Title: Real-Time Information Would Have Improved Federal Response to COVID-19 Description: COVID-19 has drawn attention to the urgent need for real-time information on things like positive cases and resources. Real-time data can allow public health officials to make responsive decisions. While the Department of Health and Human Services (HHS) has long been required to develop a national situational awareness network, none exists. We find out more from GAO's Jennifer Franks. Related GAO Work: GAO-22-104600, COVID-19: Pandemic Lessons Highlight Need for Public Health Situational Awareness Network Released: June 2022 [Jennifer Franks:] HHS has not yet taken steps to directly identify, document, and share all of the challenges and lessons learned from COVID-19. [Holly Hobbs:] Hi, and welcome to GAO's Watchdog Report, your source for news and information from the U.S. Government Accountability Office. I'm your host Holly Hobbs. COVID-19 has drawn attention to the urgent need for real-time information on things like positive case numbers and resource needs. Real-time data can allow public health officials to make responsive decisions that could improve health outcomes. And while the Department of Health and Human Services has long been required to develop a national situational awareness network that would include this information--more than 15 years later, none exists. Today, we'll find out more from Jennifer Franks, an expert on federal data systems and a director in our Information Technology and Cybersecurity team. Thanks for joining us. [Jennifer Franks:] Thanks for having me, Holly. [Holly Hobbs:] So Jennifer, what all could this network do and why is it so important? [Jennifer Franks:] So this network would provide near-real-time situational awareness and bio-surveillance information needed to prepare for and then respond to infectious disease outbreaks like the COVID-19 pandemic. In addition to reported case numbers, information such as disease detection and critical response resources or even medical care capacity, like the number of health care providers or laboratory capacity or maybe even the vaccines, those would be the types of information collected and reported by the network. And this network would also consider environmental threats. And it's the data from those threats that could directly impact the preparedness status of public health emergencies across each of the 59 states and territorial health departments whose information would be available within this centralized network. [Holly Hobbs:] And so what would this network allow the federal government to do that it didn't do during COVID-19? [Jennifer Franks:] So access to the information in a near-real-time capacity could have allowed officials to make more informed decisions about our public health, our safety and even resource allocations to directly support the needs of health care providers across the various federal, state, and local levels. [Holly Hobbs:] So there were federal legal requirements for HHS to create a situational awareness network long before COVID. What happened? [Jennifer Franks:] So multiple laws mandated that the Department of Health and Human Services develop a near-real-time public health network that would be based on integrated systems. There are already established and implemented systems that could be integrated to fully support the development of this network, like the Bioscience Platform for the National Syndromic Surveillance Program and HHS Protect, which is a system that was established early COVID-19 to manage public health information across various entities. But to date, HHS has not made much progress in establishing the network. [Holly Hobbs:] So what's causing the lack of progress? [Jennifer Franks:] The lack of progress is really due to the department not prioritizing its development, and then not establishing an appropriate management and governance structure. Within this structure they would have included a lead operational division with clearly defined roles and responsibilities for establishing and implementing this network, as well as an organization to provide oversight of the network's efforts. And this would have been aligned with their federal legal requirements. But this governance structure does not yet currently exist. [Holly Hobbs:] So, in short Jennifer, has HHS taken any steps to develop this network? [Jennifer Franks:] Yes, HHS has indeed taken some steps, but they have been minimal. So during our review, the department began to draft a work plan; and this work plan included proposed roles and responsibilities for the governing body. It even identified the federally entity and then noted the hiring of a chief informatics officer. And although this step was initiated, the department has not yet provided a timeframe for completing their efforts within the work plan. [Holly Hobbs:] So, what all would we expect HHS to do to complete or implement their work plan? [Jennifer Franks:] There are several things HHS would need to do to fully implement this work plan. They would need to conduct a public meeting with stakeholders and experts where they could openly discuss some goals and uses of a network, and then develop a strategy and implementation plan. I mentioned before that one of the overall goals of this network is for it to be a system comprised of interoperable systems that will facilitate information sharing across varying public health entities. So once HHS holds the public meeting with stakeholders, they could directly use the input from these entities to then clearly define the goals, and perhaps functions, and even uses of the network. {MUSIC} [Holly Hobbs:] So Jennifer just told us that while HHS has taken some steps to develop a situational awareness network, which would allow quicker responses to public health emergencies, it hasn't prioritized this effort and still needs to take a number of actions to meet its legal requirements to do so. Jennifer, in our new report, we recommended that HHS prioritize efforts to develop a situational awareness network. But did we recommend any specific actions to help HHS accomplish this? [Jennifer Franks:] Yes, we made several other recommendations, and these were aimed at establishing a lead operational division for implementing those legal requirements centered around the establishment of the network. And then again, defining roles and responsibilities, as well as establishing an oversight office to provide guidance for completing these activities. Regarding the work plan, we made a recommendation for HHS to commit to a deadline for finalizing and implementing the work plan. We lastly made some recommendations for HHS to identify, document, and share the lessons learned from the COVID-19 pandemic with their key stakeholders. And then we asked them to incorporate lessons learned from this current pandemic into the plans for implementing the network. [Holly Hobbs:] And last question, what's the bottom line of this report? [Jennifer Franks:] More than 15 years ago, after the first of three pandemic-related laws initially mandated the establishment of this network, the federal government does not yet have a near-real-time network to facilitate early detection and rapid response to catastrophic diseases. And if this network had been available at the onset of our current pandemic, it could have been used to provide vital information to better manage a timely pandemic response. And, after having over two years of experience and responding to the pandemic, HHS has not yet taken steps to directly identify, document, and share all of the challenges and lessons learned from COVID-19. And it's these challenges and lessons that could directly be implemented into the planning of this network. [Holly Hobbs:] That was Jennifer Franks talking about GAO's recent review of HHS's efforts to develop a National Public Health Situational Awareness Network. Thanks for your time, Jennifer. [Jennifer Franks:] Thanks for having me. [Holly Hobbs:] And thank you for listening to The Watchdog Report. To hear more podcasts, subscribe to us on Apple Podcasts, Spotify, or wherever you listen. And make sure to leave a rating and review to let others know about the work we're doing. For more from the congressional watchdog, the U.S. Government Accountability Office, visit us at GAO.gov.