"It's $ 500 versus literally $ 5,000," said Bob Kocher, partner at venture capital firm Venrock, which has helped California manage its coronavirus testing efforts.
In the early 2010s, the federal government spent billions to encourage doctors to replace fax machines with electronic records. This program, known as the HITECH Act, did not contain similar resources for health authorities to help them digitize faxes and other non-standard results automatically. Hospitals and doctors' offices also didn't have to develop technology that automatically sends relevant test results to local health authorities.
Health departments, whose budgets have been cut in the past ten years, have been unable to fund the digital upgrades themselves.
"The best way to describe it is to imagine that you are on the information highway but traveling with a bus pass," said Oscar Alleyne, program director at the National Association of County and City Health Officials. “Money was invested to include medical practices in electronic patient records. There was no investment in building a similar technology to incorporate public health into this system. "
The C.D.C. has modernized public health reporting, but on a smaller scale. In the mid-2010s, the agency used $ 13 million from the Affordable Care Act to help state and city health agencies digitize. Although this program has made some progress, it has not switched the country to a fully digital public health reporting system. There have been some smaller one-off grant programs in recent years, but no long-term funding source for digitization.
"What we learned very quickly is that this is a difficult problem," said Dr. Peace, the former C.D.C. Director. "They have hundreds of laboratories and thousands of tests. Nothing is interoperable because they weren't asked to."
Dr. Frieden found that in other countries, such as the UK and Canada, patient information is transmitted with a unique number that indicates who it belongs to. The United States attempted to establish a similar system in the mid-1990s, but it died after Congress passed a law that prevented the federal government from creating the new ID numbers.