With the number of coronavirus cases surging in most U.S. states, several healthcare providers are seeking to enable an unprecedented level of data sharing with the creation of the National Response Portal (NRP).
Built on Google Cloud by cloud solutions provider SADA, the NRP is an open data platform intended to help hospitals and communities better understand and respond to the COVID-19 pandemic by providing an “on the ground’ picture of the situation.
“At the beginning of the outbreak we were in a time of great uncertainty. No one had ever seen COVID before. We didn’t know what to expect,” says Dr. Edmund Jackson, chief data officer at HCA Healthcare, which sparked the NRP project. “At HCA, we realized that in order for us to prepare for it, we needed to see more than we usually do. We had to understand as a healthcare system, not as individual participants, but as a system, what the total state of COVID was in the nation.”
Numerous data hubs and portals emerged in the wake of the outbreak, providing data access to data from Johns Hopkins University, the World Health Organization (WHO), and the Centers for Disease Control (CDC). While Jackson says those efforts were invaluable, he says hospitals need more granular data specific to their regions to best respond to the crisis.
“Using the publicly available data sets, it wasn’t clear how many beds we were going to need, how many ventilators we were going to need,” Jackson says. “What were the PPE requirements? What we really needed was the current ICU census of all the hospitals in a particular region, how many ventilators are available, and what are the growth rates of the utilization of those assets?”
Combatting crises with data
The NRP aims to help healthcare systems share and display anonymous, aggregated metrics from participating hospital systems to provide a real-time view of the pandemic. The portal enables hospital systems across the U.S. to submit daily data on metrics such as ICU bed supply and utilization, ventilator supply and utilization, total COVID-19 test result numbers (positive, negative, and pending), and total numbers of discharged patients. The platform also draws from public data sets on local shelter-in-place policies and traffic or mobility patterns to help hospital administrators and government officials understand how public behaviors and policies affect the spread of the virus.
“It’s about trying to get granular data so that, not only in this crisis that we’re in, but, as a crisis of any magnitude rolls through communities you could provide a much more precise response, whether it’s a policy response, a healthcare needs response, or an allocation of support resources,” says Manish Shah, senior vice president and CIO of Community Health Systems, one of the largest hospital organizations in the U.S.
Aside from adhering to all regulatory and statutory restrictions on healthcare data, one of the big challenges to making the NRP work is ensuring that all the data it ingests is validated and fit for the purpose.
“We are working with healthcare organizations to develop documentation, scripts, and tools to ensure that we are working from the same playbook and that we’re getting consistent results,” explains Michael Ames, senior director of healthcare and life sciences at SADA.
To streamline efforts, the NRP mirrors data formats in use by the CDC and other state and federal agencies.
“Rather than go after everything we had, we spent a lot of time identifying what’s the minimum amount of data that’s necessary so that we can clearly define it and make it easy for people to participate,” says Jackson.
By gathering daily anonymized data directly from the nation’s healthcare systems, the portal enables users to see when a hospital facility is experiencing a surge in diagnoses and when ICU and ventilator utilization in a region is reaching critical levels.
“The available data is spotty in ways, sometimes at the state level and here and there at the county level,” Ames says. “We are working hard to onboard more healthcare organizations to bring that data in.”
Data sharing breakthrough
For now, NRP’s data contributors include HCA Healthcare (which operates 186 hospitals and 2,000 sites of care), Community Health Services (operator of 95 hospitals in 16 states), and the Cleveland Clinic Foundation (operator of the Cleveland Clinic as well as 11 regional hospitals and 19 family health centers). Ames says many other healthcare systems have expressed interest in participating. Hospitals, clinics, and healthcare systems interested in participating can find more information here.
The NRP is free to access for anyone in the general public and consists of two major components: an interactive map that enables individuals to plug in their address to see information on COVID-relevant resources nearby, and a series of dashboards that aggregate and summarize a variety of information at the national, state, and county level for every county in the U.S.
“For example, you can drill into your county and see in timeline bars the different social distancing policies that have been put in place for your state, when they were enacted, when they were allowed to end (if they were allowed to end), and a chart showing the extent to which people have respected those policies,” Ames says. “Overlaid on top of that, we can see diagnosis and death rates for that locale.”
Sharing clinical data is complicated, and it’s something the healthcare industry has been wrestling with for a long time. HCA Healthcare’s Jackson says he hopes the level of data sharing enabled by the NRP will be the breakthrough needed to change that.
“We share data in things such as the [Health Information Exchange], and those are very good for routine care and sharing details about patients, and integrating them with the EMR, but communications around crises are more specific and require different data to be shared,” Jackson says. “In practice, what that means is that the clinical leaders of organizations get together on phone calls or WebExes and share what’s going on. We’re hoping the portal will be an example of how it can be improved.”
Community Health System’s Shah notes that hurricane season has started in the U.S. even as the pandemic continues to spread. A resource such as the NRP could be invaluable to first responders who need to understand the distribution of healthcare resources as they respond to evolving crises.
“It could allow national organizations like FEMA to be able to quickly ascertain information from the ground level so they can divert resources where they’re most needed,” Shah says.