Coronavirus prompts hospitals to share information on stocks of protective equipment

Some hospitals have a surplus of protective equipment and others not enough. Centers for Disease Control and Prevention are working on system that would track inventory across the United States

The big obstacle is not the technology. The problem is to make hospitals comfortable sharing information about their preparedness – information they had previously considered confidential.

Protective masks have become a very popular commodity, even in hospitals. At Nashville General Hospital, for example, several weeks ago, employees casually contacted the Director of Supply Chain Management, Tom Cooper, and asked if they could have a box for personal use.

Cooper told them that the masks were only available to “clinicians as needed, for their jobs.”

And Cooper said he felt more protective of his hospital’s supply – especially N95 respirators. Distributor of the General Hospital, Medline, already restricted orders respirators. Cooper said he couldn’t get more than his usual monthly allowance, even though he could afford it.

“For now, everything is fine,” he said. “But next month, what could happen?” “

“Panic shopping”

The CDC has tried to avoid such a shortage and the costs associated with shortages. Often there is a lot of disposable protective gear for everyone, but it isn’t always in the right places before pandemics.

“This can lead to ‘panic buying’,” said Megan Casey, a nurse epidemiologist at the CDC. “This is where establishments buy as much as possible, just for the sake of safety. “

At present, public health agencies only know what is in government stocks of protective equipment. Health and Human Services Secretary Alex Azar told Congress in recent weeks that the government had 30 million masks, although 300 million may be needed. (The few U.S. companies making masks say demand for the past few weeks has been overwhelming. exceeded their production capacity, even if they increase.)

The country’s 6,000 hospitals were more of a black box – now and in previous outbreaks. In past outbreaks – with H1N1 flu, for example – some hospitals have resorted to informal supply exchanges around the corner, according to project managers at the Center for Medical Interoperability, a nonprofit based in Nashville.

Last year, before the emergence of COVID-19, the center won a $ 3 million contract with the CDC to build a system that requires hospitals to submit their inventory information in real time. Information can usually be retrieved directly from an institution’s electronic medical record system. Using this accumulated data, CDC should be able to use a digital dashboard to easily identify which facilities need it most.

“It could also, potentially, provide a tool for hospitals to request personal protective equipment from state or local health departments, inventory or even other hospitals that may have a surplus,” Casey said. “We see this as a potential opportunity to share resources and have these kinds of discussions.”

Competitive advantage

But the prospect of sharing supplies is where the healthcare industry makes it difficult to cooperate even in a crisis, said Melanie Thomas. She is the director of information at Nashville General, one of the pilot sites for the CDC-sponsored project.

“It is sometimes difficult and scary to share data and equipment, especially with your competition,” said Thomas, “because you want to have the edge. “

Nashville General is the smaller of the pilot sites, which include Northwestern Memorial in Chicago and Nashville-based Community Health Systems, a for-profit chain of nearly 100 hospitals in the United States.

Thomas acknowledged that it is easier for his taxpayer-funded hospital to grant access to his inventory system because he lacks the purchasing power to store equipment.

“It will never be our problem,” she said. “We want the information shared because we are going to have just enough of it.”

And when they are exhausted, she would like to know where to turn for more.

A theoretical threat becomes real

The Center for Medical Interoperability began its work quietly, a few months before the emergence of COVID-19. But project managers have noticed a greater willingness to participate among large health systems now that a theoretical threat has become very real.

“We know… their supply chains are under strain right now because these products come from China,” said Tommy Ragsdale, director of strategy at the center.

China needs the disposable equipment made there for its own use. And only a handful of companies in the United States still manufacture protective gear in the country. One has orders for over a billion masks.

“It certainly created different discussions at the hospital and health system level than we had in October or November,” Ragsdale said.

The CDC has injected an additional $ 600,000 into the data sharing project, with an accelerated commissioning date in May, Ragsdale said. The center plans to host a webinar on April 1 for additional hospitals interested in participating in later phases.

At this point, the CDC said, there is no mandate for hospitals to participate. But Ragsdale said he hoped they would see the benefits: “It’s clearly for the greater good.”

This story is part of a partnership that includes Nashville Public Radio, NPR and Kaiser Health News.

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