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 Today in Health it, the story is from the Harvard Business Review hbr.org. Rolling out the covid vaccine is a huge data challenge. My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of this week in Health IT a channel dedicated to keeping health IT staff current and engaged.

Today's sponsor is health lyrics. Health lyrics provides executive coaching specifically for healthcare leaders. Do you ever want another set of eyes or ears to talk through your IT challenges that your systems faces? How about someone to talk through your career moves? That is what I do at Health Lyrics.

I put my experience and network to work for my coaching clients. Most health systems will pay for executive coaching for their key IT staff, not just the CIO. If you're interested in learning more, check out health lyrics.com. All right. On to today's story. Uh, interesting story in hbr.org. Again, the title Rolling out the Covid vaccine is a huge data challenge.

Lemme give you a little excerpt to get us started. Okay. From the article, as the rollout of COVID 19 vaccine gets underway in the United States, the country is confronting a major IT challenge how to track distribution of the vaccine and determine who receives them. This is crucial to ensure individuals get the recommended number of doses.

That guidelines determining who is next in line are followed, and that enough of the US population, at least 60 to 70% or higher, I guess in some cases is vaccinated to achieve herd immunity, the hard truth. That policymakers, health systems, pharmacies, and public health leaders must face is that the current US data infrastructure is not up to the task.

It's a huge statement. In this article, we outlined four broad actions to improve the data infrastructure that can be taken to ensure that the vaccination effort is effective and equitable, or text privacy in thwart wrongdoing. I'm gonna get to a so what. So for each one of these, this is our first today in health.

It, so thanks for joining us. Um, for each one of these, I'm gonna do a so what at the end, which the, so what is ? Really, from my perspective, from ACIO for a health systems perspective, what would I do with this? Uh, first of all, that's a huge statement that, you know, it's the, the, it's not up to the task. The US data infrastructure is not up to the task.

It's a big deal. And they do outline four broad actions, but part of my, so what's gonna be, you can't fix this stuff overnight. Uh, I like the actions. I think they're interesting and I think they're a good foundation for a conversation. Uh, but this is not the kind of stuff you just . Turn on. So here they are, uh, standardize how personal health data is exchanged, as you can see already.

I mean, these, these are, these are big things. Alliance states, immunization, registries, and states and federal reporting analytics, design, immunization, passports that are portable, equitable, and protect privacy. And number four, address privacy portability and cybersecurity. Trade out trade-offs. Uh, again, I mean, you just see from these

These titles, these are not the kind of things you turn on overnight. These are the kind of things that you work on over years and get ready for the next pandemic. If that does occur, and hopefully it will not in our lifetime, but in the off chance that it does, these are the kind of things that should be in place.

Alright, so let's, let's break each one of these down real quick. . Standardize how personal health data is exchanged. Uh, we have three real barriers to that. One is regulatory, second is interoperability itself, uh, and the third is identification. . That they, they put out there. Uh, so not only do you have hipaa, which is, you know, really regulates how we share this information, but you also have state level, uh, regulatory frameworks like the California Consumer Privacy Act, which makes it difficult for the US government to access records, uh, proprietary systems in healthcare.

Art continue to be the norm. And so interoperability continues to be a problem getting better, but continues to be a problem. And then there's no single patient Id, uh, that is available for this. Um, I love the fact that at the end here, they say, we believe that this can be addressed. The patient ID, that this can be addressed by leveraging existing identity verification and management systems from other industries beyond healthcare.

I am so much in agreement with that. I can't begin to tell you, we're trying to come up with this NPI, this national patient Identifier and we're gonna go through all this work. We're gonna get, have legislative. And the reality is that many, many, many systems already exist to create a a, an identifier. So, um.

Uh, you know, we are recreating the wheel and we're gonna spend millions and millions, if not hundreds of millions trying to recreate the wheel and we have a wheel. Um, alright, so, you know, that's the first one, standardized how personal health data is exchanged. The second one, line states immunization registries.

So there's a couple of key points in this that I think are interesting. Um, United States has fragmented systems at the state level. Um, they don't have good, uh, agreements for sharing that information. Um, today only 60% of American adults are registered on immunization information systems. That's one problem.

Here's the one that I think is more profound. One study found that among those who administer vaccines, only 31.6% of clinicians and 38.4% of pharmacists submitted records to these registries. Okay? So kinda hard to do interoperability if you're not going to . Have the data as I will talk about later. And, uh, let's see.

I, that's probably enough of that one. . You know, it, it's kinda hard to track vaccines if the information's not getting in there. And then once it gets in there, if it's locked up into a state system that's not shared with another state, um, this is, has to be a national type solution. Uh, so it's a, a state run solution that needs national, uh, capabilities, which gets to the next one.

Design immunization, passports that are portable, equitable, and protect privacy. Again, this is, you know, this is the kind of place where technology just hands down is better. We had that old card, the yellow card that you could walk around with. I still remember. I mean, I had my immunizations on it, those kind of things.

Um, you know, digital is much better for that. A, a passport that's on your phone is much better for that and, uh, that's what they're putting forward here. And then they address privacy portability and cybersecurity trade-offs. The reality is medical identity theft is still huge. We had a record number of breaches in December, um, and I'm sure I'll cover that story eventually, but, uh, we've, we've gotta address that before we can say, Hey, let's, let's aggregate all this information to make it easier for those people who are going to, uh, steal the information from us.

So, uh, so let me get to the so what on this article. Again, I'm gonna try to keep each of these, uh, episodes to, uh, uh, five to eight minutes. Here's the, so what, don't let anyone convince you that this is an easy fix. Sure. It's a fairly easy technology fix. We have a lot of apps which track information about us on our phones.

Uh, we can use them to prove our identity, pay for stuff, collect more information on us. This isn't hard from a technology perspective, but let's look at the issues that they raise, regulatory, interoperability, and privacy to name a few. This is gonna require broad consensus from many constituents in order to move this forward.

States want to protect their information from the federal government. Even the most progressive states want that. We worry about interoperability, but this article points out that we aren't even, uh, putting the information into the registries. I'm not sure how you can make the, the information interoperable until we have the information to make it interoperable.

You know, I'd like to see this fixed at the state level with an independent network set up to share the information. If you think back, some of you aren't old enough to do this, but think back to the ATM network. Back in the day there was Sirus and there was Mac on the back of your card, and that told you which ATMs you could use.

Um, you know, I like the, I like an independent network because, you know, an IND independent network can have government oversight. Uh, but a government network probably would have government oversight, which is not that good. It's, you know, chicken in the hen house problem. So, I'd like it, I'd like the states to really fix the data collection problem.

I'd like an independent network to connect up all the states and then I'd like federal government oversight, uh, on that. Not access to the re information, but, uh, oversight into the information. All right. Uh, that's all for today. If you know of someone who might benefit from our channel, please forward them a note.

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Hillrom and Starbridge Advisors. Thanks for listening. That's all for now.