics and laboratory data perspective, we went from sort of an antiquated system that was built for almost 18th century public health in low-volume, low-complexity types of reporting,” Brenner said. “A core diagnostic dataset for COVID — that includes clinical data, demographic data, data around a specific test, as well as the result of this — this needed to happen … as quickly as possible without losing data, without losing the integrity of the data or quality of it.”

With new testing capabilities, FDA’s rapid expansion of diagnostic data volume has pushed the agency to scale up its data collection and reporting system exponentially.

The cloud has been another technology that has enabled great scaling up of public health technologies. Indian Health Service IT Operations Division Director Paul Kundtz said telehealth has been critical for continuing delivery of health care amid the pandemic and said he’s working on a cloud-based solution to boost telehealth capabilities.

“We’ll have a pretty robust solution, bringing telehealth forward to the future,” Kundtz said. “Prior to COVID, we were doing around 2,000 telehealth encounters per month. At our peak, we reached over 40,000, and now we’re tapering down a little bit to around the 30,000 range, so it’s still exponentially higher in the infrastructure needed to support that.”

Using data from remote doctor visit encounters, the Health Resources and Services Administration has been conducting analysis to understand the efficacy of telehealth throughout the pandemic to understand how to move forward with supporting it in the future.

“We’re … gathering the data and really understanding what we can do in order to continue the care that patients have received,” said Cmdr. Heather Dimeris, associate director of HRSA’s Federal Office of Rural Health Policy. “With COVID, now we look at [how] everybody needs access, and not only do we need access … but we’re now looking at direct consumer care where you need to have access for broadband services in a patient’s home.”

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