'We feel like we were data shamed': Christus' Dr. Sam Bagchi on COVID-19 reporting issues

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COVID-19 data reporting has been a challenge for hospitals and health systems, especially as state and federal governments change reporting requirements and experience glitches when updating their systems.

In Texas, Christus Health has been working with state health officials to report all lab data through an automatic data file, as required by the state. When the pandemic began, the state's infectious disease tracking system was outdated and healthcare providers continue to struggle to meet the narrow requirements for accurately reporting data.

"We have been working with the state to perfect our data systems," said Sam Bagchi, MD, Christus Health's executive vice president and chief clinical officer. "We have a giant spreadsheet with all the data displayed per their rigid system so they can ingest the file. We started to do that right away and thought that our file sends were successful. Then they changed their requirements and added more data points on April 16, June 25 and July 15, requiring more than 40 data fields per test results."

Dr. Bagchi said Christus was one of the first health systems in the state to submit data in the new format on July 15. There was a large amount of new data coming in about old instances of COVID-19, and the state calculated that into new positivity ratings. In some cases, the data files didn't go through and the state requested labs and health systems to re-submit their data in a different form. When the positivity rate increased, the state blamed "coding errors" for the sharp increase.

"We were frustrated because they labeled the mistake as coding errors, but they were not," said Dr. Bagchi. "There weren't any billing or coding problems. The issue was aspects of the data files needed to be fine-tuned before submission. But all the results were accurate. We feel like we were data shamed; we were leading the charge to put the data out there and then they blamed us for a 'coding error.' We are working hard to make sure results are getting to the right place to keep communities informed."

He said there are several systems that have been unable to successful send their data files due to the rigid reporting requirements; Texas has hired outside consultants to help the health department work through their challenges and modernize the system.

"They need enough people and the right technology to track COVID-19 data," said Dr. Bagchi. "The team working on the data are working hard, but we need more of them and they need more technical resources."

At the health system level, Dr. Bagchi doesn't know how the re-submitted data is processed and affects state reports. But, he added that the health system is working hard to make sure the results are processed correctly without duplications.

Christus has not experienced the same challenges in Louisiana and New Mexico, the other states where it has hospitals, because the state reporting systems' infrastructures are more modern.

"Our data integrity has been very strong and we take that seriously," said Dr. Bagchi. "We care about the communities we serve and know what's happening. That is core to our mission and important to how we operate."



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