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Replacing Ohio’s dysfunctional coronavirus reporting system could take ‘many months,’ or longer, experts say

The Plain Dealer  Cleveland logo The Plain Dealer Cleveland 8/24/2020 By Peter Krouse,

CLEVELAND, Ohio - Antiquated computer systems that prevent Ohio’s Department of Health from effectively analyzing contact tracing for the coronavirus also are posing problems for other states - and developing better systems could take a year or longer, big-data experts say.

Tom Frieden, a former director of the U.S. Centers for Disease Control who now heads an effort by Resolve to Save Lives to improve disease reporting, said inadequate technology is a problem across the country and could take “many months” to replace.

“If there’s a bottom line here, Ohio is not alone,” Frieden told and The Plain Dealer. “Virtually every state has a similar problem.”

The media outlets contacted Friedman and Ken Loparo, a professor in the department of electrical, computer and systems engineering at Case Western Reserve University, after Gov. Mike DeWine announced he could not keep a promise to share the state’s contact tracing data.

What is wrong with Ohio’s system?

DeWine and his health department said the state’s 19-year-old disease-reporting system is not configured in a way that allows for analysis of contact tracing data to identify where coronavirus outbreaks are occurring.

“The system does not have a search mechanism,” Health Department spokeswoman Melanie Amato said at the time. “Without manually reviewing every COVID-19 case, it is impossible to identify every outbreak.”

So, health officials have been reporting only anecdotal evidence to alert the public to outbreaks.

What are other states doing?

Frieden said health officials in many states rely on Microscoft Excel spreadsheets, paper and pen, or “systems that were designed many years ago and do not have modern agile architecture.”

As a result, they are overwhelmed by the complexity of the contact tracing that’s required, he said, noting that it may take two hours to interview a coronavirus victim to collect key information and to identify all the people that person came in contact with.

And the system for logging all the coronavirus cases is fed by a fragmented network of health departments, labs and pharmacies. There could be 100 different laboratories reporting in 100 different ways at 100 different times, Frieden said.

There’s also the problem of building a system that protects patient privacy and doing everything on a scale never done before.

“We’ve never tried to do contact tracing on anything like this scale,” Frieden said. " . . . . The volume is astonishing.”

What is needed?

To effectively analyze the spread of a disease as complex as COVID-19, Ohio and other states need a much more robust software than the 19-year-old Ohio Disease Reporting System, Loparo said. “In the computer world, that’s ancient.”

Solving the problem could be a matter of identifying the right vendors with the right hardware and software and contracting with them to put a system in place, he said. But that could take 12 to 18 months, after the state settles on the right suppliers.

Loparo suggests that the Ohio Department of Health may want to reach out to one of the state’s research universities, such as CWRU, where he is co-academic director of the Internet of Things collaborative with Cleveland State University and faculty director of the Institute for Smart, Secure and Connected Systems.

CWRU, he said, could help with underlying research or development questions that could help the state select the right technology partner.

Frieden said it could be “many months” before a really robust and effective system can be developed for use in the United States.

“This is really hard,” he said. “If it weren’t hard there would be a good system out there.”


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