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No one in the Trump administration has attempted to manipulate national COVID-19 data or unduly influence the operations of the new Department of Health and Human Services (HHS) Coronavirus Data Hub, said the head of the company contracted to develop and maintain the database.

"Unequivocally zero," Christopher Johnson, president of TeleTracking Technologies in Pittsburgh, said in an exclusive interview with MedPage Today. "It's been very, very clear since the beginning that the goal has always been transparency.... A lot of the raw data is being published and it's clearly traceable. There's been no indication, no intent, no inkling of that, at least from my perspective. I have zero question about the integrity, ethics, or moral fiber of the people I've encountered."

Moment in the Spotlight

TeleTracking has come into the spotlight now that HHS has debuted the data hub. It replaces the CDC's National Healthcare Safety Network (NHSN), to which states and hospitals had previously been submitting COVID-19 data such as intensive care unit capacity, ventilator use, personal protective equipment (PPE) levels, and staffing shortages. But in guidance to hospitals, updated July 10 and published with little fanfare, HHS ordered hospitals to stop submitting such data to the NHSN and instead submit it either to HHS or to their state health department, which would then submit it to HHS. The data is now posted on the dashboard via the department's new HHS Protect data system, which was developed by TeleTracking.

The company was founded in 1991 with businessman Michael Zamagias as its main investor; he is the company's chairman and CEO. "He had a vision and saw the problem," which is that healthcare is "horribly inefficient," Johnson said. "Of the $4 trillion spent on U.S. healthcare, roughly half of that is in labor, and that labor is terribly inefficient -- it's a very complex system, and you're dealing with human beings that are at their weakest in many cases." The company "saw it as an opportunity to create better visibility into what is happening, starting with a 'bed board' that shows you what's happening with beds and the patients in the hospital." That expanded to include workflows around transporters, workers who clean the rooms, and biomedical engineers who make sure equipment is in the right place at the right time.

Over the years, the company has invested more than $1 billion into "a technology platform, a team of operational experts, and a set of best practices that we can apply to help healthcare organizations perform better operationally -- more productively, more efficiently," said Johnson. The company now serves more than 1,100 hospitals in the U.S., Canada, and Great Britain, with offices in North Carolina, Tennessee, and London.

The interaction with the federal government came about gradually, beginning about 5 years ago, he said. "We had the opportunity to meet with the House Ways & Means Committee" and testify at a 2016 hearing on the use of technology to improve cost and efficiency in healthcare, Johnson explained. Company officials also met with people at the Centers for Medicare & Medicaid Services and across government, "really as a way to create awareness that there's an opportunity here to make an improvement in the cost of healthcare."

CDC Involved in Move to HHS Protect

And then COVID hit. "It became clear to everyone very, very quickly that there was a need for situational awareness across the U.S.," said Johnson. "We had an opportunity to speak with HHS around what they were trying to achieve -- to create data so policymakers and emergency responders could make decisions on allocation of resources."

Contrary to some media reports, the bidding for the contract seemed to be competitive, he said. "There were definitely conversations where they would reference other reviews that were happening. We were working with them on our stuff, and they would say they were speaking to others as well." TeleTracking was awarded the 6-month, $10.2-million HHS Protect contract in April and began executing it "almost immediately," Johnson said.

When TeleTracking started its work, "there were multiple ways" in which the government was collecting hospital data -- "the NHSN that the CDC ran, TeleTracking, and there were others, like direct feeds into HHS from the states," he explained. "From the outside looking in, that may not seem like the best way to do it but I understood the thought process behind it; we needed as much data as we could get."

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