Wednesday, November 25, 2020

Teletracking; COVID-19 Data tracking Contract debate(2020)

 

Abstract

Teletracking is a data collection and processing company that has been around for nearly thirty years. In the beginning of October, the Trump administration renewed a contract that was signed in March of this year, with Teletracking to track and process COVID-19 data from hospitals across the United States. This case is going to analyze the effects that this contract is having on the general population of the United States, specifically the strain that it has put on health care workers who are faced with COVID-19 cases on a daily basis, and also businesses who rely on this data and information to determine if it is safe to re-open and to what capacity. The four ethical theories that will be used to analyze this case will be Individualism, Utilitarianism, Kantianism, and Virtue Theory ethics. Each Theory disagrees with the actions taken in this case; Individualism disagrees because profit is not being maximized and not for the overall population. Since most of the country is upset with this decision, Utilitarianism will also disagree with this case. This move was made without considering the effect it would have on health officials and was also made very secretly so Kantianism has a major problem with those actions. This case does not show great leadership, or good decision making which is the basis of virtue theory. To correct this action, the government needs to have the center for disease control oversee data collection, since they have a decade old system in place. There should also be rules set in place to give the public access to the detail of government contracts and how they are given out.

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Stakeholders

With a contract this important, and with it being directly linked to the pandemic, there are many stakeholders in this controversy. You could say that everyone in America is a stakeholder because everyone wants to use this data to know
the current situation of the pandemic and how worse/better it is getting. The majority stakeholders are state officials, who rely on this information to know how to regulate their respective states during the pandem
ic. Health officials and hospital workers have been delegated to using two very similar systems that is causing huge discrepancies in data and making it challenging to process this data. This effects small business owners as well, as they need this data to know when to re-open and to what capacity they can run. The last majority stakeholder is schools and universities as they are responsible for hundreds to thousands of children and young adults and use this data to formulate either a re-opening plan, or plan to stay remote and teach from home. Overall, every citizen is a stakeholder because we all need this data to understand what direction the pandemic is heading. Without this data, many people will be left in the dark and left to wonder the status of COVID-19.

Case Summary

In the spring of 2020, a pandemic that was rapidly spreading across the globe, finally reached the shores of America. COVID-19 is a highly contagious virus that exudes flu like symptoms and other various symptoms, which has infected over ten million people in the United States and has resulted in over two hundred thousand deaths. While the country tries to get a hold on this virus and stop the spread, one key component of this has been to track the data from hospitals to see where the virus is most prominent and to determine what hospitals are lacking beds, masks, ventilators, hazmat suits, and other essentials to fighting this virus. In the spring, a company called Teletracking, a Pittsburgh based company, was awarded a $10.2 million dollar contract by the Trump administration (Temple-Raston & Mak, 2020). This contract was set to run for six months, with a renewal option after the six months were up. While the trump administration was confident in their choice of data collection, many were puzzled on why the data collection responsibility was not given to the Center for Disease Control, which has had a system in place to track things like this for over a decade. Among those surprised was Angie Franks, the CEO of Central Logic, which provides technology for hospital systems. She said in a statement, “I was surprised to see that TeleTracking was the company that was pulling that data together. There are other companies that pull data together and this is not what I know of what TeleTracking does. So, it was not really surprising to see that it was, maybe not working as effectively as anticipated”


CDC Report on COVID-19
(NPR, 2020). When the contract expired last month, Teletracking was awarded anther identical contract on October second which will expire next spring. This caused an uproar on capitol hill, especially from the democrats, who cited that the contract was only offered to a sole company, rather than be offered in a bidding style process. They also stated that there were several inconsistencies over the six-month period which included the state and federal reporting of hospital beds, being inaccurate by a large margin. Also, the timing in which the data was supposed to be reported was significantly delayed. Regarding the issue of there only being one bidder for the contract, the HHS said back in the spring that the contract was rewarded with a no bid process, but then flipped their answer and said that it was a competitive bid. The same answer is being said today, as the HHS said that there was a total of six companies in the bidding war for the contract. As of today, no other companies have been linked to the bidding process and the federal investigation agencies are currently undergoing an investigation as to determine the legitimacy of the awarded contract. Many top Democrats are willing to take matters into their own hands as Senator Bob Menendez of New Jersey told reports that if the administration did not reverse the move, and put the CDC back in charge, “we will look at withholding funding until the administration changes course” (Stolberg, 2020). A non-disclosure agreement was also built into the contract so that the details of how the contract was given, or how the data is being collected is hidden from the public and even state officials.
COVID-19 Testing facility 

            Even though many are questioning the move, the Center for Disease control director said that he is fine with the change, even though many experts fear that the contract renewal will further sideline the agency. However, hospitals that already have been reporting to state health departments can keep doing this if they get a written release form from the state that says they can keep doing so. There are supporters to the renewed contract and there is the HHS has given their reasons on why they went with the change. Michael Caputo, the spokesperson for the HHS said that the CDC has been seeing a lag of a week or more in data coming from hospitals and that only 85 percent of hospitals have been participating (Stobbe, 2020). The change is meant to speed up the data collecting process and relay the information back to the HHS at a faster pace than the CDC has been going at. A CDC official who decided to remain anonymous, disputed Capito’s figures and said that only 60 percent of hospitals participate but that most data is collected and reported within two days (Stobbe, 2020). The CDC’s National Healthcare Safety Network system was launched 15 years ago and is best known for collecting and publicly reporting data on hospitals infections. It has been a key component in reducing the amount of certain hospital infections. Even though this system has been in place for many years, others have stated that it is outdated and that having to enter the information manually, has been a difficult task for hospitals during this pandemic. Dr. Hanfling, an expert in emergency preparedness and vice president at In-Q-Tel, a strategic investment firm said, “This is not just about HHS vs CDC. It is that we have outdated data collection systems that aren’t automated, are burdensome on health care providers, and don’t give you real-time situational awareness (Stolberg, 2020)”. Many believe that this move was made, to influence the results of the upcoming election. The administration’s decision to take control of the hospital data out of the hands of the CDC and give it to Teletracking, while centralizing the operations in Washington, drew public outcry who feared that data would be used in a political way. Many feared that data would be skewed or even withheld from the public to give a different perspective on how the pandemic is going. Many state officials and data modelers rely on the CDC data to determine when it is safe to re-open certain businesses and at what capacity based on the number of cases in that state. With the control being out of the CDC’s hands, it will be an even more uphill battle when it comes to collecting numbers for the coronavirus. Mr. Arrieta of the department of health and human services addressed the transparency issue by saying that it is considering giving members of congress access to the new database and was “exploring the best way” to make information from it available to the public, including to news organizations and academic researchers.  This new contract has raised eyebrows across Washington and now has the public’s attention. As of right now there is an ongoing investigation on how the contract was awarded and if it was in fact through a bidding system. As of right now, the contract runs through the new year and will be up for a renewal in March.

Individualism


Individualism, first developed by Adam Smith, is an ethical theory that Smith describes as being self-motivating to do the right thing. Smith says that self-interest will motivate people into exchanges, whether it be business or other sorts of exchanges, and a backdrop of morality will allow the invisible hand to work in the real world. Later, Milton Freidman developed his own way of thinking about individualism and how it works in the business world. Friedman’s individualism, says that the only goal of a business is to make profit, and to maximize the owners and stockholders’ profit within the confines of the law. Looking at the controversy surrounding the Teletracking contract, which was renewed this October, an Individualist would say that this is an unethical move and that taking away the Center for Disease Control’s job of data collecting is only going to make things more difficult during this pandemic. Many hospitals and health officials are already reporting discrepancies in certain states between the data they were using from the C.D.C and the data from Teletracking. Health officials are now saying that by allowing this other company access to the data, they have essentially created a duplicate data collection system that makes it very stressful and more complicated than it was before. Dr Grace Lee, a pediatric infectious disease physician and associate chief medical officer at the Lucile Packard Children’s Hospital at Stanford, said that the CDC system has been working well; “I'm very surprised that we are being mandated to report into a parallel system when hospitals have gotten used to reporting into NHSN. It's adding burden at a time when hospitals again are now responding to the surge of COVID-19," she adds, "The timing couldn't be worse, to be honest”

(NPR, 2020). Not only has this move slowed down the process at which data is being collected and looked at, it has left a wave of uncertainty throughout many small business owners across the United States. This will hurt business chances to re-open at the correct time because there is going to be large differences in the data collected by the C.D.C and by Teletracking. Also, having the investigation on how the contract was awarded goes against what Individualist believe in. Even though there has not been any update on whether there was foul play or not, the many speculations and confusion among health officials, leads to believe that eventually there will be evidence of illegal activity while awarding the contract to Teletracking. Having the details of the contract be hidden with a non-disclosure agreement, goes against the norm when awarding government contracts. Although it is not necessarily against the law, many have called for the details to be made public. A better way to ensure long term profit for the future, would be to allow the C.D.C primary control of the data collection, since most, if not all hospitals are already used to it, to ensure that data on COVID-19 is handled in a professional way and distributed to the public, so that they can have a better understanding on the status of the Coronavirus.

Utilitarianism

            Utilitarianism is an ethical theory that was conceived by John Stuart Mill during the mid to late 1800s. The main idea of Utilitarianism is to maximize happiness for the overall population. Utilitarianism states that happiness or pleasure are the only things of intrinsic values. The controversy surrounding the Teletracking fails to maximize happiness for the overall population, and is causing stress and unhappiness among many people, specifically healthcare workers. With Teletracking taking over the data collection process, hospitals were given only a few days’ notice of the change their data tracking ways, causing mass confusion and stress in this transition process. Not only has this been a difficult transition, but discrepancies between the C.D.C’s numbers and Teletrackings’, has caused even more public outcry to switch it back to the original system, and leave the data collection up to the Center for Disease Control. With so many people upset about the change, it is very clear to see that many people are not happy with the change, therefore happiness is not being maximized throughout most of the population. Before the switch, hospitals were said to be being able to handle the data collection, and the C.D.C’s system was one that they were very familiar with and it was easy for them to use. This new system that has been implemented has only caused mass confusion and unhappiness among healthcare workers. There was a general feeling that they had a good grip on COVID-19 data and that this information was going to help slow the spread. With contract renewal for Teletracking, especially during the middle of the pandemic and at the start of “cold and flu” season, things have become very difficult for healthcare workers and people across the country, which is failing to maximize happiness for the overall population. Switching up the data collection systems has so far proved detrimental to the fight against COVID-19 and has forced officials to work more hours and crunch more numbers unnecessarily, which is causing a wave of unhappiness and stress across the country which goes against what Utilitarianism stands for.

Kantianism

            Kantianism is an ethical theory developed by Immanuel Kant during the late 1700s. Kantian ethics can be described as treating others with respect and never treating people as simply a mere means. The Formula of Humanity is a very important component to Kantianism, and the formula of humanity can be best described as treating others as an end, and not simply as a mere means to an end. It puts individuals first, rather than just focus on the overall population. It is trying to have everybody treated with respect and not just as a step towards an ends. The Teletracking controversy has put many people in a very difficult position especially during a pandemic. The sudden change in data collection process has left many health officials with an even steeper uphill battle, than the one they have been battling for the past six months. The change was made because the Trump administration preferred the Teletracking company over the Center for Disease control when it came to collecting and processing COVID-19 data. Back in September, it was reported by CNN that Trump had lost his patience with the C.D.C, and the progress that it was making regarding the pandemic. Even though the C.D.C data system is used by every state and has had their system in place for over fifteen years, the administration decided to go with Teletracking, a long-standing data collection company with no experience in tracking hospital data. The change was viewed by many as a political move to manipulate the numbers in his favor for the upcoming election. This contract renewal was motivated politically and did not take into consideration the effect it would have on the general population. Kantian ethics views this as using health officials as a mere means to strengthen his political campaign. There was no mass polling done among hospitals to see what system they preferred, instead they made the change very suddenly and gave the hospitals very little time and is causing workers to learn this new system on the fly. There was no consideration for many individuals and there was no regard for others rationality on who should oversee data collection. This move seemed very politically motivated and took very little to no consideration about how this would affect the workers. Kant thinkers will have a very serious problem with this because it was not a rational decision. It did not give other individuals the chance to make a rational decision, and the fact that much information is being hidden about how the contract was given, is a sign of dishonesty and deceit among millions of people.

Virtue Ethics

            Virtue theory is an ethical theory based on four virtues. Those four virtues are courage, honesty, temperance, and justice. Businesses should act in this way if they want to be known as an ethically sounds and responsible company. The way the Teletracking contract was given has left many very confused. The non-disclosure agreement between the Human Health Services department and Teletracking has lost the trust the American population had in their government and the on-going investigation is causing more and more people to feel this way. This new contract is supposedly going to help the country get a better hold on the pandemic, but as discrepancies between data keep rising, many are questioning the decision that the White House made. The fact that most, if not all, of the bidding information has yet to be released, is showing the dishonesty of the government, which would, according to virtue theory, make them act in an unethical way. To be an ethical entity, honesty is a major component, and the government is clearly being very secretive in this controversy. The contract renewal has made it very difficult on health workers. Having to switch data systems within the span of two days has made the already difficult pandemic even more so. The government failed to take into consideration the effect this new contract would have on health employees, and decided to go through with the deal, even though many were outspoken. This shows a failure in leadership and has given the impression that those on capital hill have only their personal interests in mind. Being a leader means being able to guide people through the most difficult of situations. People look up to a leader and want to follow them through anything. Much of the American population feels like the government is leaving them to fend for themselves and work out this confusing change on their own. The contract renewal now is seeming like a very poor move by the government. Although it is early in the new deal, it is starting to look like a bad choice, and being able to make the correct choice in hard times is a virtue that ethical companies/entities must have. As more and more speak out about the new deal, it is being discussed if this going to be a detrimental choice by the government.

Justified Ethics Evaluation

            The contract awarded to Teletracking has so far proven to be a very controversial decision. The HHS continues to back its decision, claiming that it will help speed up the process of colleting COVID-19 data but with so many hospital and health workers already speaking out against the move, one must wonder if this was the correct decision. Since it looks like as of now, it was awarded without any other companies having a chance to put their bid in, it seems like this move was politically motivated. The Trump administration has had a rocky relationship with the Center for Disease Control, and since the contract renewal seemingly came overnight, it looks like the administration just wanted the C.D.C out of their way. As politically motivated as this move may or may not have been, it is safe to say that it has worsen the pandemic in the United States. There was a very familiar system already in place that health experts had been familiar with for over a decade. To now must juggle between two different data systems, is only going to slow down the process of getting crucial information out to the public. This was a very unethical move, as it has not necessarily helped anyone a great deal and has only seemed to hinder the efforts of health experts across the nation.

 

 

Solution

For this situation to be resolved and for the government to remain ethical, the first course of action should be to release how the bidding process went. If there was a legit bidding process, and that six other companies were involved and were outbid, then the current situation will not be as volatile. If it is reveled that the contract was offered to the sole bidder of Teletracking, then that is a serious flaw in the U.S government and the case should be investigated and if needed, be brought to court to determine the legitimacy of the contract. This is very important because it is the overall population that is being directly affected by the lack of information being disclosed. This step will shine a light on this very confusing case, but the problem of the actual data collection remains. For health workers and hospitals to be able to process data effectively and efficiently, an option should be given to use either Teletrackings data system, or the Center for Disease Controls data system. There could certainly be hospitals and health centers that work better with Teletrackings system, but the overall census claims that the C.D.C’s system was easier and more effective for them because they were familiar with it. This option would attempt to maximize data collecting efficiency across all hospitals in the U.S, and not force them into using both. The final step in correcting this situation is making the bidding process for something that will affect all Americans, open to the public. Non-disclosure agreements should be barred from being built into contracts such as this one. There should also be a vote taken from various hospitals across the country, to see which company or companies they would prefer, instead of a handful of people making the choice for them. As something as serious as a pandemic, frontline healthcare workers should be able to choose how they process the data. They are the ones who must deal with this virus head on and are put at risk every day from catching COVID-19. To leave the choice up to them would ensure faster data mining, and more accurate statistics for a virus that we know very little about.








Works Cited

·       Temple-Raston, D., & Mak, T. (2020, October 02). HHS Renews $10.2 Million Contract For Controversial COVID-19 Data Tracking Company. Retrieved November 20, 2020, from https://www.npr.org/2020/10/02/919064606/hhs-renews-10-2-million-contract-for-controversial-covid-19-data-tracking-company

·       Stolberg, S. (2020, July 15). 'Sole Source' Contract for Covid-19 Database Draws Scrutiny From Democrats. Retrieved November 20, 2020, from https://www.nytimes.com/2020/07/15/us/politics/coronavirus-database.html

·       Stobbe, M. (2020, July 15). Coronavirus data is funneled away from CDC, sparking worries. Retrieved November 20, 2020, from https://apnews.com/article/57de8f0d25d9066731e6bd8cad0373c4

·       NPR, P. (2020, July 15). White House Strips CDC Of Data Collection Role For COVID-19 Hospitalizations. Retrieved November 20, 2020, from https://www.kpbs.org/news/2020/jul/15/white-house-strips-cdc-of-data-collection-role/

·       Diamond, J., Valencia, N., & Murray, S. (2020, September 25). Trump has lost patience with CDC head after series of mixed messages. Retrieved November 20, 2020, from https://www.cnn.com/2020/09/25/politics/redfield-trump-cdc-morale/index.html

 


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