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December 1, 2020

'Who's gotten a coronavirus vaccine?' It's a simple question—but America may not be ready to answer it.

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    America could have an authorized vaccine against the novel coronavirus within weeks, giving hope to a nation that's struggled to get the epidemic under control. However, officials are warning that gaps in the country's health IT capabilities could hamper efforts to distribute the vaccine and ensure that Americans get the proper dosage.

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    Inept health IT could hamper coronavirus vaccine distribution

    Public health experts say data, and the ability to share that data, will play a vital part in distributing an authorized coronavirus vaccine to millions of Americans nationwide. According to Morning Consult, that's because health care officials and providers will need to use state immunization registries to track which patients have been vaccinated; whether patients develop any side effects to the vaccine; and whether patients received multiple doses of the vaccine, if necessary.

    However, health IT officials warn that America's health system doesn't have the IT capabilities needed to properly collect and share data related to vaccine distribution.

    For example, as Morning Consult reports, there currently is no mechanism that allows data from state immunization registries "to flow quickly across states, to federal health agencies, or among some providers." Ultimately, health IT officials say these shortcomings could hamper officials' efforts to vaccinate as many Americans as possible as quickly as possible.

    Federal agencies scramble to stand up a data-sharing system

    To address the issue, federal health agencies are scrambling to stand up new platforms intended to facilitate data sharing when it comes to coronavirus vaccinations.

    For example, CDC is working to launch a new data hub called the Immunization Gateway, which is intended to enable providers to connect to state immunization systems, as well as to share and access information across those systems. The gateway also aims to allow patients to access some immunization data.

    Meanwhile, Operation Warp Speed, which is the Trump administration's central initiative to develop and distribute a coronavirus vaccine, has been working on its own vaccine management system, Morning Consult reports. According to Morning Consult, that system would allow providers to report vaccination data, and then send that data to state immunization registries and CDC.

    The Operation Warp Speed system essentially would "leapfro[g] the process of submitting data to the state registries directly," Morning Consult reports. The system also would allow people to schedule vaccinations, send text reminders to people who've scheduled vaccinations, and help officials to manage the vaccine supply chain, according to Morning Consult.

    The efforts face a quickly approaching deadline. In September, CDC released a vaccine distribution playbook for states that said every vaccine distribution site in a state should be ready to report data to the immunization registries "at the time of vaccination." However, according to Morning Consult, CDC didn't release data use agreements for participating in the new gateway to states until late October.

    The efforts also are running into "legal and tech" problems, Morning Consult reports.

    For instance, Politico reports that CDC has confirmed it wants providers to submit "'identifiable'" data that will allow the system to track specific individuals—a feature that is legally complicated, experts have said.

    In addition, Hadly Clark, who oversees health data and technology projects at the Milken Institute's FasterCures center, told Morning Consult that some health care providers, such as smaller health clinics that aren't equipped with advanced technology, aren't connected to their states' immunization registries.

    And even if providers are able to report data to their own state's registry, sharing across the registries hasn't been adequately tested, according to experts.

    Claire Hannan—executive director of the Association of Immunization Managers, a group that represents state and city vaccine planners—told Morning Consult, "The central issue for us is around this data flow, and several of these systems through which the data flows are new, and they need to be tested."

    According to Politico, CDC in September said it was working on holding training sessions for its new platform. Rebecca Coyle, executive director of the American Immunization Registry Association, recently told Politico that around 10 states have been testing CDC's new platform and she hasn't been made aware of any major concerns.

    Experts aren't optimistic

    Ultimately, health IT experts aren't optimistic that the federal government and states can roll out these systems quickly enough for them to benefit health care providers.

    Mike Popovich—CEO of STChealth, a vendor that maintains some states' immunization registries—said, "There's a lot going on there that has to happen in the current time frame, and I'm not optimistic."

    For example, he noted that, initially, providers may have to report data both to their state's immunization registry and to new federal platforms, which would place a greater burden on providers. "I'm not sure the plan has been fully thought out," Popovich added.

    Ben Moscovitch, a health IT specialist at Pew Charitable Trusts, similarly said, "There's several outstanding questions, and as a country we're running out of time to have the systems and policies in place."

    And Lori Freeman, CEO of the National Association of County and City Health Officials (NACCHO), told the New York Times, "A month before the vaccine is about to become available is not the time to think about making systems across 3,000 health departments in 50 states interoperable. … It just doesn't work."

    Separately, Clark said, "The stakes are very high to launch something like that so quickly."

    And Adriane Casalotti, chief of government affairs at NACCHO, seemingly agreed. "The importance of the data cannot be understated," Casalotti told Politico. "If local health departments don't have access to that data in as near real-time as possible, you're not going to be able to really use it to make changes to ensure that we're getting the vaccine to who needs it" (Galvin, Morning Consult, 10/26; Tahir/Roubein, Politico, 9/13; Tahir, "Future Pulse," Politico, 11/18; Goodnough/Kaplan, New York Times, 11/22).

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