No Hanky-Panky at HHS’s New COVID Data Hub, Contractor Says

No one in the Trump administration has attempted to manipulate national COVID-19 data or unduly influence the operations of the new Department of Health and Human Services (HHS) Coronavirus Data Hub, said the head of the company contracted to develop and maintain the database.

“Unequivocally zero,” Christopher Johnson, president of TeleTracking Technologies in Pittsburgh, said in an exclusive interview with MedPage Today. “It’s been very, very clear since the beginning that the goal has always been transparency…. A lot of the raw data is being published and it’s clearly traceable. There’s been no indication, no intent, no inkling of that, at least from my perspective. I have zero question about the integrity, ethics, or moral fiber of the people I’ve encountered.”

Moment in the Spotlight

TeleTracking has come into the spotlight now that HHS has debuted the data hub. It replaces the CDC’s National Healthcare Safety Network (NHSN), to which states and hospitals had previously been submitting COVID-19 data such as intensive care unit capacity, ventilator use, personal protective equipment (PPE) levels, and staffing shortages. But in guidance to hospitals, updated July 10 and published with little fanfare, HHS ordered hospitals to stop submitting such data to the NHSN and instead submit it either to HHS or to their state health department, which would then submit it to HHS. The data is now posted on the dashboard via the department’s new HHS Protect data system, which was developed by TeleTracking.

The company was founded in 1991 with businessman Michael Zamagias as its main investor; he is the company’s chairman and CEO. “He had a vision and saw the problem,” which is that healthcare is “horribly inefficient,” Johnson said. “Of the $4 trillion spent on U.S. healthcare, roughly half of that is in labor, and that labor is terribly inefficient — it’s a very complex system, and you’re dealing with human beings that are at their weakest in many cases.” The company “saw it as an opportunity to create better visibility into what is happening, starting with a ‘bed board’ that shows you what’s happening with beds and the patients in the hospital.” That expanded to include workflows around transporters, workers who clean the rooms, and biomedical engineers who make sure equipment is in the right place at the right time.

Over the years, the company has invested more than $1 billion into “a technology platform, a team of operational experts, and a set of best practices that we can apply to help healthcare organizations perform better operationally — more productively, more efficiently,” said Johnson. The company now serves more than 1,100 hospitals in the U.S., Canada, and Great Britain, with offices in North Carolina, Tennessee, and London.

The interaction with the federal government came about gradually, beginning about 5 years ago, he said. “We had the opportunity to meet with the House Ways & Means Committee” and testify at a 2016 hearing on the use of technology to improve cost and efficiency in healthcare, Johnson explained. Company officials also met with people at the Centers for Medicare & Medicaid Services and across government, “really as a way to create awareness that there’s an opportunity here to make an improvement in the cost of healthcare.”

CDC Involved in Move to HHS Protect

And then COVID hit. “It became clear to everyone very, very quickly that there was a need for situational awareness across the U.S.,” said Johnson. “We had an opportunity to speak with HHS around what they were trying to achieve — to create data so policymakers and emergency responders could make decisions on allocation of resources.”

Contrary to some media reports, the bidding for the contract seemed to be competitive, he said. “There were definitely conversations where they would reference other reviews that were happening. We were working with them on our stuff, and they would say they were speaking to others as well.” TeleTracking was awarded the 6-month, $10.2-million HHS Protect contract in April and began executing it “almost immediately,” Johnson said.

When TeleTracking started its work, “there were multiple ways” in which the government was collecting hospital data — “the NHSN that the CDC ran, TeleTracking, and there were others, like direct feeds into HHS from the states,” he explained. “From the outside looking in, that may not seem like the best way to do it but I understood the thought process behind it; we needed as much data as we could get.”

Johnson said the company wasn’t involved in any discussions of bypassing the CDC, and at first that wasn’t part of the plan. “What we knew was, there was a desire to streamline the process and relieve the burden on hospitals to the best of their ability.” At that point, he added, “some people were using NHSN, some were not. If you were still using NHSN you could still use it; we just gave them the ability to do it in a different way.”

But then it was decided to have hospitals send their data only to HHS. “The decision to move to TeleTracking in a primary way and no longer collect data through NHSN was a decision that [CDC Director] Dr. [Robert] Redfield was a participant in,” he said. Johnson said he feels that decision was misunderstood.

“The CDC has the same access to data they had before,” he continued. “It was portrayed as the CDC being ‘cut out’ of the COVID response. I never saw that as the case at all. We interact daily with people from HHS, CDC, and other agencies; that has continued uninterrupted as we move through this process.” The goal for the project “has always been to have the most complete and transparent data set, so we can understand collectively as a nation, at the federal, state, and local level, what’s happening.”

The Ultimate Customers

Johnson sees healthcare providers as his ultimate customers. “We’re committed to helping caregivers do their God-given calling,” he said. “It amazes me — healthcare, unlike any other field, is a calling; they are drawn to it. Those are the people we serve; that’s who we’ve been focused on.”

Claims that TeleTracking was awarded the contract because its executives are donors to President Trump are untrue, said Johnson. “I personally have never donated to really any campaign,” he said, adding that company chairman Michael Zamagias hasn’t donated to Trump either as far as Johnson knows (public campaign contribution databases confirm it, although Zamagias has donated to Republican congressional candidates).

Johnson also debunked rumors that TeleTracking retained access to the data being collected. “People had some belief that TeleTracking was some private industry in Pittsburgh and all the data is stored in our building; that’s not true,” he said. Instead, TeleTracking helps HHS acquire the data for use in their system, which “is very modern, very robust, very well done — all the things you’d expect from a modern data platform.”

On average, hospitals are reporting to the system once a day, and although most of the reporting is currently being done manually, Johnson is hopeful much of it can be automated. “The technology exists for us to automate these processes and increase the speed of transfer,” he said. Part of the reason that hasn’t happened yet is that “the types of data required in order to make better-informed decisions continues to evolve … As we settle on a core set of attributes necessary for management of this and any other crisis, the opportunities for automation are readily available.”

Johnson said he is proud of the work that his company has done, and that the feedback he has gotten from hospitals has been overwhelmingly positive. “We would hope publication of this data will continue to get more robust, more high-fidelity over time, and we hope to alleviate some of the unfounded fears of what was happening. I think we’re making great progress.”